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1.
Breast Cancer Res Treat ; 167(2): 425-437, 2018 01.
Artigo em Inglês | MEDLINE | ID: mdl-28951987

RESUMO

PURPOSE: There are no published data from specific regions of sub-Saharan Africa describing the clinical and pathological characteristics and molecular subtypes of invasive breast cancer by ethnic group. The purpose of this study was to investigate these characteristics among the three major ethno-cultural groupings in Kenya. METHODS: The study included women with pathologically confirmed breast cancer diagnosed between March 2012 and May 2015 at 11 hospitals throughout Kenya. Sociodemographic, clinical, and reproductive data were collected by questionnaire, and pathology review and immunohistochemistry were performed centrally. RESULTS: The 846 cases included 661 Bantus (78.1%), 143 Nilotes (16.9%), 19 Cushites (2.3%), and 23 patients of mixed ethnicity (2.7%). In analyses comparing the two major ethnic groups, Bantus were more educated, more overweight, had an older age at first birth, and had a younger age at menopause than Nilotes (p < 0.05 for all comparisons). In analyses restricted to definitive surgery specimens, there were no statistically significant differences in tumor characteristics or molecular subtypes by ethnicity, although the Nilote tumors tended to be larger (OR for ≥ 5 cm vs. < 2 cm: 3.86, 95% CI 0.77, 19.30) and were somewhat more likely to be HER2 enriched (OR for HER2 enriched vs. Luminal A/B: 1.41, 95% CI 0.79, 2.49). CONCLUSION: This case series showed no significant differences in breast cancer tumor characteristics or molecular subtypes, but significant differences in sociodemographic characteristics and reproductive factors, among the three major ethnic groups in Kenya. We suggest further evaluation of ethnic differences in breast cancer throughout the genetically and culturally diverse populations of sub-Saharan Africa.


Assuntos
Neoplasias da Mama/epidemiologia , Neoplasias da Mama/genética , Receptor ErbB-2/genética , Adulto , África Subsaariana , Idoso , Neoplasias da Mama/patologia , Etnicidade/genética , Feminino , Humanos , Quênia , Pessoa de Meia-Idade , Inquéritos e Questionários
2.
J Clin Pathol ; 66(4): 307-11, 2013 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-23378268

RESUMO

INTRODUCTION: The majority of women with breast cancer in Kenya present with node-positive (stage II) or locally advanced Q7 disease (stage IIIB). Diagnosis is made on fine needle aspirate cytology and treatment is with surgery if resectable. Diagnostic core biopsy is available only at subspecialty hospitals. Processing and reporting of biopsy tissue are not standardised. Hormone receptor and HER2 analyses are rarely done preoperatively. METHODS: As part of a larger study investigating the prevalence of triple negative breast cancer in Kenya, a multidisciplinary workshop of collaborators from 10 healthcare facilities was held. Process gaps were identified, preanalytic variables impacting on ER/PR/HER2 discussed and training in core biopsy provided. Local remedial strategies were deliberated. CONCLUSION: We describe our experience and outcome from the workshop, which can be modelled for other resource poor settings.


Assuntos
Neoplasias da Mama/diagnóstico , Técnicas de Laboratório Clínico/normas , Comportamento Cooperativo , Comunicação Interdisciplinar , Equipe de Assistência ao Paciente , Biomarcadores Tumorais/análise , Biópsia por Agulha Fina/normas , Neoplasias da Mama/química , Neoplasias da Mama/economia , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Técnicas de Laboratório Clínico/economia , Países em Desenvolvimento/economia , Feminino , Custos de Cuidados de Saúde , Humanos , Imuno-Histoquímica/normas , Quênia , Invasividade Neoplásica , Estadiamento de Neoplasias , Equipe de Assistência ao Paciente/economia , Guias de Prática Clínica como Assunto , Valor Preditivo dos Testes , Prognóstico , Receptor ErbB-2/análise , Receptores de Estrogênio/análise , Receptores de Progesterona/análise
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