Background: Breast cancer (BC) is the second most common of all cancers and the commonest in women contributing 12% of all new cancer cases and 25% of all cancers in women. It is the most prevalent cancer in Ethiopia. Even if the estimation of BC survival is beneficial to improve the current breast cancer care & treatment, studies are lacking in Ethiopia.

Objectives: To identify determinants of survival and to estimate cumulative survival probabilities of patient’s with BC that are diagnosed from 2013-2018 in Hawassa University Comprehensive Specialized Hospital and Yanet Hospital.

Methods: A health facility-based retrospective study of 302 patients was conducted. Data was collected by a structured record review checklist and by telephone interview. The median survival was estimated by Kaplan- Meier. Log Rank test was used to compare survival among groups. Cox proportional hazards model was used to identify determinants. Results were repaired as hazard ratio (HR) along with the corresponding 95% CI. Sensitivity analysis was done with the assumption of lost to follow-ups (LTF) might die 3 months after last hospital visit.

Results: Majorities of patients (83.4%) were presented at an advanced stage. The study participants had followed for a total of 4685.62 person-months. Their median survival is 50.61 months (IQR=18.38-50.80) which declined to 30.57 months in worst case analysis (WCA) and the outcome of 57 patients were unknown (majorities, 96% being advanced stage) and 67 patients were died. The overall survival (OS) of patients at two years is 69.3% and it declines to 51.3 % in WCA. Rural residence (AHR=2.71, 95% CI: 1.44, 5.09), travel time >7 hours (AHR=3.42, 95% CI: 1.05, 11.10), duration of symptom 7-23 months (AHR=2.63, 95% CI: 1.22, 5.64), > 23 months (AHR=2.37, 95% CI: 1.00, 5.59), advanced stage (AHR=3.01, 95% CI: 1.05, 8.59) and not taking chemotherapy (AHR=6.69, 95% CI: 2.20, 20.30) were independent predictors of death. Through WCA, rural residence, advanced stage of BC, not having breast surgery, poor adherence to chemotherapy were independent predictors of death.

Conclusion: The two years OS is less than 69.3% in Hawassa. Rural residence, advanced stage and poor adherence to chemotherapy were independent determinants of death. Increasing early diagnosis of BC and access to cancer treatment is mandatory.

Keywords: Breast cancer, Survival, Determinants, Sothern Ethiopia