Characterization of hormonal receptors and human epidermal growth factor receptor-2 in tissues of women with breast cancer at Muhimbili National Hospital, Dar es salaam, Tanzania

Abstract

BackgroundBreast cancer is a leading cause of morbidity and deaths among women worldwide. In Tanzania there is no published data on human epidermal growth receptor-2 (HER2/neu) expression in breast carcinoma. Hormonal receptors and HER2/neu status reportedly influence post-mastectomy adjuvant therapy and predict treatment outcome and prognosis. Here we evaluate hormonal receptors and HER-2 status in biopsies of women with breast cancer at Muhimbili National Hospital (MNH).MethodsA cross-sectional study of female breast post-modified radical mastectomy (MRM)/incisional biopsies confirmed to be carcinoma at the Histopathology Unit (January–December 2013). Tissue blocks having poor morphology, without tumor, secondary tumors, cases outside the study period and male patients were excluded. Routine staining was done followed by immunohistochemistry for estrogen (ER), and progesterone (PgR) receptors and HER2. Data analyzed using Statistical Package for Social Sciences (SPSS).ResultsA total of 218 cases were confirmed to be carcinoma including 70 meeting inclusion criteria. Age at diagnosis ranged 18–75 years and mean age was 48.36 years. Majority (64.3%) were in the 36–55 years age-group. Histologically, most (88.6%) women had invasive ductal carcinoma including 43.1% of intermediate grade. A great majority (78%) were stage three. Due to logistical constrains, 75.7% (n = 53/70) cases where immunostained for hormones including 43.4% (ER+), 26.4% (PgR+), and 28% (ER+/PgR+). Furthermore, 65.7% (n = 46/70) cases were immunostained for HER-2 and 15.2% (n = 7/46) were positive, 45.6% were triple negative (ER-,PgR-,HER2-), 23.9% (ER+,PgR+,HER2-) or luminal B, 2.2% (ER+,PgR-,HER2+),13% (ER-,PgR-,HER2+) and 15% (ER+,PgR-,HER2-) with none being triple positive.ConclusionsHormonal receptors and HER2 expression at MNH appears to be comparable to previous Africans/African Americans reports but not with studies among Caucasians and the current proportion of triple negative breast carcinomas (TNBC) is higher than in a previous Tanzanian report and majority are luminal. HER2 over-expression is relatively common. It is strongly recommended that receptor status assessment be made routine for breast cancer patients at MNH.

Breast Cancer in Togolese Women: Immunohistochemistry Subtypes

“…This result is in agreement with the literature data which reported 15-20% of HER2 positive in invasive breast cancer [32]. Our result is similar to the nding reported in Tanzania [15] and Ivory Coast [23] but is different from the rate found in Ghanaian women [ 16,24].…”

“…had positive lymph nodes and the majority had T3 or T4 tumors stage. These unfavorable clinicopathological characteristics such as high grade, large tumors size, axillary lymph node involvement and advanced stage are the same as those reported in several studies [14,15,17,21,26,27]. The advanced stage of diagnosis in our patients could be explained by the delay of consultation, the absence of national breast cancer screening program in the population, the poor health care facilities and the use of traditional medicine.…”

“…In this retrospective study, IHC was performed in only the third (37.5%) of breast cancers diagnosed from 2016 to 2020 because of the unavaibility and the high cost of receptor testing. As in our country, access to IHC remains limited in most countries of Sub-Saharan Africa [12][13][14][15].…”

Hormonal Receptors, Human Epidermal Growth Factor Receptor-2 and Triple Negative Immunohistochemical Typing of Women Breast Cancer in Kampala, Uganda.

“…In all the three studies, most of the patients were of young age and had advanced stage at the time of presentation. Hormonal receptors and HER-2 protein expression together with other biological characteristics among women with breast cancer are generally comparable to those of other indigenous Africans and majority of patients have TN breast cancer [12].…”

“…In the study that was done in West Africa it was found that, hormonal receptors negative and triple negative breast cancer (TNBC) were representing the majority of cases [9]. Three studies done in Tanzania by Mbonde et al [10] reported 33% and 18% of ER and PR expression, respectively, Rambau et al [11] reported 32.7%, 42.3%, 23.1% and 38.4% for ER, PR, HER2 and TNBC, respectively and Mwakigonja et al [12] also reported 43.4%, 26.4%, 28%, 15.2% and 45.6% for ER, PR, HER2 and TNBC, respectively of the patients were expressing the markers and therefore, they were expected to bene t from hormonal therapy. In all the three studies, most of the patients were of young age and had advanced stage at the time of presentation.…”