Survival Outcomes of Breast Cancer Patients in South India Over 20 Years

Sep 21, 2026

This retrospective cohort study investigates the distribution and clinicopathologic features of breast cancer patients in South India and evaluates overall survival, identifying predictive factors. It also examines how risk factors influence disease free survival (DFS) and distant disease free survival (DDFS). Data come from comprehensive follow-up using patient contact, medical record review, and provider collaboration, with follow-up gaps handled through telephone contact. Results include 3256 patients with median follow-up of 8.1 years.

LanguageEnglish

CategoryResearch & Report

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Introduction

Breast cancer mortality trends in developed countries

Research gap in developing countries, including India

Rationale for focusing on Kerala survival outcomes

RESEARCH ARTICLE Editorial Process: Submission:09/15/2023 Acceptance:08/06/2024 Survival Outcomes of Breast Cancer Patients in South India Over 20 Years Dhanya Mary Louis1, Merin Mathew2, Georg Gutjahr3, Dehannathparambil Kottarathil Vijayakumar4, Keechilat Pavithran5, Lakshmi Malavika Nair4 * Abstract Objective: The study aimed to investigate the distribution and clinicopathologic features of breast cancer patients in South India, while also examining the overall survival (OS) and identifying predictive factors affecting it. Additionally, we aimed to assess the influence of risk factors on Disease Free Survival (DFS) and Distant Disease-Free Survival (DDFS) . Methods: This retrospective cohort study on breast cancer trends used comprehensive follow-up including regular patient contact, medical record review and collaboration with healthcare providers. Patients without follow-up information for more than 12 months were contacted by telephone, while those with no follow-up after 2 years were labelled as lost to follow-up. Results: A total of 3256 patients were identified from a single cancer institute in India. The median follow-up time was 8.1 years. The 5-year survival rates were 89%, 84%, 85%, 88% and 10-year were 82%, 78%, 79%, 83% for luminal cancers, Triple Negative Breast Cancers, HER2 enriched and luminal with HER2 enriched respectively. Conclusion: Poorer survival rates were seen among those with pT3/4 tumors, nodal involvement at diagnosis, Estrogen receptor negative status, high Ki67 proliferative index and higher TNM stage at diagnosis of the disease. Although our patients were younger and had more aggressive types of cancer, their DFS, DDFS and overall survival were comparable to other developed nations. Keywords: Breast cancer-developing countries-distant disease-free survival-disease free survival-overall survival Asian Pac J Cancer Prev, 25 (8), 2633-2644 Introduction Breast cancer is characterised by its heterogeneous nature, encompassing various subtypes with distinct cellular composition and clinical behaviors [1] . It remains as one of the leading causes of mortality among women in both developing and developed countries [2] . Due to rapid advancements in treatment paradigms and improved population screening, mortality rates for breast cancer are steadily declining in developed countries. A recent study conducted in Austria, found that there is a decline in breast cancer-related mortality over the past few decades, the annual percent change ranging from 17.5% to-0.8%, indicating a substantial reduction in the number of breast cancer deaths [3] . Similarly, a study conducted in Sweden found a 49% decrease in the 5 year breast cancer-related mortality during the period from 1989-2013 [4]. These positive trends can be attributed to the following developments. Firstly, increased awareness and public education regarding the symptoms of breast cancer, as well as screening programs have helped detect breast cancer in its early stage. Secondly, newer chemotherapeutic agents and targeted therapies have become more affordable and accessible, improving the survival of patients with breast cancer world over. Thirdly, the multidisciplinary approach which involves collaboration with different specialists including surgeons, medical oncologists, radiation oncologists and pathologists provides a comprehensive treatment protocol for each patient. Lastly, several therapeutic options for metastatic breast cancer patients are now available, which allow many women to live longer with the disease [5] . However, while numerous studies have been conducted on breast cancer survival rates in Western populations, limited research has been undertaken in developing countries like India, where breast cancer patients show distinct characteristics and diagnostics and treatment options are more limited. A pooled analysis involving 5 million patients across 195 world countries from 1990-2015 showed a notable increase in

FAQs

What was the main objective of the study?

The study aimed to investigate the distribution and clinicopathologic features of breast cancer patients in South India, evaluate overall survival, and identify predictive factors. It also assessed how risk factors influence DFS and DDFS.

How was the follow-up conducted in this retrospective cohort study?

Follow-up relied on regular patient contact, medical record review, and collaboration with healthcare providers. Patients without follow-up information for more than 12 months were contacted by telephone, and those without follow-up after 2 years were labeled lost to follow-up.

Which factors were associated with poorer survival rates?

Poorer survival was linked to pT3/4 tumors, nodal involvement at diagnosis, estrogen receptor negative status, high Ki67 proliferative index, and higher TNM stage at diagnosis.

Sep 21, 2026

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