Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series

Abstract

BackgroundBreast cancer is the most common malignancy accounting for 25% of all cancers in females. In Africa, breast cancer prevalence and mortality are steadily increasing. Knowledge of hormone receptors and human epidermal growth factor receptor-2 (HER-2) expressions are vital for breast cancer management plans and decision making. There is wide regional variation in the proportion of these biomarkers, especially in African countries. Hormone receptors positivity in indigenous African and African American women is considered to be low and triple negative breast cancer is a dominant phenotype. There is paucity of data regarding hormone receptors (ER and PR) and HER2 expressions in North-eastern Africa (Eritrea and Sudan). The purpose of this study was to evaluate the expression of ER, PR and HER2 in Eritrean and Sudanese case series and correlate these biomarkers with the clinicopathological profile.MethodClinicopathologic data of patients were collected from clinical records. Immunohistochemistry biomarkers (ER, PR, and HER2) were assessed in consecutive female patients who had been diagnosed with invasive breast cancer from 2011 to 2015 in Gezira University Pathology Laboratory, the Sudan and National Health laboratory, Asmara, Eritrea.ResultsThere were 678 cases involved in this study. The mean age was 48.8 years with ±0.53 standard error of the mean. Two-thirds of the case were ≤50 years. Invasive ductal carcinoma, no special type was the most dominant histologic type (86%) in both study groups. The majority of cases (70%) had tumour stage pT2 and pT3 and about 50% had lymph node involvement. Less than 5% of the cases had well-differentiated tumours. The ER, PR and HER2 positive rates were 45%, 32%, and 29%, respectively. The proportion of luminal-A like, luminal-B like, HER2 enriched and TNBC were 37%, 13%, 16% and 34%, respectively. Fisher extract analysis showed age (p = .015), tumour size (p = .041), and histologic grade (p = .000) were significantly associated with intrinsic subtypes. Furthermore, Logistic regression analysis stratified by origin, age, tumour size, lymph-node metastasis and grade indicated that younger women age (≤50 years) and grade III tumours were more likely to be diagnosed with ER negative breast cancer.ConclusionMost of Sudanese and Eritrean women were diagnosed at younger age and with unfavourable prognostic clinicopathologic prognostic markers. TNBC is more frequent in this cohort study; patients with grade III tumours and young age are more likely to be hormone receptors negative. Therefore, routine determination of hormone receptors is warranted for appropriate targeted therapy.

Breast Cancer in Togolese Women: Immunohistochemistry Subtypes

“…The correlation between the different subtypes and tumor size was statistically signi cant (P = 0.026). Signi cant association between tumor size with breast cancer subtype has also been reported in Sudanese and Eritrean women [43] In several study, some authors reported signi cant association between molecular subtype and histological grade [19], age [25,33] and menopausal status [33] but in this current study, we did not nd any correlation between molecular subtype and age, stage, menopausal status or histologic grade.…”

Evaluation of immunohistochemical profile of breast cancer for prognostics and therapeutic use

“…It is more common in developed countries. [ 1 2 5 17 ] Outcomes for breast cancer vary greatly depending on the cancer type, extent of disease and person's age. Five years survival rates in the developed world are high, 80% and 90%, in England and the United States, respectively.…”

“…In the present study, infiltrating ductal carcinoma seen in the age group between 24 and 80 years, with mean age 55.28 years is similar to study conducted by Sengal et al . [ 5 ] and Kaul et al . [ 21 ] Majority of ER and PR positive cases were of age >60 years, as seen in a study conducted by Alzaman et al .…”

“…[ 4 ] Hormone receptors (ER and PR) and human epidermal growth factor receptor-2 (HER-2) are the most relevant clinical biomarkers that are widely used in stratifying breast cancer cases management. [ 5 ] Knowledge of hormone receptors and HER-2 expressions are vital for breast cancer management plans and decision-making. [ 5 ] Prognostic and predictive factors are used in the management of breast cancer.…”

“…[ 5 ] Knowledge of hormone receptors and HER-2 expressions are vital for breast cancer management plans and decision-making. [ 5 ] Prognostic and predictive factors are used in the management of breast cancer. Prognostic factors are those which influences patient's overall outcome such as chances of recurrence after treatment.…”