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Poor Hormone Receptor Expression in East African Breast Cancer: Evidence of a Biologically Different Disease?

  • Breast Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Few studies have examined breast cancer hormone receptor expression in Africans. We report on the hormone receptor profile of breast cancer in East Africans in the largest prospective study for this region.

Methods

Consecutive breast cancer presentations to a hospital in Kijabe (2001–2007) were included. Demographic, clinical, and test data were collected. ER/PR and Her2 testing was based on immunohistochemistry (IHC).

Results

There were 129 subjects (median 47 years), most had invasive ductal cancer and locally advanced disease and/or metastases. ER/PR testing was done in 120: 24% had ER-positive tumours, 34% were ER- and/or PR-positive, 10% were ER-negative but PR-positive tumours, and 66% were negative for ER and PR. ER/PR positivity was not associated with stage (P = 0.28) and was not related to age, parity, menopausal status, or node metastases. Increasing tumour grade was associated with PR expression (P = 0.02) with decreasing frequency of PR positive tumours as histological grade increased; there was weak evidence of an association between grade and ER expression (P = 0.06). Of cases tested, 26.5% overexpressed Her2.

Conclusions

Breast cancer in Kijabe is an advanced-stage disease, comprised mainly of poorly differentiated cancers that are less likely to be hormone sensitive (across all stages of disease). ER/PR testing of all those affected by breast cancer should be supported as a global priority in cancer control. International and inter-African research collaborations are needed to allow genetic detailing of tumours in indigenous Africans to assess possible racial heterogeneity in the biology of breast cancer.

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Acknowledgements

We acknowledge the generosity of individuals who provided donations to support hormone receptor testing of subjects in this study. We thank Professor Mark Pegram (University of Miami) for providing comments on an earlier draft of this paper and Ms Siew Chan (University of Sydney) for assistance with analyses. Dr Houssami is supported by National Health and Medical Research Council (NHMRC) program grant no. 402764 to the Screening & Test Evaluation Program.

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Authors and Affiliations

  1. Africa Inland Church (AIC) Kijabe Hospital, Kijabe, Kenya

    P. A. Bird MBBS, FRACS

  2. University of Auckland, Middlemore Hospital, Auckland, New Zealand

    A. G. Hill MD, FRACS

  3. Screening and Test Evaluation Program, School of Public Health, University of Sydney, Sydney, Australia

    N. Houssami FAFPHM, PhD

Authors
  1. P. A. Bird MBBS, FRACS
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  2. A. G. Hill MD, FRACS
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  3. N. Houssami FAFPHM, PhD
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Corresponding author

Correspondence to N. Houssami FAFPHM, PhD.

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Bird, P.A., Hill, A.G. & Houssami, N. Poor Hormone Receptor Expression in East African Breast Cancer: Evidence of a Biologically Different Disease?. Ann Surg Oncol 15, 1983–1988 (2008). https://doi.org/10.1245/s10434-008-9900-7

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  • DOI: https://doi.org/10.1245/s10434-008-9900-7

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