Biological and Clinicopathological Characteristics of Breast Cancer at Tikur Anbessa Specialized Hospital, Addis Ababa, Ethiopia

Abstract

Breast cancer (BC) is one of the most heterogeneous types of cancer and is characterized by several molecular subtypes. Descriptive cross-sectional study was conducted on 137 confirmed BC cases at Tikur Anbessa Specialized Hospital (TASH) in Ethiopia from December 2015 to November 2016 to assess the biological and clinicopathological characteristics of BC in Ethiopian women patients. Socio-demographic characteristics of the study subjects was obtained with pretested structured interview and clinical data was collected from the Hospital records. Surgical specimens were analysed histopathologically with hematoxyline and eosin staining, and Immunohistochemistry analysis was conducted with specific antibodies to ER, PR and HER2. The mean and median age of the study participants were 47 and 46.7, respectively. More than 50% of the patients were categorized in the age group of 15-40. Sixty percent were in the age group of 41-100. Infiltrating ductal carcinoma was the most common type of BC (70%) in this study, followed by lobular carcinoma (8.5%). Almost all of the BC cases under study were at advanced stage of the disease: 48.5% were with stage III and 51% were grade II tumors. Half of the study participants belonged to T2 tumor size (2-5 cm) and 52.3% of the patients had axillary lymph node metastases. Sixty five percent were ER+, 58% were PR+ and 28% were HER2+. Luminal A was the most common tumor subtype (54%), followed by luminal B (22%) and TNBC (18%). Based on crude analysis, patients with family history of BC had a lesser likelihood of being ER+ as compared to those patients with no family history of BC [COR=0.10 (95% CI: 0.028, 0.34)]. None of the other risk factors were correlated with the prevalence of ER+ results. In conclusion, the age distribution of BC cases in this study suggests the need to create awareness and improvement of advanced diagnostic services and make available screening programs for younger people. In a resource poor setting like Ethiopia, the use of anti-estrogens (like tamoxifen) in treatment of BC cases with undetermined receptor status could be helpful as most BC cases are ER+ and hormonal therapy is relatively easily available.

Breast Cancer in Women: Epidemiological, Histological, Immunohistochemical and Molecular Sub-Types in the Republic of Congo

“…The sampling strategy was to obtain a number of cases necessary for statistical significance of the results. The size of our sample of 150 cases is closer to several studies [9,10,19,20] and significantly superior to other studies [21,22] .…”

Early onset, delayed diagnosis and laterality of breast carcinoma: Evidence from a tertiary care hospital

“…This was in line with the study conducted by Hadgu et al 11 at Tikur Anbessa Specialized Hospital (TASH) on 114 breast cancer patients (mean age = 43 years and median age = 40 years). Another study done by Shenkutie et al 15 at TASH on 137 breast cancer cases (mean age = 47 years and median age = 46.7 years) was also in line with the current findings. Similar studies from Libya and Rwanda research groups were also reported that median age of 45 and 49 years, respectively, which were not considerably far away from this study.…”

“…These study findings were comparable with study done at TASH that 45% of cases had tumor size (T2 = 47.5%) greater than 2 cm and less than 5 cm; 51% had grade II and 35.4% grade III tumors. 15 Another previous study in Ethiopia by Gemta et al 23 reported that 47.2% of case had tumor size (T2) and 17.3% and 46.2% of cases present with grade I and grade II tumors, respectively. In this study, only 2.5% of patients had tumor size (T3) greater than 5 cm.…”

“…These findings were considerably comparable with other studies conducted in Ethiopia at TASH (axillary lymph node involvement = 52.3%), at other three Hospitals in Addis Ababa (left breast = 46.2%, right breast = 53.8%) and (upper outer quadrant = 78.2%, central = 6.1%). 15 , 23 …”

Genetic Mutations Associated with Hormone-Positive Breast Cancer in Ethiopian Women

“…Additionally, data from this population shows that patients with a family history were more likely to be ER-than patients without a family history (19), suggesting that many of these patients’ cancers are due to somatic mutations. We also searched for mutations in genes related to breast cancer aggression, subtype, and progression.…”