Determinants of Breast Cancer Recurrence Among Breast Cancer Patients Attending Tikur Anbessa Specialized Hospital: Unmatched case-control study

Background Breast cancer is one of the most common cancers in women and it is the leading cause of cancer related death. Multi-modality treatments are provided to improve the outcome of patients with breast cancer. Patients with post treatment recurrence have poor prognosis than those with no recurrence. Factors related to the patient, tumor histopathology and treatment modalities determine the recurrence of this disease. Methods Facility based, unmatched case-control study design was conducted among 237 breast cancer patients attending Addis Ababa University Tikur Anbessa Specialized hospital from November 1, 2024- December 1, 2024 GC.. The cases were recurrent breast cancer patients and controls were patients with no breast cancer recurrence. Cases were selected consecutively and following each case two controls were selected. Data were extracted from patients chart using structured questioner by trained nurses. Data were entered into Epi data version 3.1; exported and analyzed by SPSS version 25. All independent variables with p-value < 0.25 in the bi-variate logistic regression analysis were entered into multivariable binary logistic regression analysis. Model fitness was checked by Hosmel-lemshow goodness of fit. An adjusted odds ratio with a 95% CI and a p-value of < 0.05 was used to identify determinants of breast cancer recurrence. Result A total of 237 patients (79 cases and 158 controls) were included in the study. The mean age of cases and controls were 46.2 (SD ± 13.3) and 48.5 (SD ± 12.9) years, respectively. No family history of breast cancer(AOR = 0.17, 95% CI: 0.03, 0.08), tumor size (AOR = 0.76, 95% CI: 0.60, 0.96),High nuclear grade (AOR = 3.4, 95% CI: 1.49,7.71), Lympho vascular invasion(AOR = 2.3, 95% CI: 1.02, 5.34) positive surgical margin(AOR = 4.4, 95% CI: 1.05, 38.6) and Estrogen receptor negative(AOR = 5.7, 95%CI: 1.51, 21.5) were found to be determinants of breast cancer recurrence. Conclusion and Recommendations: Family history, tumor size, high nuclear grade tumor, positive surgical margin, lympho vascular invasion and negative estrogen receptor were determinant of breast cancer recurrence. Breast cancer with these recurrence determinants requires more aggressive treatment and intensive follow up.