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

Asmerom Tesfamariam Sengal, Nada Suliman Haj-Mukhtar, Ahmed Mohammed Elhaj, Shahinaz Bedri, Eva Johanna Kantelhardt, Ahmed A. Mohamedani

Research output: Contribution to journalArticle

2 Citations (Scopus)

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.

Original languageEnglish
Article number804
JournalBMC Cancer
Volume17
Issue number1
DOIs
Publication statusPublished - 1 Dec 2017

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Immunohistochemistry
Breast Neoplasms
Hormones
Neoplasms
Eritrea
Sudan
Biomarkers
Lymph Nodes
Triple Negative Breast Neoplasms
Northern Africa
Eastern Africa
Ductal Carcinoma
African Americans
Decision Making
Cohort Studies
Logistic Models
Regression Analysis
Pathology
Neoplasm Metastasis
Phenotype

Keywords

  • Breast cancer subtype
  • Eritrea and Africa
  • Hormone receptor
  • Immunohistochemistry
  • Sudan

ASJC Scopus subject areas

  • Oncology
  • Genetics
  • Cancer Research

Cite this

Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series. / Sengal, Asmerom Tesfamariam; Haj-Mukhtar, Nada Suliman; Elhaj, Ahmed Mohammed; Bedri, Shahinaz; Kantelhardt, Eva Johanna; Mohamedani, Ahmed A.

In: BMC Cancer, Vol. 17, No. 1, 804, 01.12.2017.

Research output: Contribution to journalArticle

Sengal, Asmerom Tesfamariam ; Haj-Mukhtar, Nada Suliman ; Elhaj, Ahmed Mohammed ; Bedri, Shahinaz ; Kantelhardt, Eva Johanna ; Mohamedani, Ahmed A. / Immunohistochemistry defined subtypes of breast cancer in 678 Sudanese and Eritrean women; hospitals based case series. In: BMC Cancer. 2017 ; Vol. 17, No. 1.
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KW - Breast cancer subtype

KW - Eritrea and Africa

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