Time to Breast Cancer Recurrence and Associated Predictors in Public Hospitals of Addis Ababa, Central Ethiopia - A Retrospective Cohort Study

Q: What was the study objective regarding breast cancer recurrence?

To assess time to recurrence and identify predictors among women treated in public hospitals of Addis Ababa, Ethiopia.

Q: How was the study conducted and what statistical model was used?

A retrospective cohort study covered September 11, 2018 to September 12, 2023 with 322 recorded cases. Cox proportional hazards modeling identified predictor variables.

Q: Which factors were independent predictors of increased recurrence hazard?

Women aged 40 or below, overweight, positive surgical margin, axillary node-positive status, and comorbidity were independent predictors.

Q: What did the recurrence-free survival (RFS) results show?

At median follow-up, recurrence-free survival was 87.5%, and 75% RFS time was 44 months, with decreasing RFS proportions across 24, 36, 48, and 60 months.

Sep 23, 2026

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Breast cancer recurrence remains a major concern after surgery, yet the timing and key determinants are insufficiently characterized in low-income settings. This retrospective cohort study evaluated time to recurrence and associated predictors among women treated in public hospitals in Addis Ababa, Ethiopia. Using Kobo toolbox data and Stata analysis with a Cox proportional hazards model, the study estimated recurrence-free survival and identified independent factors linked to higher recurrence hazard.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages12

Reading Time30 min

AccessFree to download

Abstract

Background

Methods

Results

Conclusion

Introduction

Journal of Cancer Research and Clinical Oncology (2025) 151:187 [https://doi.org/10.1007/s00432-025-06181-2](https://doi.org/10.1007/s00432-025-06181-2) Time to breast cancer recurrence and associated predictors in Public Hospitals of Addis Ababa, Central Ethiopia: a retrospective Cohort Study Yadessa Chala1 · Tesfaye Techane2 · Bonsisa Bekele2 · Tesfaye Girma2 · Warati Fekede3 · Chalchisa Abdeta5 · Kibiru Mardasa3 · Tolera Abdeta3 · BedadaTeshome4 · Gashaye Atinkut3 · Abdinasir Wako3 · Mohammed Adem3 · Alem Deksisa3 Received: 18 January 2025 / Accepted: 24 March 2025 / Published online: 12 June 2025 © The Author(s) 2025 Abstract Background Breast cancer recurrence is a significant concern when the disease returns following surgery. The time to recurrence and factors affecting it are not well studied in low-income countries. This study aimed to assess the time to recurrence and predictors of breast cancer among women treated in public hospitals of Addis Ababa, Ethiopia. Methods Retrospective cohort study was conducted from April 30 to May 30, 2024, among randomly selected 322 recorded cases. The study covered from September 11, 2018, to September 12, 2023. Data were collected by the Kobo toolbox and analyzed by Stata Version 15. The Cox proportional hazard model was used to identify predictor variables, with assumptions checked using the Schoenfeld residual/global test (0.79). Multi-collinearity was checked using the variance inflation factor (3.72) . Variables with a P-value < 0.25 in bivariable analysis were entered into the final multivariable analysis. Variables with a P-value < 0.05 at 95% confidence level were considered independent predictors of recurrence. Result The recurrence-free survival (RFS) status at the median follow-up time was 87.5% . The incidence rate of breast cancer recurrence was 6.8 per 100 women years (95%CI = 5.34–8.13) follow-up. The 75%RFS time was 44 months (95CI% = 40–48) . The proportion of RFS survival at 24, 36, 48, and 60 months was 91.93%, 83.3%, and 67.7%, 61% respectively. Women aged 40 & below (AHR = 3.32; 95%CI 1.80–5.88), Overweight (AHR = 1.95, 95%CI 1.06-3.59), surgical margin positive (AHR = 2.1; 95%CI 1.20–4.02), axillary node-positive (AHR = 1.98; 95%CI 1.08–3.61) and comorbidity (AHR = 4.45, 95%CI 2.39–8.30) were independent predictors for increased hazard of recurrence. Conclusion This study confirms a substantial incidence of breast cancer recurrence, with identifiable predictors including comorbidity, age, overweight, positive axillary node status, lymph node involvement, and deep surgical margin. Targeted interventions aimed at improving patient understanding of recurrence risk, promoting adherence to treatment protocols, and fostering healthy lifestyle modifications are crucial for reducing recurrence rates. Keywords Breast · Cancer · Ethiopia · Predictors · Recurrence Introduction Breast cancer is a complex illness with many faces – different biological characteristics, a range of treatments, and varying outcomes for those diagnosed. At its core, it’s about cells in the breast tissue that begin to grow and multiply uncontrollably, ultimately becoming cancerous (Wu et al. 2016) . In 2020, breast cancer became the most commonly diagnosed cancer worldwide, surpassing lung cancer, with Extended author information available on the last page of the article 2.3 million new cases—that’s nearly 12% of all cancers diagnosed globally. Sadly, it’s also the fifth leading cause of cancer-related deaths, claiming 685,000 lives each year (Sunget al. 2021) . In Africa, and specifically in Ethiopia, breast cancer is the most prevalent cancer affecting people, both in terms of new diagnoses and deaths (Sharma et al. 2020) . Breast cancer represents a significant global health burden, impacting millions of women worldwide. It is the most commonly diagnosed cancer among women, and a leading cause of cancer-related mortality. This burden extends beyond mortality, enco

FAQs

What was the study objective regarding breast cancer recurrence?

To assess time to recurrence and identify predictors among women treated in public hospitals of Addis Ababa, Ethiopia.

How was the study conducted and what statistical model was used?

A retrospective cohort study covered September 11, 2018 to September 12, 2023 with 322 recorded cases. Cox proportional hazards modeling identified predictor variables.

Which factors were independent predictors of increased recurrence hazard?

Women aged 40 or below, overweight, positive surgical margin, axillary node-positive status, and comorbidity were independent predictors.

What did the recurrence-free survival (RFS) results show?

At median follow-up, recurrence-free survival was 87.5%, and 75% RFS time was 44 months, with decreasing RFS proportions across 24, 36, 48, and 60 months.

Sep 23, 2026

Uploaded by Angel