Metastatic Breast Cancer in a Tertiary Hospital in South-Western Nigeria

OBJECTIVEMetastatic breast cancer (MBC) is a common presentation among breast cancer patients in Nigeria. Treatment remains mostly palliative. This study aimed to describe the pattern of presentation of MBC, management, and survival outcome in our center. METHODSThis was a prospective study at Ekiti State University Teaching Hospital, Ado-Ekiti between January 2016 and December 2020. Data were analyzed by SPSS version 23.0. Kaplan-Meier test was used to compare survival with log rank test for statistical significance.RESULTSSeventy patients had MBC during the study period. Forty-six (65.7%) presented with metastasis and 24 (34.3%) developed metastasis during their treatment/follow-up. Their ages ranged from 27 to 86 years (mean 49.9 +/- 12 years). All patients had breast lump for 3-36 months (mean lump size, 12.0 +/- 4.7 cm). The predominant histological variant was invasive ductal carcinoma (97.1%). Fifty-nine (84.3%) tumors were moderately/poorly differentiated. Only six (8.6%) patients had immunochemical studies. Half of the patients (50%) had lungs or pleural metastasis followed by liver secondary's in 11 (15.7%). Chemotherapy (75.7%) and hormonal drugs (71.4%) were the main treatments while only 8 (11.4%) patients had radiotherapy. Survival ranged from 2 to 30 months (median 7.0 months). There was 60% mortality in patients with bone metastasis versus 97% mortality in other metastases over 2 years (log rank test: 0.002). All patients with multiple metastasis died within 1 year while solitary metastasis had 19% mortality within 1 year and 93% mortality in 2 years follow-up (Log rank test: 0.0001).CONCLUSIONMBC is associated with poorer prognosis and short survival. Improvement in the diagnostic and treatment modalities will most likely result in a better outcome in the near future.