Department of Pathology, University of Cape Coast/Cape Coast Teaching Hospital, Cape Coast, Ghana.
ACT Pathology Consult, Pedu Estate, Cape Coast, Ghana.
BMC Womens Health. 2023 Jan 3;23(1):5. doi: 10.1186/s12905-022-02142-w.
Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among women younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC).
A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Reports of core or incision biopsy, Wide Local Excision or Mastectomy with or without axillary lymph node dissection specimen and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p < 0.05.
A total of 2418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (< 40 years) and 54.29 (IQR: 16.86) in the LOBC group (≥ 40 years). Invasive carcinoma-No Special Type was the commonest tumour type with grade III tumours being the commonest in both categories of patients. Perineural invasion was the only statistically significant pathologic parameter with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67 > 20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80% vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC.
EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger study is recommended to identify the association between relevant pathological features and early onset breast cancer in Ghana. Again, further molecular and genetic studies to understand the molecular genetic drivers of the general poorer pathological features of EOBCs and its relation to patient outcome in our setting is needed.
乳腺癌是全球最常见的癌症，也是 40 岁以下女性癌症相关死亡的第二大主要原因。本研究比较了加纳报告的早发性乳腺癌（EOBC）与晚发性乳腺癌（LOBC）的人口统计学、病理学和分子特征。
采用描述性、横断面设计，对 2019 年至 2021 年的回顾性组织病理学数据进行了目的性抽样。合并了核心或切开活检、广泛局部切除术或乳房切除术加或不加腋窝淋巴结清扫标本以及匹配的免疫组织化学报告，并在 SPSS v. 20.0 中进行了分析。使用频率和百分比的描述性统计数据来描述分类变量。在 95%置信区间内进行交叉表和卡方检验，置信度为 p<0.05 时具有统计学意义。
本研究共纳入 2418 例患者，其中 20.2%（488 例）为 EOBC，79.8%（1930 例）为 LOBC。EOBC 组的中位诊断年龄为 34.66（IQR：5.55）（<40 岁），LOBC 组为 54.29（IQR：16.86）（≥40 岁）。非特殊型浸润性癌是最常见的肿瘤类型，两种类型的患者中分级 III 肿瘤最常见。神经周围侵犯是唯一具有统计学意义的病理参数，与年龄有关。EOBC 与更高的 DCIS 成分（24.8% vs 21.6%）、更低的激素受体阳性状态（52.30% vs 55.70%）、更高的增殖指数（Ki-67>20：82.40% vs 80.30%）和更多的受累淋巴结（13.80% vs 9.00%）有关。三阴性乳腺癌（26.40% vs 24.30%）是 EOBC 最主要的分子亚型。
与 LOBC 相比，我们研究中的 EOBC 通常更具侵袭性，具有更差的预后组织病理学和分子特征。建议进行更大规模的研究，以确定加纳相关病理特征与早发性乳腺癌之间的关系。此外，还需要进一步的分子和遗传研究，以了解 EOBC 一般较差的病理特征的分子遗传驱动因素及其与我们研究中患者结局的关系。
