Chemotherapy Default among Breast Cancer Patients in Yenagoa, Nigeria: Patterns and Predictors

Abstract

Background: Chemotherapy default is a critical barrier to effective breast cancer management in resource-limited settings. This study evaluated the patterns and predictors of chemotherapy default among breast cancer patients in a tertiary hospital in Nigeria.

Methods: A cross-sectional study design was utilized involving 60 patients with histologically confirmed breast cancer. Chemotherapy Default was operationally defined as the failure to complete at least 80% of the prescribed cycles, based on the principle of Relative Dose Intensity. Data regarding sociodemographic and clinical characteristics were extracted from medical records. Predictors of default were identified using a multivariable binary logistic regression model, incorporating variables that met the screening threshold of p<0.25 in bivariate analysis.

Results: The overall chemotherapy default rate was 33.3% (20/60). The multivariable analysis identified Advanced Disease (Manchester Stage 4) as the strongest independent predictor of default (Adjusted OR = 6.74; 95% CI: 1.69 – 26.86; p = 0.007). Duration of symptoms exceeding 12 months was also significantly associated with default (Adjusted OR = 4.23; 95% CI: 1.05 – 17.02; p = 0.042). Sociodemographic factors, including age and parity, were not statistically significant after adjustment for clinical stage. The study was limited by a relatively small sample size (n=60), which contributed to wide confidence intervals for the reported risk estimates.

Conclusion: Late presentation and advanced disease stage are the primary drivers of chemotherapy default in this cohort. Interventions should prioritize early detection programs and targeted counseling for patients presenting with advanced-stage disease to improve treatment adherence.