Kretzmann Hayden Gerald, Adeniyi Oladele Vincent
Division of General Surgery, Department of Surgery, Frere Hospital, East London, South Africa.
Faculty of Medicine & Health Sciences, Walter Sisulu University, East London, South Africa.
PLoS One. 2025 Jul 21;20(7):e0325387. doi: 10.1371/journal.pone.0325387. eCollection 2025.
Breast cancer (BC) is the most common cancer in women worldwide and the most frequent cause of cancer death in women in low- and middle-income countries (LMIC). The incidence of BC in Africa is on the rise, expected to double by 2050, primarily owing to late presentation and weak health infrastructure in sub-Saharan Africa (SSA). This study addresses the lack of recent data on BC cases in the Eastern Cape Province of South Africa.
The objectives of this study were to describe the clinicopathological characteristics and molecular subtypes of BC and, in addition, to examine the association between the clinicopathological characteristics and the molecular subtypes of BC in a single tertiary hospital in the Eastern Cape Province of South Africa.
A two-year (2022-2023) retrospective cross-sectional clinical record review study was conducted on patients treated for invasive BC at a tertiary hospital in the Eastern Cape Province, South Africa. The demographic, clinical and pathological characteristics and molecular subtypes were reported. Associations were investigated between the BC molecular subtypes identified and the clinicopathological characteristics of the patients.
A total of 282 patients met the study's inclusion criteria. Most patients were female (98.6%) and African (88.1%). The mean age of the patients was 58.7 years, with BC most prevalent in the age group >70 (25.2%) and postmenopausal (77.4%). Breast lump was the most common presenting complaint (98.6%), with 61% of patients presenting three months after noticing the anomaly. The most common tumour size (59.4%) was > 5 cm (mean = 6.37 ± 3.6), with the most common clinical T stage being T4 (50.4%). Lymph node involvement was seen in 50.4% of cases. Patients mostly presented in Stages III and IV of the disease (60.1%). Invasive ductal carcinoma not otherwise specified (NOS) was the most common histopathological subtype (86.2%). Grade 2 (56.2%) and Grade 3 (29.5%) BC accounted for the majority of cases. Luminal B was found in 47.4% of cases, Luminal A in 28.5%, triple negative breast cancer (TNBC) in 18.6% and human epidermal growth factor receptor 2 (HER2) enriched in 5.5% of cases, respectively.
In our setting, most patients consulted at a late stage of the disease with a large tumour size, positive lymph node status and a high histological grade. Luminal B tumours are the most common molecular subtype. These results indicate the need for more intensive breast cancer awareness campaigns, early detection, and timely referral and treatment.
乳腺癌（BC）是全球女性中最常见的癌症，也是低收入和中等收入国家（LMIC）女性癌症死亡的最常见原因。非洲的乳腺癌发病率正在上升，预计到2050年将翻一番，主要原因是撒哈拉以南非洲（SSA）地区就诊延迟和卫生基础设施薄弱。本研究旨在填补南非东开普省乳腺癌病例近期数据的空白。
本研究的目的是描述乳腺癌的临床病理特征和分子亚型，此外，在南非东开普省的一家三级医院中，研究乳腺癌的临床病理特征与分子亚型之间的关联。
对南非东开普省一家三级医院接受浸润性乳腺癌治疗的患者进行了为期两年（2022 - 2023年）的回顾性横断面临床记录审查研究。报告了患者的人口统计学、临床和病理特征以及分子亚型。研究了所确定的乳腺癌分子亚型与患者临床病理特征之间的关联。
共有282例患者符合研究纳入标准。大多数患者为女性（98.6%），非洲人（88.1%）。患者的平均年龄为58.7岁，乳腺癌在年龄>70岁组（25.2%）和绝经后（77.4%）最为普遍。乳房肿块是最常见的就诊主诉（98.6%），61%的患者在发现异常三个月后就诊。最常见的肿瘤大小（59.4%）>5 cm（平均 = 6.37±3.6），最常见的临床T分期为T4（50.4%）。50.4%的病例出现淋巴结受累。患者大多在疾病的III期和IV期就诊（60.1%）。未特指的浸润性导管癌（NOS）是最常见的组织病理学亚型（86.2%）。2级（56.2%）和3级（29.5%）乳腺癌占大多数病例。分别有47.4%的病例为管腔B型，28.5%为管腔A型，18.6%为三阴性乳腺癌（TNBC），5.5%为人类表皮生长因子受体2（HER2）富集型。
在我们的研究环境中，大多数患者在疾病晚期就诊，肿瘤体积大、淋巴结阳性且组织学分级高。管腔B型肿瘤是最常见的分子亚型。这些结果表明需要开展更密集的乳腺癌宣传活动、早期检测以及及时转诊和治疗。
