Breast Cancer Presentation, Treatment Patterns, and Progression-Free Survival at a Tertiary Oncology Centre in Bangladesh: A Retrospective Study.

backgroundBreast cancer remains a major cause of cancer-related morbidity among women worldwide, with persistent disparities in diagnosis, treatment access, and outcomes across low- and middle-income settings. Institution-based real-world data are limited in Bangladesh. This study aimed to describe the clinicopathological characteristics, molecular subtype distribution, documented treatment patterns, and progression-related outcomes of breast cancer patients managed at a tertiary care center in Bangladesh.

methodsThis retrospective observational study was conducted at Bangladesh Specialized Hospital, Dhaka, Bangladesh. Hospital records of 1058 adult breast cancer patients were reviewed. Data on demographics, tumor characteristics, molecular subtype, documented treatment modalities, and follow-up were analyzed. Progression-free survival (PFS) was assessed using Kaplan-Meier methods and Cox proportional hazards regression.

resultsLuminal A was the most common primary molecular subtype, accounting for 38.47% of cases, followed by TNBC at 23.53% and HER2-positive disease at 11.91%. Documented metastatic or recurrent disease during the available records was present in 34.59% of patients, while Stage III or IV disease at diagnosis accounted for 33.65% of the cohort. Chemotherapy was the most frequently documented treatment modality, recorded in 79.02% of patients, followed by endocrine therapy in 53.78%, breast surgery in 56.52%, HER2-directed therapy in 21.17%, and radiotherapy in 20.04%. Among luminal cases, endocrine therapy was documented in 86.61%, and among the HER2-positive analytical subgroup, HER2-directed therapy was documented in 85.96%. A total of 59 PFS events were recorded, comprising 58 progression events and one death. In multivariable Cox analysis, Luminal B, HER2-negative disease, adjusted hazard ratio 2.97, 95% CI 1.41 to 6.23, p = 0.004, and HER2-positive disease, adjusted hazard ratio 2.70, 95% CI 1.39 to 5.26, p = 0.003, were associated with poorer PFS relative to Luminal A.

conclusionIn this institution-based cohort, molecular subtype remained an important determinant of progression-related outcome. Luminal A showed the most favorable progression-related profile, whereas Luminal B, HER2-negative, and HER2-positive disease had poorer PFS. The study also demonstrates active use of multimodality treatment and provides real-world evidence on breast cancer care patterns at a tertiary oncology center in Bangladesh.