Clinicopathologic Features of Breast Cancer in Egypt—Contemporary Profile and Future Needs: A Systematic Review and Meta-Analysis

Abstract

PURPOSE Breast cancer (BC) is the most common cancer among Egyptian females. No current national cancer database is available in Egypt to provide reliable data on the specific clinicopathologic features of BC in this population. Herein, we investigated the clinical profile of BC among Egyptian women. METHODS A systematic review of studies on BC published from inception until December 2021 was performed. We explored pooled estimated proportions of different stages of BC at presentation in Egypt and other clinicopathologic features including age, menopausal status, tumor (T) and lymph node (N) stages, and biological subtypes. Data analysis was performed using meta package (R). RESULTS Twenty-six studies were eligible for our systematic review and meta-analysis, including 31,172 BC cases. In 12 studies, including 15,067 patients with BC, the estimated mean age was 50.46 years (95% CI, 48.7 to 52.1; I2, 99%), with a pooled proportion of premenopausal/perimenopausal women of 57% (95% CI, 50 to 63; I2, 98%). Among 9,738 patients with BC, pooled proportions of stage I, II, III, and IV were 6% (95% CI, 4 to 8; I2, 90%), 37% (95% CI, 31 to 43; I2, 93%), 45% (95% CI, 42 to 49; I2, 78%), and 11% (95% CI, 9 to 15; I2, 87%), respectively. The pooled proportions of patients with T3 and T4 tumors were 21% (95% CI, 14 to 31; I2, 99%) and 8% (95% CI, 5 to 12; I2, 96%), respectively, while those with positive lymph nodes were 70% (95% CI, 59 to 79; I2, 99%). CONCLUSION Dominance of advanced stage and young age at diagnosis represented the two main features of BC among Egyptian women. Our data may serve to guide the policymakers in Egypt as well as other countries with lower resources to prioritize the diagnostic and therapeutic needs in this context.

BECN1 mRNA expression in breast cancer tissue; significant correlation to tumor grade

“…Median age at presentation was 49 with a quarter of patients (5) below 40 years of age and 6 patients between 40–49. The age of presentation in our study is in agreement with studies in Egyptian female cohorts as reported by Azim et al 2023 in their metanalysis. They reported that, the median age of presentation across studies was 50.4 years and about 20% were younger than 40 years (Azim et al 2023 ).…”

“…The age of presentation in our study is in agreement with studies in Egyptian female cohorts as reported by Azim et al 2023 in their metanalysis. They reported that, the median age of presentation across studies was 50.4 years and about 20% were younger than 40 years (Azim et al 2023 ). Screening and early detection for breast cancer remain the best strategies to manage the disease.…”

“…Moreover, a striking finding in Azim et al metanalysis 2023 was the high frequency of young age of presentation in Egypt which alone is a bad prognostic factor. (Azim et al 2023 ) While late diagnosis can be overcome by intense screening programs and raising awareness, the young age of presentation warrants further investigation of the disease behavior, genetic analysis, environmental studies as well as revisiting and evaluation of screening strategies.…”

The association of FSCN1 (rs852479, rs1640233) and HOTAIR (rs920778) polymorphisms with the risk of breast cancer in Egyptian women

“…In Egypt, more than 22,000 new cases of cancer are diagnosed each year, making it the main cause of cancer-related mortality among Egyptian women [ 5 ]. The ratio of mortality/incidence rate of BC cases in Egypt was approximately double the ratio (41%) when compared with developed countries (23%) [ 6 ]. Many variables are associated with the risk of BC, including age, environmental, gynecological, and genetic factors [ 7 ].…”

Phenotypic Analysis of Circulating Myeloid Derived Suppressor Cells and Their Subpopulations in Egyptian Females with Breast Cancer: A Single-Centre Case-Control Study

“…Remarkably, more than half of BC diagnoses and two-thirds of BC related deaths were reported in low- and middle-income countries in 2020 [ 2 ]. In Egypt, BC accounts for 38.8% of cancers in females, with the estimated number of BC cases nearly 22,700 in 2020 and is forecasted to rise exponentially over time [ 3 ]. Several factors contribute to BC heterogenicity including variations in genomic, epigenomic, transcriptomic, and proteomic characteristics of malignant cells.…”