Descriptive analysis of molecular subtypes in <scp>T</scp>unisian breast cancer

Fourati, Asma; Boussen, Hamouda; May, Michèle Véronique El; Goucha, Aïda; Dabbabi, Bouthaina; Gamoudi, Amor; Sfar, Rachida; Rahal, Khaled; May, Ahmed El; Abdallah, M. Ben

doi:10.1111/ajco.12034

Cited by 32 publications

(25 citation statements)

References 29 publications

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“…However, molecular subtype differed significantly with regards to age at diagnosis. We found that the Triple Negative subtype was associated with a younger age at diagnosis compared with the other subtypes, similar to previous reports on different populations [13, 42, 63, 82, 83]. The molecular subtypes have also shown a very significant difference by menopause status.…”

Section: Discussionsupporting

confidence: 90%

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First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases

et al. 2017

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BackgroundBreast cancer is the most frequent malignancy among women in Eastern Morocco. In this paper, we provide the first report on molecular breast cancer subtypes in this region. This is the largest population–based study on breast cancer among Moroccan women.MethodsWe analyzed 2260 breast cancer cases diagnosed at the Hassan II Regional Oncology Center between October 2005 and December 2012. Clinico-pathological and therapeutic features were studied. Molecular subtypes were determined and their associations with the clinico-pathological characteristics of the tumors were examined.ResultsThe mean age at diagnosis was 48.7 years ±11.4. Invasive ductal carcinoma was the predominant histological type (77.1%), followed by lobular invasive carcinoma (15.3%). The mean size of breast tumors was 3.5 cm ± 1.96, and 84% of our patients are diagnosed with tumors of more than 2 cm. Histological grade II tumors were the most frequent (70.4%), followed by advanced histological grade (18%). Lymph node positive tumors were observed in 64.8% of cases and 29.3% of patients had distant metastasis. Most tumors were hormone receptor-positive (73%) and 28.6% were HER2 positive. 86.1% of patients with hormone receptor-positive breast cancer were given hormone therapy, while 68.9% of patients with HER2+ breast cancer received targeted therapy with Herceptin. Luminal A was the commonest molecular subtype, followed by Luminal B, Triple Negative and HER2. The highest prevalence of premenopausal patients was observed in Triple Negative subtype (72.2%), followed by HER2 (64.1%), Luminal B (62.2%), and Luminal A (55.1%). Luminal B subtype had a poorer prognosis than Luminal A. Compared with Triple Negative, HER2 subtype tend to spread more aggressively and is associated with poorer prognosis.ConclusionsUnlike Western countries, breast cancer occurs at an earlier age and is diagnosed at a more advanced stage in Eastern Morocco. In this region, hormone receptor-positive tumors are predominant and so the majority of breast cancer patients should benefit from hormone therapy. HER2 subtype presents an aggressive tendency, suggesting the importance of anti-HER2 therapy. This study will contribute in developing appropriate screening and cancer management strategies in Eastern Morocco.

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Section: Discussionsupporting

confidence: 90%

“…This result is similar to those reported in other North African countries, Saudi Arabia, but higher than the figure reported in Europe, the United States and most countries in Sub-Saharan Africa [13, 18, 28, 30, 60, 62, 63, 65, 72, 73]. Women whose breast cancers test positive for HER2 can be given targeted therapy.…”

Section: Discussionsupporting

confidence: 87%

First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases

et al. 2017

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“…These results disagree with others showing that younger breast cancer patients had a higher prevalence of luminal A and a lower prevalence of basal-like subtype compared with older patients (Tang et al, 2011;Farouk et al, 2016). However, our cohort molecular feature resemble to others who found that LB was the most common type among young women patients (Collins et al, 2012;Fourati et al, 2014). Data disagreement can be explained by differences in genetic backgrounds of populations studied, so comparable results are supported by population's consanguinity through different nations.…”

