Abstract
Some studies have suggested that breast cancer in black women is more aggressive than in white women. This study's aim was to look for evidence of differences in tumour biology between the two cohorts. This study compared the stage, grade and pathological expression of five immunohistochemical markers (oestrogen receptor [ER], progesterone receptor [PR], ERBB2, P53 and cyclin D1 [CCND1]) in tumour biopsies from age-matched cohorts of patients from Nigeria and England. Sixty-eight suitable samples from Nigerian (n = 34) and British (n = 34) breast cancer patients were retrieved from histology tissue banks. There were significant differences between the two cohorts in the expression of ER and CCND1; and stark differences in the clinical stage at presentation. But no significant differences were observed for tumour grade. There was a significantly, low ER expression in the Nigerian cases which also predicts a poor response to hormonal therapy as well as a poorer prognosis. Differences in clinical stage at presentation will most likely influence prognosis between Nigerian and British women with breast cancer.
Highlights
There is significant worldwide variation in the incidence and mortality from breast cancer. (Key et al 2001) Studies carried out in the United States among white and black women have found that black women have a lower lifetime risk of breast cancer but have poorer survival rates following diagnosis. (Harris et al 1992; Elledge et al 1994) The same trends can be seen between Nigerian and English populations in the reported incidence of symptomatic breast cancer and subsequent five year survival. (Ihekwaba, 1992; Ihezue CH et al 1994; Quinn M and Allen E, 1995; Okobia and Osime, 2001)
Environmental and/or genetic factors could lead to differences in tumour biology; such differences may result in differential response to treatment
There were significant differences in hormone receptor levels. This will predict poorer response to hormonal therapy and overall poorer prognosis in the Nigerian patients compared to the British patients
Summary
There is significant worldwide variation in the incidence and mortality from breast cancer. (Key et al 2001) Studies carried out in the United States among white and black women have found that black women have a lower lifetime risk of breast cancer but have poorer survival rates following diagnosis. (Harris et al 1992; Elledge et al 1994) The same trends can be seen between Nigerian and English populations in the reported incidence of symptomatic breast cancer and subsequent five year survival. (Ihekwaba, 1992; Ihezue CH et al 1994; Quinn M and Allen E, 1995; Okobia and Osime, 2001)Many factors could explain differences in reported disease incidence and mortality. There is significant worldwide variation in the incidence and mortality from breast cancer. (Key et al 2001) Studies carried out in the United States among white and black women have found that black women have a lower lifetime risk of breast cancer but have poorer survival rates following diagnosis. (Harris et al 1992; Elledge et al 1994) The same trends can be seen between Nigerian and English populations in the reported incidence of symptomatic breast cancer and subsequent five year survival. Many factors could explain differences in reported disease incidence and mortality. In this study we have compared the tumour type, grade, disease stage and the expression of a panel of immunocytochemical markers in age-matched cohorts of breast cancer patients from Nigeria, a predominantly black population (over 99.9%) This study’s aim was to look for evidence of differences in tumour biology between the two cohorts
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