Introduction: The aim of the study was to describe the
immunohistochemical aspects of breast cancers at Douala General Hospital, Cameroon. Methodology: This was a descriptive study with retrospective data
collection, conducted from January 1st 2010 and December 31st 2019. It was focused on histologically proven breast cancers followed up at
Douala General Hospital. Results: We collected 285 cases of breast cancer, all
female, representing an annual frequency of 28.5 cases. The mean age of the
patients was 48±13 years. The most frequent histological form was infiltrating ductal
carcinoma (83.9%), with grade II predominating (38.6%). Immunohistochemical
analyses were performed on 89 patients (31.23%). The triple-negative subtype
was the most common class (35.95%), followed by Luminal A (32.60); Human
Epidermal Receptor 2-class and Luminal B tumors were observed at a frequency of
13.48% each. Treatment consisted mainly of surgery (78.60%) combined with
chemotherapy (65.97%) and/or radiotherapy (63.16%). Hormonal treatment was used
in only 10.18% of patients. Targeted therapy was exceptional (4%). Conclusion:
Triple-negative phenotype is the most common. However, potentially
hormone-sensitive tumors account for almost half of all patients, who are
relatively young. Individualized treatments are rare. It is important to
systematize these analyses for all breast cancers, with a view to appropriate
management in our environment.
References
[1]
Sung, H., Ferlay, J., Siegel, R.L., Laversanne, M., Soerjomataram, I., Jemal, A., et al. (2020) Global Cancer Statistics: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 71, 209-249. https://doi.org/10.3322/caac.21660
[2]
Sharma, R., Aashima, Nanda, M., Fronterre, C., Sewagudde, P., Ssentongo, A.E., et al. (2020) Mapping Cancer in Africa: A Comprehensive and Comparable Characterization of 34 Cancer Types Using Estimates from GLOBOCAN. Frontiers in Public Health, 10, Article ID: 839835. https://doi.org/10.3389/fpubh.2022.839835
[3]
Ferlay, J., Shin, H.R., Bray, F., Forman, D., Mathers, C. and Parkin, D.M. (2008) Estimates of Worldwide Burden of Cancer: GLOBOCAN 2008. International Journal of Cancer, 127, 2893-2917. https://doi.org/10.1002/ijc.25516
[4]
Bray, F., Ferlay, J., Soerjomataram, I., Siegel, R.L., Torre, L.A. and Jemal, A. (2018) Global Cancer Statistics: GLOBOCAN Estimates of Incidence and Mortality Worldwide for 36 Cancers in 185 Countries. CA: A Cancer Journal for Clinicians, 68, 394-424. https://doi.org/10.3322/caac.21492
[5]
Simpson, P.T., Reis-Filho, J.S., Gale, T. and Lakhani, S.R. (2005) Molecular Evolution of Breast Cancer. The Journal of Pathology, 205, 248-254.
https://doi.org/10.1002/path.1691
[6]
Charafe-Jauffret, E., Chaffanet, M., Bertucci, F., Ginestier, C., Jacquemier, J., deLapeyrière, O., et al. (2007) Les cancers du sein: Vers un modèle cellulaire et moléculaire intégré. Médecine/Sciences, 23, 626-632.
https://doi.org/10.1051/medsci/20072367626
[7]
Daly, B. and Olopade, O.I. (2015) A Perfect Storm: How Tumor Biology, Genomics, and Health Care Delivery Patterns Collide to Create a Racial Survival Disparity in Breast Cancer and Proposed Interventions for Change: Closing the Racial Disparity Gap in Breast Cancer. CA: A Cancer Journal for Clinicians, 65, 221-238.
