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

Abstract Background Breast 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 breas...

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Main Authors: Asmerom Tesfamariam Sengal, Nada Suliman Haj-Mukhtar, Ahmed Mohammed Elhaj, Shahinaz Bedri, Eva Johanna Kantelhardt, Ahmed A. Mohamedani
Format: Article
Language:English
Published: BMC 2017-12-01
Series:BMC Cancer
Subjects:
Online Access:http://link.springer.com/article/10.1186/s12885-017-3805-4
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author Asmerom Tesfamariam Sengal
Nada Suliman Haj-Mukhtar
Ahmed Mohammed Elhaj
Shahinaz Bedri
Eva Johanna Kantelhardt
Ahmed A. Mohamedani
author_facet Asmerom Tesfamariam Sengal
Nada Suliman Haj-Mukhtar
Ahmed Mohammed Elhaj
Shahinaz Bedri
Eva Johanna Kantelhardt
Ahmed A. Mohamedani
author_sort Asmerom Tesfamariam Sengal
collection DOAJ
description Abstract Background Breast 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. Method Clinicopathologic 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. Results There 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. Conclusion Most 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.
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spelling doaj.art-88cf905617784096a3a7531cdd0689ec2022-12-22T03:36:13ZengBMCBMC Cancer1471-24072017-12-011711910.1186/s12885-017-3805-4Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case seriesAsmerom Tesfamariam Sengal0Nada Suliman Haj-Mukhtar1Ahmed Mohammed Elhaj2Shahinaz Bedri3Eva Johanna Kantelhardt4Ahmed A. Mohamedani5Pathology Department, Faculty of Medicine, University of GeziraPathology Department, Faculty of Medicine, University of GeziraNational Cancer Institute, University of GeziraWeill Cornell of Medicine- Qatar, Pathology and Laboratory Medicine, Department of Medical EducationDepartment of Gynaecology, Institute of Medical Epidemiology, Biostatistics and Informatcs, Martin-Luther UniversityPathology Department, Faculty of Medicine, University of GeziraAbstract Background Breast 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. Method Clinicopathologic 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. Results There 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. Conclusion Most 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.http://link.springer.com/article/10.1186/s12885-017-3805-4Hormone receptorBreast cancer subtypeImmunohistochemistrySudanEritrea and Africa
spellingShingle Asmerom Tesfamariam Sengal
Nada Suliman Haj-Mukhtar
Ahmed Mohammed Elhaj
Shahinaz Bedri
Eva Johanna Kantelhardt
Ahmed A. Mohamedani
Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
BMC Cancer
Hormone receptor
Breast cancer subtype
Immunohistochemistry
Sudan
Eritrea and Africa
title Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
title_full Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
title_fullStr Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
title_full_unstemmed Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
title_short Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series
title_sort immunohistochemistry defined subtypes of breast cancer in 678 sudanese and eritrean women hospitals based case series
topic Hormone receptor
Breast cancer subtype
Immunohistochemistry
Sudan
Eritrea and Africa
url http://link.springer.com/article/10.1186/s12885-017-3805-4
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