Publication-only abstracts (abstract number preceded by an "e"), published in conjunction with the 2018 ASCO Annual Meeting but not presented at the Meeting, can be found online only.
Report on breast cancer care (BRECC) registry at the Kenyatta National Hospital, Nairobi, Kenya.
2018 ASCO Annual Meeting
J Clin Oncol 36, 2018 (suppl; abstr e12546)
Author(s): Nicolas Anthony Othieno-Abinya, Alice Musibi, Catherine Nyongesa, Raymond Omollo, Benjamin Njihia, Beatrice Nyawira, Ochieng' Noel Onyango, Andrew Gachii; University of Nairobi, Nairobi, Kenya; Kenyatta National Hospital, Nairobi, Kenya; Kenya Medical Research Institution, Nairobi, Kenya; Roche Kenya LTD, Nairobi, Kenya
Background: Breast cancer is the most common cancer among women in Kenya. Kenyatta National Hospital (KNH) is the only public institution offering comprehensive cancer care in Kenya. Methods: To determine the pathology, clinical care pattern and outcome of breast cancer at the KNH. Patients with histologically or cytologically confirmed breast cancer, and able to provide written, informed consent, with no prior interventional therapy were enrolled after approval by the institutional regulatory board. Surgery, radiotherapy and systemic therapy were applied in line with Kenyan guidelines, adopted from ESMO,ASCO and NCCN. Primary endpoints were overall survival (OS) and progression-free survival (PFS) at a median follow-up of 5 years. Results: Between 08/08 2011 and 02/07/2014, 400 patients, 396 women (99%) and 4 men (1%) were included. Age range 21 to 84 years, median 48.5. Those aged < 40 years were 87 (21.8%), 175 (43.8%) aged ≥ 50 years, and 72 (18%) were > 60 years. Breast lump commonest presentation in 308 of 388 (79.4%), breast pain in 104 (26.8%). Eighteen out of 396 (4%) had history of breast cancer in first-degree relatives, 23 (5.8%) in second-degree, and 23 (5.8%) other relative. Pathology were DCIS in 32 of 386 (8.3%), LCIS in 4(1%), invasive ductal NOS in 340 (88.1%), and invasive lobular in 10 (2.6%). ER + in 185 of 312 cases (59.3%), ER- in 111 (36.6%). PR+ in 172 (55.1%), and PR- in 123 (39.4%). ER+/PR+ were 159 (51%), ER-/PR+ 13 (4.2%), ER+/PR- were 42 (13.5%), ER-/PR- were 98 (24.5%). Her2/Neu was + in 74 of 313 cases (23.6%), - in 206(65.8%), equivocal in 30 (9.6%). Hormone-receptor (HR)+/Her2+ were 172 (55.1%), HR+/Her2- were 25 (8%), HR-/Her2- cases (triple-) were 79 (25.2%). Tumour stage I was diagnosed in 26 of 353 patients (7.4%), stage II in 119(33.7%), stage III in 105(29.7%), and stage IV in 74 (21%). At 60 months follow-up, 100 patients (25%) had died. Those < 50 years had a significantly poorer overall survival than those ≥ 50 (p = 0.018). Conclusions: Close to two-thirds of patients were in stages II and III. Young age was associated with earlier death. Clinical trial information: NCT01484483
1. TAILORx: Phase III trial of chemoendocrine therapy versus endocrine therapy alone in hormone receptor-positive, HER2-negative, node-negative breast cancer and an intermediate prognosis 21-gene recurrence score.