https://doi.org/10.3322/caac.21271
[8]
Hagan, C.T., Medik, Y.B. and Wang, A.Z. (2018) Nanotechnology Approaches to Improving Cancer Immunotherapy. In: Advances in Cancer Research, Elsevier, Amsterdam, 35-56. https://doi.org/10.1016/bs.acr.2018.05.003
[9]
Bahnassy, A., Mohanad, M., Ismail, M.F., Shaarawy, S., El-Bastawisy, A. and Zekri, A.R.N. (2015) Molecular Biomarkers for Prediction of Response to Treatment and Survival in Triple Negative Breast Cancer Patients from Egypt. Experimental and Molecular Pathology, 99, 303-311. https://doi.org/10.1016/j.yexmp.2015.07.014
[10]
Fitzgibbons, P.L., Dillon, D.A., Alsabeh, R., Berman, M.A., Hayes, D.F., et al. (2014) Template for Reporting Results of Biomarker Testing of Specimens from Patients with Carcinoma of the Breast. Archives of Pathology & Laboratory Medicine, 138, 595-601. https://doi.org/10.5858/arpa.2013-0566-CP
[11]
Abe, O., Abe, R., Enomoto, K., Kikuchi, K., Koyama, H., Masuda, H., et al. (2011) Relevance of Breast Cancer Hormone Receptors and Other Factors to the Efficacy of Adjuvant Tamoxifen: Patient-Level Meta-Analysis of Randomised Trials. The Lancet, 378, 771-784. https://doi.org/10.1016/S0140-6736(11)60993-8
[12]
Atenguena, O.E., Esson Mapoko, B.S., Douanla, P., Ndangue Ntone, N., Penda Ndedi, L., Tabola, L., et al. (2019) Immunophenotypic Profile of Breast Cancers in a Black African Population: An Observational Study at Yaoundé General Hospital from January to December. Pan African Medical Journal, 44, Article No. 5.
[13]
Engbang, J.P., Essome, H., Mve Koh, V.V., Simo, G., Sime Essam, J.D., Sone Mouelle, A. and Essame Oyono, J.L. (2015) Breast Cancer in Cameroon, Histo-Epidemiological Profile: About 3044 Cases. The Pan African Medical Journal, 21, Article No. 242.
[14]
Atangana, P.J., Nguefack, C., Fotsing, C.T., Dina Bell, E., Rachel, T., Tomfeu, N., et al. (2017) Immunohistochemical Aspects of Breast Cancers in Douala and Yaoundé. Health Sciences and Diseases, 18, 14-20.
[15]
Kingu, M., Rahma, T., Nlandu, M., Bedele, K., Kiyabwe, S. and Ukundi, O. (2019) Epidemio-Clinical and Molecular Profile of Breast Cancer in Hospitals in the City of Kinshasa-RD Congo. Kisangani Médical, 9, 326-332.
[16]
Kemfang Ngowa, J.D., Ebune, J.L., Ngassam, A., Atangana, J., Kabeyene, A. and Kasia, J.M. (2015) Clinicohistopathological Features and Molecular Markers of Breast Cancer in a Group of Patients at the Yaoundé General Hospital-Cameroon. Journal Africain du Cancer, 7, 108-112. https://doi.org/10.1007/s12558-015-0380-y
[17]
Esson Mapoko, B.S., Atenguena, O., Dina Bell, M.E., Anne Juliette, F.S., et al. (2023) Epidemiological, Clinical and Therapeutic Profile of Patients Followed for Breast Cancer in a Major Referral Medical Oncology Unit in Cameroon: A Cross-Sectional Study. Pan African Medical Journal, 44, Article No. 4.
[18]
Zaki, H.M., Garba-Bouda, O., Garba, S.M. and Nouhou, H. (2013) Epidemiological and Anatomopathological Profile of Breast Cancer in Niger. Journal Africain du Cancer, 5, 185-191. https://doi.org/10.1007/s12558-013-0274-9
[19]
Kodoumé, M., Noa Ndoua, C.C., Atenguena Okobalemba, E., Tchatat Njassine, R.S., Esson Mapoko, B.S., Fozeu Fosso, L.C., Essiben, F., et al. (2023) Clinical, Paraclinical and Therapeutic Profile of Breast Cancer Surgery Patients at the Yaoundé Gyneco-Obstetric and Pediatric Hospital (HGOPY). Pan African Medical Journal, 44, Article No. 2.
[20]
Essiben, F., Foumane, P., Meka, E.J., Tchakounté, M., Dohbit, J.S., Nsahlai, C., et al. (2017) Descriptive Analysis of 192 Cases of Breast Cancer Occurring before Age 40 in Yaounde, Cameroon. International Journal of Reproduction, Contraception, Obstetrics and Gynecology, 6, Article No. 2704.
https://doi.org/10.18203/2320-1770.ijrcog20172898
[21]
Tchente Nguefack, C., Biwole, M.E., Massom, A., Kamgaing, J.T., Njamen, T.N., Ekane, G.H., Obinchemti, T.E. and Priso, E.B. (2012) Epidemiology and Surgical Management of Breast Cancer in Gynecological Department of Douala General Hospital. The Pan African Medical Journal, 13, Article No. 35.
