Breast Cancer in Togolese Women: Immunohistochemistry Subtypes

Abstract

Background Molecular classification of breast cancer is an important factor for prognostic and clinical outcome. There are no data regarding molecular breast cancer subtypes among Togolese women. The objective of this study was to evaluate the expression of ER, PR, HER2 and molecular subtypes of breast cancer receptor in Togolese patients and to establish the correlation between clinical and histological data and molecular types. Methods Clinicopathologic data of patients were collected from clinical records. Immunohistochemistry biomarkers (ER, PR and HER2) were assessed in patients who have been diagnosed with invasive breast cancer from March 2016 to March 2020 in the department of oncology. The analysis of variance and the Chi-square Test were used to analyze the data. Results A total of 117 cases were collected. Mean age of patients was 52.05 ± 12.38 with an age range of 30 to 85 years. Half of patients were over 50 years old and majority (70.9%) was postmenopausal. More than half of patients (52.1%) presented with T3-T4tumors.The most common histologic subtype of breast cancer was invasive ductal carcinoma of no special type (95.7%). Tumors grade 2 were predominant (51.3%) followed by grade 3 (42.7%). Advanced carcinomas were found in 69 patients (59%). The percentage of ER+, PR + and HER2 positive tumors was 50.4%, 37.6% and 15.4% respectively. The predominant molecular subtype was Luminal A (42.7%) followed by Triple negative (41.9%), Luminal B subtype (9.4%) and HER2 enriched (6%). There was significant association between tumor size and breast cancer subtypes (p = 0.026) but no correlation was found with age, stage, menopausal status and histologic grade. Conclusion Breast carcinoma in our patients are high grade tumors and are diagnosed at advanced stage. Luminal A and triple negative are the two predominant breast cancer subtypes in Togolese women. Consequently, Receptor testing availability should be a priority in order to offer the best breast cancer treatment.

Breast Cancer in Women: Epidemiological, Histological, Immunohistochemical and Molecular Sub-Types in the Republic of Congo

“…In this study, IHC was only performed in the 150 (12.49%) breast cancers diagnosed during this period due to the unavailability and high cost of receptor testing. This very limited access to the IHC, as evidenced by the frequency (12.49%) in our country, has also been observed in most countries of sub-Saharan Africa [9,16,17,18] . These results reflect difficulties in the regular assessment of tumor subtypes and poor access to radiation therapy and targeted agents in Mozambique, which impede the adequacy of care based on patient stage and subtype.…”

“…The sampling strategy was to obtain a number of cases necessary for statistical significance of the results. The size of our sample of 150 cases is closer to several studies [9,10,19,20] and significantly superior to other studies [21,22] .…”

“…In our study, the selection criteria were established in order to avoid bias in the interpretation of the results. These criteria were also used by Ablayi et al, [9] in 2020 in Togo; as well asMiguel et al, [7] in 2017 in Angola in a study aimed at providing a first look at the molecular subtypes of breast cancer in this country.…”

“…Breast cancer has been classified according to the World Health Organization 2012 (WHO 2012) [9] . Histological classification was performed using the Nottingham classification system and staging according to the 8th edition of the AJCC classification of 2017 [9,10] .…”