Breast Cancer In Africa Research Articles

Addressing trauma, post-traumatic stress disorder, and post-traumatic growth in breast cancer patients.

Breast cancer (BC) is a common cancer among females in Africa. Being infected with BC in Africa seems like a life sentence and brings devastating experiences to patients and households. As a result, BC is comorbid with trauma, post-traumatic stress disorder (PTSD), and post-traumatic growth (PTG). To identify empirical evidence from peer-reviewed articles on the comorbidity trajectories between BC and trauma, BC and PTSD, and BC and PTG. This review adhered to the PRISMA guidelines of conducting a systematic review. Literature searches of the National Library of Medicine, Scopus, PubMed, Google Scholar, and Scopus databases were conducted using search terms developed for the study. The search hint yielded 769 results, which were screened based on inclusion and exclusion criteria. At the end of the screening, 24 articles were included in the systematic review. BC patients suffered trauma and PTSD during the diagnosis and treatment stages. These traumatic events include painful experiences during and after diagnosis, psychological distress, depression, and cultural stigma against BC patients. PTSD occurrence among BC patients varies across African countries, as this review disclosed: 90% was reported in Kenya, 80% was reported in Zimbabwe, and 46% was reported in Nigeria. The severity of PTSD among BC patients in Africa was based on the test results communicated to the patients. Furthermore, this review revealed that BC patients experience PTG, which involves losing, regaining, and surrendering final control over the body, rebuilding a personified identity, and newfound appreciation for the body. Patients with BC undergo numerous traumatic experiences during their diagnosis and treatment. Psychological interventions are needed in SSA to mitigate trauma and PTSD, as well as promote PTG.

Breast cancer in Africa: an extensive surgical burden of paramount importance – letter to the editor

Breast cancer in Africa: an extensive surgical burden of paramount importance – letter to the editor

Demographic Pattern, Tumor Size and Stage of Breast Cancer in Africa: A Meta-analysis

Purpose: Understanding the epidemiology of breast cancer (BC) in Africa, as well as regional variation is essential for planning future intervention. Our objective was to describe summary estimates of socio-demographic and clinical characteristics of BC in Africa, thus providing researchers and policymakers baseline data for planning diagnostic and treatment programs to improve BC outcomes in the future.Method: We screened African publications on BC between 2010 and 2019 in PubMed, AJOL, Google, ScienceDirect, and ResearchGate to estimate the distribution of socio-demographic and clinical tumor characteristics. The meta-analysis used the random effect model. Result: Eighty articles were eligible, including 33,199 total patients. Overall, 58% of patients were <50 years old. In East Africa, 38% (95% CI 31-45) were diagnosed before 40 years. Conversely, in Southern Africa, 37% were diagnosed after 60 years, with Caucasian-like age distribution. The overall prevalence of male BC was high (3%), with East Africa having the highest prevalence (5% (95% CI 5.0-6.0)). Only 2% (95% CI 1-2) of patients were diagnosed with carcinoma-in-situ. Invasive tumors were 7% stage I, 26% stage II, 50% stage III, and 17% stage IV. Seventy per-cent (95% CI 60-80) had clinical nodal involvement. The smallest tumors were in North Africa. The largest and most advanced tumors were in West Africa. Trend analysis showed decreasing age, an increasing population of unmarried BC patients, a relatively high proportion of uneducated BC patients, and a stable proportion of late-stage disease in the last decade. Conclusion: Regional variation in the presentation of BC throughout Africa necessitates region/country-specific targets for improving BC control.

Systematic review of family studies of heritable breast cancer in Africa.

