BackgroundThis study aimed to estimate the rate of HER-2/neu (c-erbB2) immunohistochemical overexpression in different histological types of breast cancer found in the middle Euphrates region of Iraq, a region that was exposed to high levels of depleted uranium. HER-2/neu (c-erbB2) overexpression was correlated with common clinicopathological parameters such as age, grade, stage, tumor size and lymph node involvement to determine if any particular biomarker for exposure to depleted uranium could be found in the tumor samples from this region.Materials and MethodsThe present investigation was performed over a period starting from September 2007 to June 2008. Formalin-fixed, paraffin-embedded blocks from 90 patients with breast cancer were included in this study. A group of 25 patients with benign breast lesions (fibroadenoma) was included as a comparative group, and 20 breast tissue sections were used as controls. Labeled streptavidin-biotin (LSAB) complex method was employed for immunohistochemical detection of HER-2/neu.ResultsHER-2/neu immuno-expression was positive in 67.8% of breast cancer, while it was negative in all benign breast lesions (fibroadenoma) (P < 0.05). HER-2/neu immunostaining was significantly associated with histological type and recurrence of breast cancer (P < 0.05). It was positively correlated with tumor grade, but this finding was not significant (P > 0.05).ConclusionBased upon the findings of this study, it can be concluded that HER-2/neu overexpression plays an important role in the pathogenesis of breast cancer and is associated with a worse prognosis. The findings indicate that in regions exposed to high levels of depleted uranium, HER-2/neu overexpression is high, but its correlation with age, grade, stage, tumor size, and lymph node involvement is similar to studies that have been conducted on populations not exposed to depleted uranium.

Introduction Cancer is one of the major causes of death worldwide. Health systems whether in developed or in developing countries like Iraq are burdened with different programs to control cancer. Our study is intended to provide information about cancer in the region of Middle Euphrates Area (MEA) of Iraq, which is one of the major areas in Iraq that exposed to the depleted Uranium (DU) at different time periods. Therefore, we are aiming to explore more information about the behavior of cancers in this region of Iraq (pattern and distribution). Aim: our study aims to describe the landscape of cancer with wide focus on the clinicopathological behavior of different types of cancers in MEA of Iraq to determine whether any differences have cropped up over time in Iraqi patients presentations. Patients and methods This study is a retrospective descriptive study design. Data were collected from a single tertiary cancer care oncology centre for three consecutive years from 2016 up to 2018. This Database covers nearly the entire Middle Euphrates area of Iraq. All statistical tests performed at a 95% level of significance with a two-sided p-value of 0.05 indicating statistical significance. Results and conclusion According to this study, the three most common cancers among the entire population were breast, lung, and brain cancers. Females constituted 57.0% of the entire study. Most cancers including breast cancer presented with aggressive clinicopathological behavior. Middle age groups of both sexes are more at risk of developing different cancers. Such findings are important and pave the way for future scientific cancer control programs in Iraq especially for breast cancer. The cancer appears to be flourishing in Iraq , which could be due to multiple factors. Finding a new strategy to predict the treatment response, recurrence or aggressiveness of cancers in Iraq is crucial.

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Breast cancer is a heterogeneous disease with a distinct profile of the expression of each tumor. Triple-negative breast cancer (TNBC) is a molecular subtype of breast cancer characterized by an aggressive clinical behavior linked to loss or reduced expression of estrogen, progesterone, and Her2/neu receptors. The study's main objective was to investigate the clinical significance of epidermal growth factor receptor (EGFR) overexpression in a series of Iraqi patients with TNBC. The sectional analytic study involved immunohistochemical analysis of EGFR expression in randomly selected 53 formalin fixed paraffin embedded tissue blocks of TNBC cases out of 127 Iraqi patients with TNBC and correlated expression data with clinicopathological parameters including survival time. Machine learning (statistical tests and principal component analysis (PCA)) was used to predict the outcome of the patients using EGFR expression data together with clinicopathological parameters. EGFR was expressed in approximately 28% of TNBC cases. We estimated the risk of mortality and distant metastasis based on EGFR expression and clinicopathologic factors using the principal component analysis (PCA) model. We found a substantial positive correlation between clinical stage and distant metastasis, clinical stage and death, death and distant metastasis, and death and positive EGFR expression. Overall, EGFR expression was linked to a poor prognosis and increased mortality. A higher risk of distant metastasis and death was associated with an advanced clinical stage of the tumor. Furthermore, the existence of distant metastases increased the risk of death. These findings raise the possibility of using EGFR expression data with other clinicopathological parameters to predict the outcome of patients with TNBC.

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