Comparison of receptor-defined Breast Cancer Subtypes between German and sudanese women: A facility-based cohort study

Asmerom Tesfamariam Sengal, Nada Suliman Haj Mukhtar, Martina Vetter, Ahmed Mohammed Elhaj, Shahinaz Bedri, Steffen Hauptmann, Christoph Thomssen, Ahmed Abdalla Mohamedani, Claudia Wickenhauser, Eva Johanna Kantelhardt

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Abstract

Purpose The objective of this study was to compare tumor characteristics, biomarkers, and surrogate subtypes of breast cancer between Sudanese and German women. Methods Tumor characteristics and immunohistochemistry markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) were collected from the routine assessment of consecutive patients with invasive breast cancer diagnosed from 2010 to 2015 (Gezira University Pathology Laboratory, Gezira, Sudan) and from 1999 to 2013 (Breast Centre, Martin-Luther-University, Halle, Germany). Results A total of 2,492 patients (German [n = 1,932] and Sudanese [n = 560]) were included. Age at diagnosis ranged from 20 to 94 years. Sudanese women were, on average, 10 years younger than German women, with a mean (6 standard deviation) age of 48.8 (13.5) and 58.6 (12.4) years, respectively. The Sudanese women had a higher grade, larger tumor, and more lymph node positivity compared with German women. ER-, PR-, and HER2-negative proportions were 55%, 61.8%, and 71.3%, respectively, for Sudanese women versus 22.7%, 32.3%, and 82.5%, respectively, for German women. The triple-negative subtype was more prevalent in Sudanese women (34.5%) than in German women (14.2%). The strongest factor associated with ER-negative disease was grade III (odds ratio, 19.6;95%CI 11.6 to 33.4; P < .001). Sudanese patients were at higher risk for ER-negative breast cancer, with an odds ratio of 2.01 (P = .001; adjusted for age, size, nodal status, histologic type, and grade). Stratified by grade, the influence of origin was observed in grade I and grade II tumors, but not in grade III tumors. Conclusion Sudanese women had more aggressive tumor characteristics and unfavorable prognostic biomarkers. After adjustment, Sudanese origin was still associated with hormone receptor-negative disease, especially in grade I and II tumors. These findings suggest differences in tumor biology among these ethnic groups. J Glob Oncol 00.

Original languageEnglish
JournalJournal of Global Oncology
Volume2018
Issue number4
DOIs
Publication statusPublished - 1 Jan 2018

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Cohort Studies
Breast Neoplasms
Estrogen Receptors
Neoplasms
Progesterone Receptors
Odds Ratio
Sudan
Tumor Biomarkers
Ethnic Groups
Germany
Breast
Biomarkers
Lymph Nodes
Immunohistochemistry
Hormones
Pathology

ASJC Scopus subject areas

  • Medicine(all)

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Comparison of receptor-defined Breast Cancer Subtypes between German and sudanese women : A facility-based cohort study. / Sengal, Asmerom Tesfamariam; Mukhtar, Nada Suliman Haj; Vetter, Martina; Elhaj, Ahmed Mohammed; Bedri, Shahinaz; Hauptmann, Steffen; Thomssen, Christoph; Mohamedani, Ahmed Abdalla; Wickenhauser, Claudia; Kantelhardt, Eva Johanna.

In: Journal of Global Oncology, Vol. 2018, No. 4, 01.01.2018.

Research output: Contribution to journalArticle

Sengal, AT, Mukhtar, NSH, Vetter, M, Elhaj, AM, Bedri, S, Hauptmann, S, Thomssen, C, Mohamedani, AA, Wickenhauser, C & Kantelhardt, EJ 2018, 'Comparison of receptor-defined Breast Cancer Subtypes between German and sudanese women: A facility-based cohort study', Journal of Global Oncology, vol. 2018, no. 4. https://doi.org/10.1200/JGO.2017.010082
Sengal, Asmerom Tesfamariam ; Mukhtar, Nada Suliman Haj ; Vetter, Martina ; Elhaj, Ahmed Mohammed ; Bedri, Shahinaz ; Hauptmann, Steffen ; Thomssen, Christoph ; Mohamedani, Ahmed Abdalla ; Wickenhauser, Claudia ; Kantelhardt, Eva Johanna. / Comparison of receptor-defined Breast Cancer Subtypes between German and sudanese women : A facility-based cohort study. In: Journal of Global Oncology. 2018 ; Vol. 2018, No. 4.
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abstract = "Purpose The objective of this study was to compare tumor characteristics, biomarkers, and surrogate subtypes of breast cancer between Sudanese and German women. Methods Tumor characteristics and immunohistochemistry markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) were collected from the routine assessment of consecutive patients with invasive breast cancer diagnosed from 2010 to 2015 (Gezira University Pathology Laboratory, Gezira, Sudan) and from 1999 to 2013 (Breast Centre, Martin-Luther-University, Halle, Germany). Results A total of 2,492 patients (German [n = 1,932] and Sudanese [n = 560]) were included. Age at diagnosis ranged from 20 to 94 years. Sudanese women were, on average, 10 years younger than German women, with a mean (6 standard deviation) age of 48.8 (13.5) and 58.6 (12.4) years, respectively. The Sudanese women had a higher grade, larger tumor, and more lymph node positivity compared with German women. ER-, PR-, and HER2-negative proportions were 55{\%}, 61.8{\%}, and 71.3{\%}, respectively, for Sudanese women versus 22.7{\%}, 32.3{\%}, and 82.5{\%}, respectively, for German women. The triple-negative subtype was more prevalent in Sudanese women (34.5{\%}) than in German women (14.2{\%}). The strongest factor associated with ER-negative disease was grade III (odds ratio, 19.6;95{\%}CI 11.6 to 33.4; P < .001). Sudanese patients were at higher risk for ER-negative breast cancer, with an odds ratio of 2.01 (P = .001; adjusted for age, size, nodal status, histologic type, and grade). Stratified by grade, the influence of origin was observed in grade I and grade II tumors, but not in grade III tumors. Conclusion Sudanese women had more aggressive tumor characteristics and unfavorable prognostic biomarkers. After adjustment, Sudanese origin was still associated with hormone receptor-negative disease, especially in grade I and II tumors. These findings suggest differences in tumor biology among these ethnic groups. J Glob Oncol 00.",
author = "Sengal, {Asmerom Tesfamariam} and Mukhtar, {Nada Suliman Haj} and Martina Vetter and Elhaj, {Ahmed Mohammed} and Shahinaz Bedri and Steffen Hauptmann and Christoph Thomssen and Mohamedani, {Ahmed Abdalla} and Claudia Wickenhauser and Kantelhardt, {Eva Johanna}",
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AU - Vetter, Martina

