Elidrissi Errahhali Manal, Elidrissi Errahhali Mounia, Ouarzane Meryem, El Harroudi Tijani, Afqir Said, Bellaoui Mohammed
Medical Biology Unit, Faculty of Medicine and Pharmacy of Oujda, University Mohammed the First, Oujda, Morocco.
Hassan II Regional Oncology Center, Oujda, Morocco.
BMC Womens Health. 2017 Jan 9;17(1):3. doi: 10.1186/s12905-016-0361-z.
Breast cancer is the most frequent malignancy among women in Eastern Morocco. In this paper, we provide the first report on molecular breast cancer subtypes in this region. This is the largest population-based study on breast cancer among Moroccan women.
We analyzed 2260 breast cancer cases diagnosed at the Hassan II Regional Oncology Center between October 2005 and December 2012. Clinico-pathological and therapeutic features were studied. Molecular subtypes were determined and their associations with the clinico-pathological characteristics of the tumors were examined.
The mean age at diagnosis was 48.7 years ±11.4. Invasive ductal carcinoma was the predominant histological type (77.1%), followed by lobular invasive carcinoma (15.3%). The mean size of breast tumors was 3.5 cm ± 1.96, and 84% of our patients are diagnosed with tumors of more than 2 cm. Histological grade II tumors were the most frequent (70.4%), followed by advanced histological grade (18%). Lymph node positive tumors were observed in 64.8% of cases and 29.3% of patients had distant metastasis. Most tumors were hormone receptor-positive (73%) and 28.6% were HER2 positive. 86.1% of patients with hormone receptor-positive breast cancer were given hormone therapy, while 68.9% of patients with HER2+ breast cancer received targeted therapy with Herceptin. Luminal A was the commonest molecular subtype, followed by Luminal B, Triple Negative and HER2. The highest prevalence of premenopausal patients was observed in Triple Negative subtype (72.2%), followed by HER2 (64.1%), Luminal B (62.2%), and Luminal A (55.1%). Luminal B subtype had a poorer prognosis than Luminal A. Compared with Triple Negative, HER2 subtype tend to spread more aggressively and is associated with poorer prognosis.
Unlike Western countries, breast cancer occurs at an earlier age and is diagnosed at a more advanced stage in Eastern Morocco. In this region, hormone receptor-positive tumors are predominant and so the majority of breast cancer patients should benefit from hormone therapy. HER2 subtype presents an aggressive tendency, suggesting the importance of anti-HER2 therapy. This study will contribute in developing appropriate screening and cancer management strategies in Eastern Morocco.
乳腺癌是摩洛哥东部女性中最常见的恶性肿瘤。在本文中，我们提供了该地区分子乳腺癌亚型的首份报告。这是摩洛哥女性中基于人群的最大规模乳腺癌研究。
我们分析了2005年10月至2012年12月期间在哈桑二世地区肿瘤中心诊断的2260例乳腺癌病例。研究了临床病理和治疗特征。确定了分子亚型，并检查了它们与肿瘤临床病理特征的关联。
诊断时的平均年龄为48.7岁±11.4岁。浸润性导管癌是主要的组织学类型（77.1%），其次是小叶浸润癌（15.3%）。乳腺肿瘤的平均大小为3.5厘米±1.96厘米，84%的患者被诊断为肿瘤大于2厘米。组织学II级肿瘤最为常见（70.4%），其次是高级别组织学肿瘤（18%）。64.8%的病例观察到淋巴结阳性肿瘤，29.3%的患者有远处转移。大多数肿瘤为激素受体阳性（73%），28.6%为HER2阳性。86.1%的激素受体阳性乳腺癌患者接受了激素治疗，而68.9%的HER2+乳腺癌患者接受了赫赛汀靶向治疗。管腔A型是最常见的分子亚型，其次是管腔B型、三阴性和HER2型。绝经前患者在三阴性亚型中患病率最高（72.2%），其次是HER2型（64.1%）、管腔B型（62.2%）和管腔A型（55.1%）。管腔B型亚型的预后比管腔A型差。与三阴性相比，HER2亚型往往更具侵袭性扩散，且预后较差。
与西方国家不同，摩洛哥东部乳腺癌发病年龄较早，诊断时分期较晚。在该地区，激素受体阳性肿瘤占主导，因此大多数乳腺癌患者应从激素治疗中获益。HER2亚型呈现侵袭性倾向，提示抗HER2治疗的重要性。本研究将有助于制定摩洛哥东部合适的筛查和癌症管理策略。