Section: Discussioncontrasting

confidence: 99%

Prognostic Value of BCL2 in Women Patients with Invasive Breast Cancer

Ayadi

Cherif

Hamed³

et al. 2018

Asian Pac J Cancer Prev

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Background: Breast cancers are heterogeneous, making it essential to recognize several biomarkers for cancer outcome predictions especially in young women where the classical prediction parameters are not suitable. The goal from this study is to evaluate the impact of B cell lymphoma 2 (BCL2), P53 and Ki-67 proteins expression on survival in young women patients with invasive ductal carcinoma. Patients and methods: Samples and clinical data from 238 patients were collected between 2003 and 2017. They were selected according to 2 criteria: age ≤40 years old and most of them are affected by an Invasive Ductal Carcinoma. We evaluated BCL2, P53 and ki-67 expression by immunochemistry test, and then we assessed correlations of these biomarkers expression with patient’s clinicopathological characteristics and survival. Results: Triple negative breast cancer group showed a high frequency among our cohort but we emphasize an almost equitable distribution among all molecular groups. Contrary to other studies which reported that luminal A was correlated with better prognosis, our analysis demonstrated that luminal A is correlated with the Scarff, Bloom and Richardson (SBR) grading 2 or SBR grading 3. To better investigate the prognosis, we analyze three biomarkers known by their impact on physiopathology behavior on breast cancer BCL2, ki-67and P53. BCL2 is the more relevant one, it was correlated with molecular subtypes (p=0.0012) and SBR grading (p=0.0016). BCL2 seems to be the good prognostic biomarker related to survival (p=0.004) with a protective role among patients when endocrine therapy is not provided and Lymph Node (LN) involvement is positive (p=0.021, p=0.000 respectively). Conclusions: The classical prognostic parameters based mainly on the molecular classification in breast cancer seem insufficient in the case of young women. BCL2 protein expression analysis provides a better prognostic value. BCL2 should be clinically associated in current practice when young women specimens are diagnosticated.

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“… 12 , 13 While luminal A is the most prevalent subtype in most regions, 12 it is worth noting that the frequency of triple negative tumors is high among certain communities, such as African American, 14 , 15 Omani, 16 and Tunisian. 17 In 2010, Tamimi et al 18 analyzed 5 immunohistochemistry markers (ER, PR, HER2, epidermal growth factor receptor [EGFR], and Chromosome [CK] 5/6) in 231 breast cancer cases located in the Eastern Province of Saudi Arabia. Their results showed that in our population there is a higher prevalence of HER2-positive and lower prevalence of luminal type tumors compared with western populations.…”

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confidence: 99%

Molecular subtypes of breast carcinoma in Saudi Arabia

Alnegheimish

Alshatwi

Alhefdhi

et al. 2016

SMJ

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Objectives:To determine the distribution of various molecular subtypes of breast cancer in Saudi Arabia and to assess the association between these subtypes and age at diagnosis, tumor size, histopathological type, grade, presence of carcinoma in-situ, and lymph node status.Methods:This observational retrospective study, between January 2010 and December 2014, was conducted at King Khalid University Hospital, Riyadh, Saudi Arabia. We classified 359 breast cancers into 4 molecular subtypes, using immunohistochemistry: luminal A (estrogen receptor [ER], or progesterone receptor [PR] positive and human epidermal growth factor receptor 2 [HER2] negative), luminal B (ER and/or PR positive and HER2 positive), HER2-positive (ER and PR negative and HER2 positive), and triple negative (ER, PR, and HER2 negative). We evaluated the relationship between these subtypes and clinicopathological features using Chi square test.Results:The most prevalent subtype was luminal A (58.5%), followed in descending order of frequency by triple negative (14.8%), luminal B (14.5%), and HER2-positive (12.3%). The average age at diagnosis was 49.8 years, and average tumor size at diagnosis was 3.19 cm.Conclusion:Luminal A tumor was the most common molecular subtype and HER2-positive was the least common. Most lobular carcinomas were luminal A tumors. Human epidermal growth factor receptor 2-positive and triple negative tumors had a higher histologic grade and a larger tumor size at diagnosis, and they were more common in women under 50 years. Carcinoma-in-situ was least common in triple negative tumors. We found no association between lymph node status and molecular subtypes.

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Descriptive analysis of molecular subtypes in Tunisian breast cancer

Cited by 32 publications

References 29 publications

First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases

First report on molecular breast cancer subtypes and their clinico-pathological characteristics in Eastern Morocco: series of 2260 cases

Prognostic Value of BCL2 in Women Patients with Invasive Breast Cancer

Molecular subtypes of breast carcinoma in Saudi Arabia

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