Association between epidemiological and clinico-pathological features of breast cancer with prognosis, family history, Ki-67 proliferation index and survival in Tunisian breast cancer patients

Abstract

Breast cancer has different epidemio-clinical characteristics in Middle East and North-African populations compared to those reported in the Western countries. The aim of this study is to analyze the epidemiological and clinico-pathological features of breast cancer in Tunisia and to determine prognostic factors with special interest to family history, Ki-67 proliferation index and comorbidity. We retrospectively reviewed epidemiological and clinico-pathological data from patients’ medical records, treated in the Medical Oncology Department at Abderrahmane Mami Hospital, in the period 2011–2015. Data has been collected on 602 breast cancer patients and analyzed using SPSS software V.23.0. Our study showed high fractions of young breast cancer patients and cases with dense breasts. The most prevalent comorbidities observed in the studied cohort were cardiovascular diseases and diabetes. Familial breast cancer was found in 23.3% of cases and was associated with younger age at diagnosis (p<0.001) and advanced stage (p = 0.015). Ki-67 index >20% was significantly associated with early age at diagnosis, lymph node involvement (p = 0.002), advanced tumor grade (p<0.001) and high risk of relapse (p = 0.007). Ki-67 cut-off 30% predicted survival in luminal cases. Survival was worse in patients with triple negative breast cancer compared to non-triple negative breast cancer, inflammatory breast cancer compared to non-inflammatory breast cancer, moderately to poorly differentiated tumors compared to well-differentiated tumors and with positive lymph nodes compared to pN0 (p<0.05). Our study showed new insights into epidemiological and clinico-pathological characteristics of breast cancer that are not well explored in Tunisian population. Considering our findings along with the implementation of electronic health record system may improve patient health care quality and disease management.

Clinical characteristics of breast cancer patients admitted to academic surgical wards in Tehran, Iran: an analytical cross-sectional study

“…In consistence with our results, many studies reported that the left breast is at greater risk of developing cancer and the UOQ is the most common location of breast cancer [ 20 – 22 ]. It might be important to pay attention to the area of primary involvement because some evidence showed that the survival of BC patients with UOQ involvement is significantly better than tumors located elsewhere in the breast [ 23 – 25 ].…”

“…The most common subtype of BC in the present study was Luminal B, followed by Luminal A, TNBC, and Her2-enriched. The frequency of molecular subtypes in our study followed the same order as those of Mighri et al [ 22 ], Al Tamimi et al [ 26 ], and Caldarella et al [ 27 ]. However, these results are inconsistent with some previous studies conducted in Algeria, Egypt, Japan, and the USA [ 28 – 31 ].…”

Pathologically confirmed women's breast cancer: A descriptive study of Tunisian and Algerian series

“…In this study, triple negative BCs were found in 10.5% in the Tunisian series. Previous Tunisian studies reported variable triple negative BCs' frequencies: 22.5%, 20 15.5%, 42 and 14% 47 . In the Algerian series of this study, the rate of triple negative BCs was 13.7%, similar to the Tunisian one, but lower than that described in another Algerian series (20.8%) 39 .…”

An angiogenesis-related lncRNA signature predicts the immune microenvironment and prognosis of breast cancer

“…Moreover, higher expression of OTUD6B−AS1 was observed in breast cancer tissues with larger tumor size (T stage) ( Figure 10B ), and high expression of OTUD6B−AS1 was positively related with advanced tumor stage ( Figure 10C and Table 1 ). OTUD6B−AS1 was upregulated to a greater extent in breast cancer tissues with high (≥ 30%) Ki-67 expression compared with those with low (< 30%) Ki-67 expression [ 17 , 18 ] ( Figure 10D ). Interestingly, OTUD6B−AS1 expression was also correlated with molecular subtypes ( Table 1 ).…”