Breast Cancer Research and Treatment

, Volume 135, Issue 1, pp 59–66 | Cite as

Invasive breast carcinomas in Ghana: high frequency of high grade, basal-like histology and high EZH2 expression

  • Judy Pang
  • Kathy A. Toy
  • Ken A. Griffith
  • Baffour Awuah
  • Solomon Quayson
  • Lisa A. Newman
  • Celina G. Kleer
Preclinical Study


Breast cancer in African-American women has a worse outcome than in Caucasian women. The ancestors of most African-American women come from West Africa, including Ghana. The Polycomb group protein EZH2 is a marker of poor outcome in breast cancers from Caucasian women. The histopathological features and biomarker expression of African breast cancers remain obscure. Here, we investigated a cohort of Ghanaian breast cancers to better define the prevalent tumor types and to test if EZH2 protein may identify aggressive tumors. A group of 169 breast tissues (100 invasive carcinomas and 69 benign) from women treated at Komfo Anoyke Teaching Hospital between 2006 and 2011 were histologically classified and investigated for EZH2 expression. EZH2 nuclear expression we defined as high or low following previously published criteria. Of the 100 invasive carcinomas, 89 % were ductal, 2 % were lobular, and 9 % were metaplastic. Basal-like pathological features were present in 30 % of the tumors. Of the invasive carcinomas, 7 % were grade 1, 41 % grade 2, and 52 % grade 3. EZH2 protein was overexpressed in invasive carcinomas compared to benign breast (p < 0.0001). In invasive carcinomas nuclear EZH2 overexpression was significantly associated with basal-like subtype (p = 0.03) and high histologic grade (p < 0.05). Cytoplasmic EZH2, which has not been previously reported, was present in 16 % of invasive carcinomas and it was associated with triple negative status (p = 0.02). Our results provide the first comprehensive histopathological study of this patient population and uncover the association of EZH2 with high grade and basal-like tumors. We provide the basis for further detailed investigations on this cohort to advance diagnosis and treatment of African and African-American women.


African-American Breast cancer EZH2 Enhancer of zeste 2 Triple negative Basal like Health disparity 


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Copyright information

© Springer Science+Business Media, LLC. 2012

Authors and Affiliations

  • Judy Pang
    • 1
  • Kathy A. Toy
    • 1
  • Ken A. Griffith
    • 2
    • 3
  • Baffour Awuah
    • 5
  • Solomon Quayson
    • 6
  • Lisa A. Newman
    • 2
    • 4
  • Celina G. Kleer
    • 1
    • 2
  1. 1.Department of PathologyUniversity of Michigan Medical School, 4217 Comprehensive Cancer CenterAnn ArborUSA
  2. 2.Comprehensive Cancer CenterUniversity of Michigan Medical SchoolAnn ArborUSA
  3. 3.Department of BiostatisticsUniversity of Michigan Medical SchoolAnn ArborUSA
  4. 4.Department of SurgeryUniversity of Michigan Medical SchoolAnn ArborUSA
  5. 5.Department of Radiation OncologyKomfo Anoyke Teaching Hospital (KATH)KumasiGhana
  6. 6.Department of PathologyKomfo Anoyke Teaching Hospital (KATH)KumasiGhana

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