Survival of breast cancer patients and the potential for better prognostication

Abstract

Many factors influence the survival of patients with breast cancer. Tumour biology is likely the most important; secondly, the treatment options and the response to the treatment. Individuals with the same stage and similar pathological diagnoses can experience different clinical courses. Patient factors including ethnicity affect tumour biology, treatment and its response. There are prognostic tools using clinical and tumour indicators, but most are not individualised. Molecular platforms for personalised medicine has since evolved and perhaps will provide better prognostication. In this thesis, we study the ethnic difference in survival between an Asian and a Western population: Singapore and Stockholm; survival between different ethnic groups in Singapore: Chinese, Malays and Indians; the effects of biological factors of tumours on survival amongst the different ethnic groups in Singapore; and the use of a custom molecular array as a potential for better prognostication in addition to standard clinical tests in Singaporean women.