Immunohistochemical Profile, Disease-Free Survival, and Pattern of Recurrence Among Non-Metastatic Breast Cancer Patients of the Philippine General Hospital During the First 5 Years of Implementation of the Department of Health-Breast Cancer Medicine Access Program

Background: Breast cancer is the third leading cause of cancer mortality in the Philippines. The Department of Health (DOH) started the Breast Cancer Medicine Access Program (BCMAP) in 2011, providing chemotherapeutic and hormonal drugs for Stage I-IIIB Breast Cancer patients. Objectives: This study determined the 5-year disease-free survival and patterns of recurrence of patients enrolled in the Breast Cancer Medicine Access Program (BCMAP) of the Philippine General Hospital. Methodology: This is a retrospective cohort study of patients enrolled in BCMAP from January 2012 to December 2016. Kaplan-Meier survival analysis was used to determine the disease-free survival. Cox-Mantel Log Rank Test and Cox Proportional Hazards were used to determine factors that influenced survival. Results and Conclusion: Of the 1,680 patients enrolled in the study period, 231 did not finish their treatment. The most common molecular subtype was Luminal A, and majority had High Risk St. Gallen Category. The most common site of recurrence was the bone. Only 612 patients were included in the analysis of survival due to incomplete data. Median disease-free survival had not yet been reached, but those who did have recurrence, did so in a median time of 17 months. Survival was found to be significantly influenced by co-morbidities, lymphovascular invasion, ER and PR statuses, and molecular subtypes. Even though a lot of patients benefitted from the BCMAP, lacking data and a significant number of patients lost to follow-up limited the analysis of outcomes. Complete data collection and stronger follow-up is recommended.