Breast Cancer in African Women
C Bewtra. Creighton University Medical Center, Omaha, NE
Background: The incidence of breast carcinoma is increasing in the African countries. It is presumed that the cancer is more aggressive and occurs in younger age, similar to that seen in the African –American (AA) women in US.
Design: I retrospectively studied twenty-one consecutive breast carcinoma specimens received in Komofo Anokye Teaching Hospital (KATH) in Kumasi, Ghana during a two-month period and compared the clinicopathological and immunohistochemical features with Caucasian (White) and African American (AA) women as described in the literature. Formalin fixed, paraffin embedded tumor tissue werestained by routine H&E and immunoperoxidase stains for ER, PR, HER-2, EGFR and CK 5/6 with appropriate controls.
Results: I found approximately 35.2% (24 out of 68) of the presenting palpable breast masses to be malignant. There is a preponderance of the usual ductal type (23 out of 24, 95.8%), mostly (90%) showing high grade (2 and 3). 55% of patients had axillary metastasis, 33% showed skin involvement and 16% had chest wall invasion. The mean tumor size was 4.6 cm and the mean age of patients was 42 years (median age 47.5 yrs). Immunohistochemical profiles of 8 cases showed majority (5 out of 8) with triple (ER, PR, HER-2) negative pattern, but did not show the usual basal phenotype. Basal cytokeratin 5/6 was negative in 7 out of 8 cases and both EGFR and HER-2 were negative in all cases.
Conclusions: In summary, the carcinomas in African women occurred in younger age, and were of higher grade and stage. Majority were triple negative, ductal type but not of typical luminal or basal cell types. These findings are different from the Caucasian Americans but somewhat similar to the African Americans and may have prognostic implications in the breast cancer patients of sub-Saharan Africa.
Tuesday, March 23, 2010 9:30 AM
Poster Session III # 34, Tuesday Morning