Prevalence and Outcomes of Inflammatory Breast Cancer Among Patients Diagnosed With Breast Cancer at Kenyatta National Hospital

Abstract

Background: Inflammatory Breast Cancer (IBC) represents a rare yet aggressive variant of breast cancer. Despite its rarity, difficulty in diagnosis and poor prognosis, there has been no study done in local Kenyan setting to establish the prevalence and outcome of this condition. Objective: To establish the prevalence and outcomes of inflammatory breast cancer among patients diagnosed with breast cancer at Kenyatta National Hospital (KNH). Methodology: This was a retrospective study. Patients who were diagnosed with inflammatory breast cancer between January 2017 to December 2019 were sampled from KNH Health Information department. Consecutive sampling was used to extract a minimum 100 files of patients with inflammatory breast cancer within the study period. The data gathered was patients’ demographic characteristics, stage of diagnosis, histology and immunohistochemistry of tumor, treatment given and outcomes of IBC. Data was collected over a two-month period after ethical approval and permission from KNH. The collected data was entered, coded and analyzed by the use of Statistical Package for Social Sciences version 26.0 (SPSS 26.0). Means and standard deviations was used in analyzing continuous data while analysis of categorical data was done using frequencies and percentages. Continuous variables were compared using the T-Test while categorical variables were compared with the chi square or Fischer’s exact test. Logistic regression was performed to investigate factors associated with mortality and recurrence. A p value of 0.05 served as cut off for statistical significance. Results: The burden of IBC is low accounting for 8.1 percent among breast cancer patients. The findings have established that a three-year survival was 16.7 percent with a median survival of 24 months. This highlights the aggressive nature of this subtype and the urgent need for targeted interventions to improve outcomes for affected individuals. Despite the poor prognosis associated with IBC, the observed three-year recurrence-free survival (RFS) rate was 25%. Those with stage IV (Odds ratio (OR) =7.38, 95%CI: 1.42 – 38.42, p =0.018) and those who were on palliative treatment (OR = 19.33, 95%CI:2.05 – 82.55, p =0.003) were likely to have adverse outcome. Those with stage 3c Odds ratio (OR) =6.11, 95%CI:3.11 – 12.1, p =0.011 were likely to have a recurrence compared to those with stage 3b. Conclusion: The three-year survival rate of patients with IBC was low at 16.7% and 25% recurrence free survival. This indicated the aggressive nature and poor prognosis associated with IBC