Breast cancer in Saudi females : epidemiology, survival and quality of life

Abstract

Breast cancer (BC) is the leading cause of cancer-related mortality in Saudi Arabia. Its incidence continues to increase. Research into the epidemiology of BC, including its mortality, in the Saudi population is limited. This thesis investigated BC incidence and survival patterns in the Saudi female and evaluated its impact on their Health-Related Quality of Life. Data on 27,664 women diagnosed with BC were obtained from the Saudi Cancer Registry from 1994 to 2018 and 3,408 females from the King Faisal Specialist Hospital and Research Centre (KFSH&RC) registry between 2008 and 2017. Age-specific and age-standardised incidence rates were calculated. The distribution of BC by age, stage, tumour grade and region were examined. BC incidence rates increased between 1994 and 2017 from 6.26 to 24.58 per 100,000 persons per year; the median age at diagnosis was 49 years; the most common type was infiltrating ductal carcinoma (78%). Grades II and III accounted for the majority of cases (70%), and regional BC accounted for 43%. The 5-year overall survival rate calculated using Kaplan Meier was 73%. Older patients experienced lower survival rates (76.1%) than younger ones (79.7%), and advanced grades exhibited lower survival rates, with 68% for grade 4 compared to 88.6% for grade 1. Surgery is the cornerstone of therapeutic intervention, with a 5-year overall survival rate of 97%. Quality of life was assessed in 275 females diagnosed with BC attending KFSH&RC using disease-specific tools (EORTC QLQ-C30 & BR23). The results showed low quality of life scores on QLQ-C30 (52±25.7). The utility values obtained were mapped onto a generic measure (EQ5D) to estimate health-related utility values. This study demonstrated the importance of early detection of BC to improve survival and the importance of further research to better understand how to improve the quality of life in Saudi women diagnosed with BC.