Inflammatory breast cancer in North Africa: Comparison of clinical and molecular epidemiologic characteristics of patients from Egypt, Tunisia, and Morocco

Abstract

Understanding molecular characteristics that distinguish inflammatory breast cancer (IBC) from non-IBC is crucial for elucidating breast cancer etiology and management. We included 3 sets of patients from Egypt (48 IBC and 64 non-IBC), Tunisia (24 IBC and 40 non-IBC), and Morocco (42 IBC and 41 non-IBC). Egyptian IBC patients had the highest combined erythema, edema, peau d'orange, and metastasis among the 3 IBC groups. Egyptian IBC tumors had the highest RhoC expression than Tunisians and Moroccan IBCs (87% vs. 50%, vs. 38.1, for the 3 countries, respectively). Tumor emboli were more frequent in Egyptian IBC than non-IBC (Mean ±SD: 14.1 ± 14.0 vs. 7.0 ± 12.9, respectively) (P < 0.001) and Tunisians (Mean ± SD: 3.4 ± 2.5 vs. 1.9 ± 2.0, respectively) (P < 0.01). There was no difference of emboli in Moroccan tumors (1.7 ± 1.2 vs. 1.8 ± 1.2 for IBC and non-IBC, respectively (P = 0.66). This study illustrates that RhoC overexpression and tumor emboli are more frequent in IBC relative to non-IBC from Egypt and Tunisia. Tumors of Moroccans were significantly different from Egyptian and Tunisian tumors for RhoC expression and emboli. Future studies should focus on relating epidemiologic factors and clinical pictures to molecular features of IBC in these and other populations.

Outcome of inflammatory breast cancer in Moroccan patients: clinical, molecular and pathological characteristics of 219 cases from the National Oncology Institute (INO)

“…In a French study, we note that IBC patients are less obese, and only 21% of patients presented high BMI [ 12 ]. Furthermore, results from a comparative study between North-African series show no significant difference in BMI between IBC and non-IBC patients, but the authors still insist on the need for further studies because of the increasing incidence of obesity among women in North Africa [ 27 ].…”

The tumor microenvironment and inflammatory breast cancer

“…Compared to the 2% incidence, IBC accounted for 7% (1936/27747) of mortality for all breast cancer, so the mortality rate of IBC was significantly higher than other types of breast cancer 9 . The incidence of IBC has a large geographical difference with a 2% incidence in China 10 , and a 6-10% incidence in the countries of North Africa, particularly in Morocco, Algeria, Tunisia, and Egypt 11 . Robertson et al 12 reported that the five-year survival rate of the patients with IBC was less than 5% when treated with single surgical resection or chemotherapy.…”

Photodynamic therapy as an effective therapeutic approach in MAME models of inflammatory breast cancer

“…These symptoms along with blockage of lymphatic vasculature cause swelling of the breast, hence the name IBC. Epidemiologic studies have indicated that IBC is a heterogeneous disease [7, 8]. The expression of molecular markers in IBC differs depending on patient population; for example, Egyptian IBC patients have higher expression of RhoC GTPase than do patients from Tunisia, Morocco, and the USA [7, 8].…”

“…Epidemiologic studies have indicated that IBC is a heterogeneous disease [7, 8]. The expression of molecular markers in IBC differs depending on patient population; for example, Egyptian IBC patients have higher expression of RhoC GTPase than do patients from Tunisia, Morocco, and the USA [7, 8]. Conventional therapies (surgery, radiation, chemotherapy) alone or in combination are less effective against IBC than other breast cancers with the 3-year relative survival rate being only 42 % as compared to 85 % [1].…”