Clinicopathological presentation of breast cancer patients with different molecular subtypes at Muhimbili National Hospital

Abstract

Background: Breast cancer is among the most common (2nd to cervical cancer) incident cancer among women worldwide. In Tanzania, the current proportion of breast cancer is up to 27.76/100,000 population (Globocan 2020). However, mortality is very high in Tanzania due to late-stage disease or aggressive tumour types. Tanzania also is facing a challenge of inadequate resources which then has created a gap in the description of clinicopathological presentations of breast cancer. Prior local studies had some limitations including; exclusion of males, small sample size (n ≈70) and incomplete IHC. Objectives: To analyze the clinicopathological presentation of breast cancer patients with different molecular subtypes at MNH. Materials and Methods: This descriptive retrospective cross-sectional Hospital based study included a total of 446 patient data files (male & female) between 2014 and 2019 at MNH. Patients diagnosed with epithelialized breast cancer and complete IHC were included. All patients with incomplete IHC data were excluded. Data was collected using a structured questionnaire and analyzed using SPSS. Results: In this Study 446 patients met the inclusion criteria including females (98.4%) and 1.6% were males. Most patients came with duration of chief complaint of 24 months (35.9%) and most presented with stage 3 (36.8%) and stage 4 (59.9%). The most common histology type was IDC (83.2%). However, among patients with IDC 36.3% presented with Luminal A and 34.3% presented with Triple negative molecular subtypes. Lastly, the most prevalent molecular subtype was Luminal A (36.3%); followed by Triple negative (34.3%), Luminal B (15%) and lastly HER-2 enriched (14.3%). Nevertheless, Luminal A and Triple negative molecular subtypes are common in patients with stage 3 & 4 disease. Conclusion: Late presentation was a challenge and was associated with stage 3 & 4 disease and Luminal A and Triple negative subtypes. Lumina A and Triple negative were the commonest molecular subtypes. IDC histology type was the commonest.