Clinicopathologic characteristics of early-onset breast cancer: a comparative analysis of cases from across Ghana

Abstract

Background Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among women younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC). Methods A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Reports of core or incision biopsy, Wide Local Excision or Mastectomy with or without axillary lymph node dissection specimen and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p < 0.05. Results A total of 2418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (< 40 years) and 54.29 (IQR: 16.86) in the LOBC group (≥ 40 years). Invasive carcinoma—No Special Type was the commonest tumour type with grade III tumours being the commonest in both categories of patients. Perineural invasion was the only statistically significant pathologic parameter with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67 > 20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80% vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC. Conclusion EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger study is recommended to identify the association between relevant pathological features and early onset breast cancer in Ghana. Again, further molecular and genetic studies to understand the molecular genetic drivers of the general poorer pathological features of EOBCs and its relation to patient outcome in our setting is needed.

Clinicopathological Features of Invasive Breast Cancer: A Five-Year Retrospective Study in Southern and South-Western Ethiopia

“…The mean age in this study was comparable with previous studies conducted in Ethiopia by Gemta et al (44 years), Kantelhardt et al (43 years), and Ersumo (44.77 years) [ 13 , 17 , 18 ]. Similar findings were also reported from other African counties with a mean age ranging from 45.8 to 48.7 years [ 19 , 20 , 21 , 22 , 23 ]. In contrast to these studies, the mean age of BC patients at diagnosis is higher in high-income countries [ 24 ].…”

“…[13,17,18]. Similar findings were also reported from other African counties with a mean age ranging from 45.8 to 48.7 years [19][20][21][22][23]. In contrast to these studies, the mean age of BC patients at diagnosis is higher in high-income countries [24].…”

Elevated Pre-Treatment Systemic Immuno-Inflammatory Indices, Triple-Negative Breast Cancer, and p53 Mutation are Associated with Early-Onset Breast Cancer in Southern Nigeria

“…Additionally, the frequency of TNBC and Luminal A were higher among patients with early-onset BC compared with late-onset BC. This agrees with the findings of Akakpo et al [24] in Ghana. In this study, the highest frequency of obesity was found among patients with Luminal A breast cancer (85.7%).…”

“…The frequency of TNBC recorded in this study (34.2%) is higher than the frequency of 24.7% and 27% reported by Akakpo et al . [24] and Huo et al . [25] in Ghana and African women, respectively but lower than the frequency (82%) reported by Stark et al .…”

“…This agrees with the findings of Akakpo et al . [24] in Ghana. In this study, the highest frequency of obesity was found among patients with Luminal A breast cancer (85.7%).…”