e22508 Background: The incidence of breast cancer (BC) in Africa (40.4 per 100,000) is 49% that of Europe and North America (81.9 per 100,000) but the mortality rate is 42% higher (19.4 versus 13.7 per 100,000). The high mortality is due to lack of screening. However, more targeted screening based on genomic risks are also missed because of stigmatization, poor family history, and limited information on BC susceptibility gene mutations. Internationally based family members are influencing cultural attitudes to BC in Africa leading to reduced stigmatization, increased better family history and uptake of genomic screening. Family-based studies of BC in Africa would provide useful information on prevalence of mutations that can inform genomic screening panels. We conducted systemic review of all family-based studies of BC in Africa to document state of the art, identify barriers and facilitators of this research method and methods of advancing the science. Methods: Using a comprehensive research strategy, we reviewed articles indexed in PubMed and African Journals Online (AJOL) to identify studies of familial BC in Africa. Specifically, we searched for family-based, study design papers on BC in each country in Africa using the following keywords: breast cancer, family-studies, hereditary, genetic, gene, mutations, and Africa. We excluded case-control, and registry studies, and clinical trials. We extracted relevant information from each study using standardized criteria: number of first- and second-degree relatives affected by BC, mutations, genetic variations, and polymorphisms. Results: A total of 12 out of 727 studies met our inclusion criteria. 80% of these studies were published after the year 2010. There were 9 publications from North Africa evaluating 191 families in total. One study reported novel breast cancer candidate genes: MMS19, DNAH3, POLK and KATB6 and nine publications investigated the mutation spectrum of BRCA genes. One publication from West Africa and one publication from Southern Africa included 1 and 219 families, respectively. All the studies done in these two regions reported targeted genomic screening for only BRCA genes. No study was done in Central and East Africa. Conclusions: There is paucity of family-based studies of breast cancer in Africa. Given the high level of heterogeneity in African genomes, these types of studies may be needed to identify high penetrance, germline mutations to better understand hereditary BC risk and ultimately develop a multigene panel testing to for diagnosis of heritable BC in this population.

BRCA1 point mutations in premenopausal breast cancer patients from Central Sudan.

Premenopausal breast cancer (BC) is one of the most common cancers of women in rural Africa and part of the disease load may be related to hereditary predisposition, including mutations in the BRCA1 gene. However, the BRCA1 mutations associated with BC in Africa are scarcely characterized. We report here 33 BRCA1 point mutations, among which 2 novel missense variants, found in 59 Central Sudanese premenopausal BC patients. The high fractions of mutations with intercontinental and uniquely African distribution (17/33, 51.5% and 14/33, 42.4%, respectively) are in agreement with the high genetic diversity expected in an African population. Overall 24/33 variants (72.7%) resulted neutral; 8/33 of unknown significance (24.3%, including the 2 novel missense mutations); 1 (3.0%) overtly deleterious. Notably, in silico studies predict that the novel C-terminal missense variant c.5090G>A (p.Cys1697Tyr) affects phosphopeptide recognition by the BRCA1 BRCT1 domain and may have a pathogenic impact. Genetic variation and frequency of unique or rare mutations of uncertain clinical relevance pose significant challenges to BRCA1 testing in Sudan, as it might happen in other low-resource rural African contexts.

Genomic Profiling of Breast Cancer (BC) in Mali by Oligonucleotide Comparative Genomic Hybridization (CGH) Array.

Abstract Background: Epidemiological studies suggest that BC in Africa exhibit specific biological characteristics as compared to BC from US/Europe. In order to identify therapeutic targets that would be specific from Africa, we analyzed 28 samples from Mali by high resolution CGH array, and compared gene gains/losses to the ones observed in USA [André F et al, Clin Cancer Res, 2009]Patients and methods: 71 paraffin-embedded samples of invasive BC from patients treated by surgery at Bamako were retrieved, 28 of them (from 2 pts stage 1; 13 pts stage 2; 11 pts stage 3 and 2 pts stage 4) were eligible for CGH array (1) (Agilent, 4*44K) (cancer cells>50%; undamaged DNA >1µg).Results were compared to 106 samples from MD Anderson, profiled in the sample genomic platform using the same array (1)Results: The median age was 49 year old. Twenty-one samples (75%) were ER-negative. No difference was observed regarding the frequency of gene gains in 17q12-21 (ERBB2) nor 8p11-12 (FGFR1). Six regions were more frequently gained in BC from Mali, as compared to those from US (FDR<5%). Two regions included targetable molecular abnormalities. 9p34 region was gained in 43% of samples and included Abl1, a tyrosine kinase involved in CML, and VAV2, a guanine exchange factor. 22q11-13.1 region was gained in 34% of samples and included bcr, ewsr1, pdgfb and MAF-E. These two regions were gained in less than 5% of BC from US. Finally, a region located in 6p21 was gained in 56% of BC from Mali. This region included a cluster of genes involved in immune response (lymphotoxin A, MICA/MICB).Conclusion: BC from Mali present some candidate specific targetable alterations as gains of Abl1, bcr and pdgf-B. FISH and IHC are being done in order to validate targets.Additional high throughput analyses will be performed to characterize such tumors, including virus arrays, exon arrays and hot spot mutations. Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 3059.