[22]
Dem, A., Traoré, B., Dieng, M.M., et al. (2006) Les cancers gynécologiques et mammaires à l’Institut du cancer de Dakar. Cahiers d’études et de recherches francophones/Santé, 18, 25-29. https://doi.org/10.1684/san.2008.0093
[23]
Darré, T., Amegbor, K., Sonhayé, L., Kouyate, M., Aboubarak, A., N’Timo, B., et al. (2013) Histo-Epidemiological Profile of Breast Cancers: About 450 Cases Observed at the CHU of Lomé. Médecine d’Afrique Noire, 60, 53-58.
[24]
Sando, Z., Fouogue Tsuala, J., Fouelifack Ymele, F.Y., Fouedjio, J.H., Mboudou, T. and Essame Oyono, J. (2014) Profile of Gynecological and Breast Cancers in Yaoundé-Cameroon. The Pan African Medical Journal, 17, Article No. 28.
https://doi.org/10.11604/pamj.2014.17.28.3447
[25]
Esson Mapoko, B.S., Atenguena, O., Esther Dina, B.M., Anne Juliette, F.S., et al. (2023) Determinants of Prolonged Survival after Breast Cancer Diagnosis at Yaoundé General Hospital. Pan African Medical Journal, 44, Article No. 1.
[26]
Cucinotta, E., Calbo, L., Palmeri, R., Pergolizzi, F.P. and Melita, G. (1996) Bilateral Carcinoma of the Breast. Chirurgia Italiana, 49, 9-14.
[27]
Togo, A., Traore, A., Traore, C., Dembele, B.T., Kante, L., Diakite, I., et al. (2010) Breast Cancer in Two Hospitals in Bamako (Mali, Diagnostic and Therapeutic Aspects). Journal Africain du Cancer, 2, 88-91.
https://doi.org/10.1007/s12558-010-0060-x
[28]
Echimane, A.K., Ahnoux, A.A., Adoubi, I., Hien, S., M’Bra, K., D’Horpock, A., et al. (2000) Cancer Incidence in Abidjan, Ivory Coast. Cancer, 89, 653-663.
https://doi.org/10.1002/1097-0142(20000801)89:3<653::AID-CNCR22>3.0.CO;2-Z
[29]
Adani-Ifè, A., Amégbor, K., Doh, K. and Darré, T. (2020) Breast Cancer in Togolese Women: Immunohistochemistry Subtypes. BMC Women’s Health, 20, Article No. 261. https://doi.org/10.1186/s12905-020-01130-2
[30]
Millikan, R.C., Newman, B., Tse, C.K., Moorman, P.G., Conway, K., Smith, L.V., et al. (2007) Epidemiology of Basal-Like Breast Cancer. Breast Cancer Research and Treatment, 109, 123-139. https://doi.org/10.1007/s10549-007-9632-6
[31]
Howlader, N., Altekruse, S.F., Li, C.I., Chen, V.W., Clarke, C.A., Ries, L.A.G., et al. (2014) US Incidence of Breast Cancer Subtypes Defined by Joint Hormone Receptor and HER2 Status. JNCI: Journal of the National Cancer Institute, 106, dju055.
https://doi.org/10.1093/jnci/dju055
[32]
Titloye, N.A., Foster, A., Omoniyi-Esan, G.O., Komolafe, A.O., Daramola, A.O., Adeoye, O.A., et al. (2016) Histological Features and Tissue Microarray Taxonomy of Nigerian Breast Cancer Reveal Predominance of the High-Grade Triple-Negative Phenotype. Pathobiology, 83, 24-32. https://doi.org/10.1159/000441949
[33]
Tamimi, R.M., Baer, H.J., Marotti, J., Galan, M., Galaburda, L., Fu, Y., et al. (2008) Comparison of Molecular Phenotypes of Ductal Carcinoma in Situ and Invasive Breast Cancer. Breast Cancer Research, 10, R67. https://doi.org/10.1186/bcr2128