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Clinicopathologic characteristics of early-onset breast cancer: A comparative analysis of cases from across Ghana

Article scientifique 2022 Anglais

Résumé

Abstract Background: Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among persons younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC). Methods: A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Core/incision biopsy, mastectomy and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p<0.05Results: A total of 2,418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1,930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (<40 years) and 54.29 (IQR: 16.86) in the older, LOBC group (>/40 years). Invasive carcinoma - No Special Type (NST) was the commonest tumour type with grade III tumours being the highest recorded tumour grade in both age groups. Perineural invasion was statistically significant with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67>20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80 vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC. Conclusion: EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger data set is needed to explain the lack of statistical significance of pathological features. Further molecular and genetic studies to understand the molecular genetic drivers of the general poorer outcome of EOBCs in our setting is recommended.

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Akakpo, P., Imbeah, E., Edusei, L., Naporo, S., Ulzen‐Appiah, K., Clegg‐Lamptey, J., Dedey, F., Nsaful, J., Affram, N., Wiafe, B., Mensah, S., Nortey, M., Sheriff, M., Amponsah‐Manu, F., Agbedinu, K., Jiagge, E. (2022). Clinicopathologic characteristics of early-onset breast cancer: A comparative analysis of cases from across Ghana. https://doi.org/10.21203/rs.3.rs-1971697/v1

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Patrick Kafui Akakpo Emmanuel Gustav Imbeah Lawrence Edusei Simon Naporo Kofi Ulzen‐Appiah Joe‐Nat Clegg‐Lamptey Florence Dedey Josephine Nsaful Nelson Affram Beatrice Wiafe Samuel Mensah Michael Nortey Mohammed Sheriff Forster Amponsah‐Manu Kwabena Agbedinu Evelyn Jiagge

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