Der Edmund M, Gyasi Richard K, Tettey Yao, Edusei Lawrence, Bayor Marcel T, Jiagge Evelyn, Gyakobo Mawuli, Merajver Sofia D, Newman Lisa A
University of Ghana Medical School and Korle-Bu Teaching Hospital, Accra, Ghana.
Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
Breast J. 2015 Nov-Dec;21(6):627-33. doi: 10.1111/tbj.12527.
Breast cancers that have negative or extremely low expression of estrogen receptor and progesterone receptor and non-amplification of human epidermal growth factor receptor-2 (HER2)/neu are termed triple-negative breast cancer (TNBC). The majority of TNBC tumors belong to the biologically aggressive basal subtype, and they cannot be managed with targeted endocrine or anti-HER2/neu agents. In western, high resource environments, risk factors for TNBC include younger age at diagnosis and hereditary susceptibility. Women of African ancestry in the United States and in continental Africa have higher frequencies of TNBC, prompting speculation that this risk may have an inherited basis and may at least partially explain breast cancer survival disparities related to racial/ethnic identity. Efforts to document and confirm the breast cancer burden of continental Africa have been hampered by the limited availability of registry and immunohistochemistry resources. Our goal was to evaluate the breast cancers diagnosed in one of the largest health care facilities in western Africa, and to compare the frequencies as well as risk factors for TNBC versus non-TNBC in this large referral tertiary hospital. The Korle Bu Teaching Hospital is affiliated with the University of Ghana and is located in Accra, the capital of Ghana. We conducted an institutional, Department of Pathology-based review of the breast cancer cases seen at this facility for the 2010 calendar year, and for which histopathologic specimens were available. The overall study population of 223 breast cancer cases had a median age of 52.4 years, and most had palpable tumors larger than 5 cm in diameter. More than half were TNBC (130; 58.3%). We observed similar age-specific frequencies, distribution of stage at diagnosis and tumor grade among cases of TNBC compared to cases of non-TNBC. Ghanaian breast cancer patients tend to have an advanced stage distribution and relatively younger age at diagnosis compared to Caucasian Americans and African Americans. The triple-negative molecular marker pattern was the most common subtype of breast cancer seen among this sample of Ghanaian women, regardless of age, tumor grade, or stage of diagnosis. Research into the molecular pathogenesis of TNBC may help elucidate the reasons for its increased prevalence among women with African ancestry.
雌激素受体和孕激素受体呈阴性或极低表达且人表皮生长因子受体2（HER2）/neu无扩增的乳腺癌被称为三阴性乳腺癌（TNBC）。大多数TNBC肿瘤属于生物学侵袭性的基底亚型，无法使用靶向内分泌或抗HER2/neu药物进行治疗。在西方资源丰富的环境中，TNBC的风险因素包括诊断时年龄较小和遗传易感性。在美国和非洲大陆，非洲裔女性患TNBC的频率较高，这引发了一种推测，即这种风险可能有遗传基础，并且可能至少部分解释了与种族/族裔身份相关的乳腺癌生存差异。由于登记和免疫组织化学资源有限，记录和确认非洲大陆乳腺癌负担的努力受到了阻碍。我们的目标是评估在西非最大的医疗保健机构之一诊断出的乳腺癌，并比较这家大型转诊三级医院中TNBC与非TNBC的频率及风险因素。科勒布教学医院隶属于加纳大学，位于加纳首都阿克拉。我们对该机构在2010日历年所见的乳腺癌病例进行了基于病理学系的机构审查，且这些病例有组织病理学标本。223例乳腺癌病例的总体研究人群中位年龄为52.4岁，大多数可触及的肿瘤直径大于5厘米。超过一半是TNBC（130例；58.3%）。与非TNBC病例相比，我们观察到TNBC病例在特定年龄频率、诊断时分期分布和肿瘤分级方面相似。与美国白人和非裔美国人相比，加纳乳腺癌患者往往诊断时分期较晚且年龄相对较小。无论年龄、肿瘤分级或诊断阶段如何，三阴性分子标志物模式是在这群加纳女性样本中最常见的乳腺癌亚型。对TNBC分子发病机制的研究可能有助于阐明其在非洲裔女性中患病率增加的原因。
