1. Table (1):Relation between lymph node and molecular subtypes.
- Clinicopathological features of breast cancer molecular subtypes in Egyptian women reside at Sharkia governorate. Rasha Haggag, Ahmad Zahran, Fouad Abou-Taleb Department of Medical Oncology, Faculty of Medicine, Zagazig University, Sharkia, Egypt
Purpose / Objective
Table (1):Relation between lymph node and molecular subtypes.
Figure (1): Cumulative TDP and lymph node metastasis.
Results
Breast cancer (BC) is the most common cancer among Egyptian women. It may be classified into four distinct molecular types based on immunohistochemical markers for estrogen, progesterone and HER-2/neu with different clinical behavior.
Lack of sufficient data on molecular subtypes of breast cancer in Egypt, prompted us to conduct this study in our locality.
A total of 130 female patients were included with median age of 50 years, with premenopausal of 56.9% and postmenopausal of 43.1%. Luminal A subtype was the most predominant (46.9%), followed by Luminal B (21.5%), then triple negative subtype (19.2%) and HER2/neu subtype (12.3%). The commonest histologic type was infiltrating duct carcinoma (88.5%), followed by infiltrating lobular carcinoma (6.2%) and mixed type (5.4%).
Stage III and VI constituted 59% of the cases at presentation. The subtypes had no significant difference under different menopausal status. However, in the age-specific groups, the age group of > 50 years was more likely to get Luminal A (60%) which also constituted 37.3% of age group ≤ 50 years (p =0.07).
Among the molecular subtypes, significant difference was found in the incidence of lymph node (LN) metastasis ≥1 positive LN (P=0.04). Patients with the Luminal B subtype more frequently had LN metastases than other subtypes. In contrast, the least lymph node metastases were in the HER2/neu subtype patients. Distant metastasis was more in Luminal B subtype and absent in HER2/neu subtype (p =0.05). Cumulative 6 month time to disease-progression was significantly better for LN negative as compared with LN positive (p = 0.03) .
Patients and methods
To identify the clinicopathological features and their association with BC molecular subtypes, we included all breast cancer patients presented from June 2012 to June 2013 to three cancer centers at Sharkia governorate, Egypt.
According to the biomarkers, patients were categorized into four subtypes: luminal A (ER+ and/or PR+, Her-2-), luminal B (ER+ and/or PR+, Her-2+), triple negative (ER- and/or PR-, Her-2-), and HER2/neu (ER- and/or PR-, Her-2+).
Relationship between the subtypes and clinicopathologic features was determined.
Conclusions
The majority of our patients at the time of diagnosis had more lymph node metastasis, advanced stages, and younger age. So, more efficient screening programs for breast cancer are needed, and more prospective studies are suggested to evaluate prognosis of different subtypes in Egyptian patients
LN negative
LN positive p
Luminal A
21(55.3%)
40(43.5%)
0.04
Luminal B
(10.5%)4
(26.1%)24
Triple –ve
(13.2%)5
(21.7%)20
Her2 rich
(21.1%)8
(8.7 % ) 8
Total
38 (100%)
92 (100%)