Systematic Review of Breast Cancer Biology in Developing Countries (Part 2): Asian Subcontinent and South East Asia

Abstract

There has been no systematic appraisal of ethnicity-based variations in breast cancer (BC) biology amongst women from developing countries. A qualitative systematic review was conducted of breast cancer size, stage, grade, histological type, extra-mammary involvement, hormone receptor status as well as patient demographics. This review includes patients from Africa, the Middle East, Eastern Europe, Mexico, the Caribbean and South America. BC in these regions present at an earlier age with large aggressive tumours. Distant metastases are frequently present at the time of diagnosis. African women have a higher frequency of triple negative tumours. Over half of Middle Eastern women have lymph node involvement at the time of diagnosis. Despite experiencing a lower incidence compared to the Ashkenazi Jewish population, Palestinian women have poorer five-year survival outcomes. The majority of women from Mexico and South America have stage two or three disease whilst over sixty percent of women from Eastern Europe have either stage one or stage two disease. The biological characteristics of BC in the Caribbean cannot be fully assessed due to a paucity of data from the region. BC amongst the developing world is characterised by an early peak age of onset with aggressive biological characteristics. Strategies that improve breast cancer awareness, address amenable risk factors and improve early detection are essential.

Incidence and Mortality and Epidemiology of Breast Cancer in the World

“…In Mexico and South America, women are diagnosed at stages two or three of the disease. But 60 percent of East European women are diagnosed at stages one and two (Bhikoo et al, 2011). If the disease is diagnosed at a localized stage, the risk of cancer death will be less than death due to other reasons.…”

Perspectives and Attitudes of Jordanian Male College Students on Breast Cancer Screening

“…Nearly, 70 % of Jordanian women are diagnosed in advanced stages, with a low survival rate and poor prognosis [1]. Late-stage discovery of BC has been considered to be the main reason for high mortality rates among women in many developing countries, and it is most often associated with lack of BC screenings [2]. Similarly, Jordanian women face high mortality rates and do not engage in BC screening for various reasons [3] In the Middle East, socio-cultural factors influence women's view of BC screening.…”

“…In Jordan, there is no established BC screening programme; consequently, BC cases are discovered when it is too late [2]. In order to implement more successful BC prevention programmes and improve patient outcomes, initiatives should be encouraged to enhance social support for women.…”

Molecular Biology of Breast Cancer in the Horn of Africa: Case Series—A Pilot Study of Breast Cancer from Eritrea

“…In contrast, luminal A tumors with good prognosis are less common in African-American women [12,20]. Studies of breast cancer in African women show they occur at a younger age, express hormone receptors less frequently and more often are triple negative [21,22].…”