Evaluation of types and treatment protocols for breast cancer among Palestinian women: a retrospective study

Abstract

BackgroundBreast cancer is the leading cause of cancer deaths among females in Palestine. The aims of this study were to assess the histological types of breast cancer, the stage at diagnosis, and oestrogen receptor status of women with breast cancer in the West Bank. MethodsThis retrospective study was conducted in the two major outpatient oncology clinics of the West Bank (Al-Watani Governmental Hospital in Nablus and Beit Jala Governmental Hospital). The data collection form was completed by reviewing patients' medical records. SPSS was used for data analysis. The study was approved by the Institutional Review Board of An-Najah National University and the Palestinian Ministry of Health. FindingsThe study included 400 women with an average age of 52·16 years (SD 11·56); as the number of patients with breast cancer in the country was not known, a sample size calculator was input with an estimate of breast cancer cases, as given by six oncologists. Ductal carcinoma was the most common histological type (79%; 317 of 400), followed by lobular carcinoma (15%; 60). Patients were most commonly diagnosed at stage three (27%; 106), followed by stage two (25%; 100), stage four (24%; 95), and stage one (20%; 81). Most patients (88%; 353) were not tested for BRCA1 and BRCA2 gene mutations. Among the tested patients, 5% (21) had BRCA1 or BRCA2 gene mutation. Regarding oestrogen receptor status, 249 out of 386 women (65%) for whom data were available had a positive test, and the progesterone receptor test was positive for 225 out of 385 women (58%) for whom data were available. In terms of HER2 receptor overexpression, 306 out of 381 women (80%) for whom data were available had negative test results. InterpretationThe most common type of breast cancer among Palestinian women is invasive ductal carcinoma. Approximately half of the patients were diagnosed at stage three or four, indicating that better awareness and earlier diagnosis are needed. A high percentage of patients had positive oestrogen receptor and progesterone receptor status, which makes hormone therapy an important part of treatment. FundingNone.