Rambau Peter, Masalu Nestory, Jackson Kahima, Chalya Philipo, Serra Patrizia, Bravaccini Sara
Pathology Department, Catholic University of Health and Allied Sciences-Bugando, Box 1464, Mwanza, Tanzania.
BMC Res Notes. 2014 Jun 26;7:399. doi: 10.1186/1756-0500-7-399.
Breast cancer is the second leading cancer worldwide. In Tanzania, though it ranks as the second leading cancer in women after cervical cancer, hormonal receptor status is not carried out routinely in patients. Adjuvant hormonal therapy is given without prior knowledge of hormonal receptors status and patients can incur unnecessary costs and side effects. This study was performed to investigate the expression of hormonal receptors, epidermal growth factor receptors (HER-2) and proliferation index of the breast cancer by Ki-67 in a few selected patients with breast cancer at referral hospital in North-Western Tanzania. The study classified breast cancer subtypes based on hormonal receptors status and the expression of epidermal growth factor receptors.
A total of 52 cases of breast cancer were investigated. Patients' mean age at diagnosis was 49 years. The majority of the tumors was invasive ductal carcinoma 47 (90.4%) and 40 (76.9%) were of histological grade III. Thirty-eight (73.1%) of the patient had lymph node metastasis at the time of diagnosis and 36 (69.2%) were at clinical stage III. Only 3 (5.8%) patients were in clinical stage I. There was a tendency of a low level of expression of the receptors, whereby Estrogen Receptor (ER) positive tumors were 17 (32.7%), progesterone receptor (PR) positive tumors were 22 (42.3%), and HER-2 positive tumors were 12 (23.1%). Triple negative tumors constituted 20 (38.4%) of the patients. Most of the tumors (75%) showed high proliferation by Ki-67. Lymph node metastasis was more common in Triple Negative and HER enriched tumors.
This study showed a tendency for a low level of expression of hormonal receptors. There was a significant proportion of Triple Negative breast cancers. Routine testing for hormonal receptors in breast cancer is recommended before the initiation of adjuvant hormonal therapy.
乳腺癌是全球第二大常见癌症。在坦桑尼亚，尽管它是继宫颈癌之后女性中第二大常见癌症，但患者并未常规进行激素受体状态检测。辅助激素治疗在未事先了解激素受体状态的情况下进行，患者可能会产生不必要的费用和副作用。本研究旨在调查坦桑尼亚西北部转诊医院部分选定乳腺癌患者中激素受体、表皮生长因子受体（HER-2）的表达以及Ki-67检测的乳腺癌增殖指数。该研究根据激素受体状态和表皮生长因子受体的表达对乳腺癌亚型进行分类。
共调查了52例乳腺癌病例。患者诊断时的平均年龄为49岁。大多数肿瘤为浸润性导管癌47例（90.4%），40例（76.9%）为组织学III级。38例（73.1%）患者在诊断时发生淋巴结转移，36例（69.2%）处于临床III期。只有3例（5.8%）患者处于临床I期。受体表达水平有降低的趋势，其中雌激素受体（ER）阳性肿瘤为17例（32.7%），孕激素受体（PR）阳性肿瘤为22例（42.3%），HER-2阳性肿瘤为12例（23.1%）。三阴性肿瘤占患者的20例（38.4%）。大多数肿瘤（75%）通过Ki-67显示高增殖。淋巴结转移在三阴性和HER富集肿瘤中更为常见。
本研究显示激素受体表达水平有降低的趋势。三阴性乳腺癌占相当比例。建议在开始辅助激素治疗前对乳腺癌进行激素受体的常规检测。