AU - Elhaj, Ahmed Mohammed

AU - Bedri, Shahinaz

AU - Hauptmann, Steffen

AU - Thomssen, Christoph

AU - Mohamedani, Ahmed Abdalla

AU - Wickenhauser, Claudia

AU - Kantelhardt, Eva Johanna

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N2 - Purpose The objective of this study was to compare tumor characteristics, biomarkers, and surrogate subtypes of breast cancer between Sudanese and German women. Methods Tumor characteristics and immunohistochemistry markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) were collected from the routine assessment of consecutive patients with invasive breast cancer diagnosed from 2010 to 2015 (Gezira University Pathology Laboratory, Gezira, Sudan) and from 1999 to 2013 (Breast Centre, Martin-Luther-University, Halle, Germany). Results A total of 2,492 patients (German [n = 1,932] and Sudanese [n = 560]) were included. Age at diagnosis ranged from 20 to 94 years. Sudanese women were, on average, 10 years younger than German women, with a mean (6 standard deviation) age of 48.8 (13.5) and 58.6 (12.4) years, respectively. The Sudanese women had a higher grade, larger tumor, and more lymph node positivity compared with German women. ER-, PR-, and HER2-negative proportions were 55%, 61.8%, and 71.3%, respectively, for Sudanese women versus 22.7%, 32.3%, and 82.5%, respectively, for German women. The triple-negative subtype was more prevalent in Sudanese women (34.5%) than in German women (14.2%). The strongest factor associated with ER-negative disease was grade III (odds ratio, 19.6;95%CI 11.6 to 33.4; P < .001). Sudanese patients were at higher risk for ER-negative breast cancer, with an odds ratio of 2.01 (P = .001; adjusted for age, size, nodal status, histologic type, and grade). Stratified by grade, the influence of origin was observed in grade I and grade II tumors, but not in grade III tumors. Conclusion Sudanese women had more aggressive tumor characteristics and unfavorable prognostic biomarkers. After adjustment, Sudanese origin was still associated with hormone receptor-negative disease, especially in grade I and II tumors. These findings suggest differences in tumor biology among these ethnic groups. J Glob Oncol 00.

AB - Purpose The objective of this study was to compare tumor characteristics, biomarkers, and surrogate subtypes of breast cancer between Sudanese and German women. Methods Tumor characteristics and immunohistochemistry markers (estrogen receptor [ER], progesterone receptor [PR], and human epidermal growth factor receptor 2 [HER2]) were collected from the routine assessment of consecutive patients with invasive breast cancer diagnosed from 2010 to 2015 (Gezira University Pathology Laboratory, Gezira, Sudan) and from 1999 to 2013 (Breast Centre, Martin-Luther-University, Halle, Germany). Results A total of 2,492 patients (German [n = 1,932] and Sudanese [n = 560]) were included. Age at diagnosis ranged from 20 to 94 years. Sudanese women were, on average, 10 years younger than German women, with a mean (6 standard deviation) age of 48.8 (13.5) and 58.6 (12.4) years, respectively. The Sudanese women had a higher grade, larger tumor, and more lymph node positivity compared with German women. ER-, PR-, and HER2-negative proportions were 55%, 61.8%, and 71.3%, respectively, for Sudanese women versus 22.7%, 32.3%, and 82.5%, respectively, for German women. The triple-negative subtype was more prevalent in Sudanese women (34.5%) than in German women (14.2%). The strongest factor associated with ER-negative disease was grade III (odds ratio, 19.6;95%CI 11.6 to 33.4; P < .001). Sudanese patients were at higher risk for ER-negative breast cancer, with an odds ratio of 2.01 (P = .001; adjusted for age, size, nodal status, histologic type, and grade). Stratified by grade, the influence of origin was observed in grade I and grade II tumors, but not in grade III tumors. Conclusion Sudanese women had more aggressive tumor characteristics and unfavorable prognostic biomarkers. After adjustment, Sudanese origin was still associated with hormone receptor-negative disease, especially in grade I and II tumors. These findings suggest differences in tumor biology among these ethnic groups. J Glob Oncol 00.

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