Characterizing the Pattern of Metastasis Based on Molecular Subtype in Breast Cancer Among Nigerian Women (Breast Cancer Molecular Subtypes and Metastasis in Nigerian Women)
Main Article Content
Abstract
Background: Breast cancer subtypes are often used as therapeutic and prognostic measures; however, it is unclear whether there is an association between molecular subtypes and site-specific metastasis. Our study aimed to evaluate the relationship between molecular subtypes and developing metastasis in specific sites.
Methods: We selected 118 breast cancer patients with immunohistochemistry confirmed molecular subtype diagnosed in 2020 and 2021 at the Department of Surgery, University College Hospital, Ibadan. We classified the molecular subtypes into four categories, HR+/HER2-, HR-/HER2+, HR+/HER2+, and triple negative (HR-/HER2-). The different sites of metastasis of interest were lungs, liver, brain, and bone. We used the chi-square test to determine the proportions and significance of the subtypes based on the different sites assessed.
Results: According to our study, 45.50%, 18.20%, and 36.40% of patients presented with lungs, liver, and other (multiple organs and contralateral breast) metastasis respectively. Additionally, HR+/HER2- and TNBC patients developed metastasis at a higher rate and account for a combined 90.10% of all metastases (the site-specific distribution was even between both subtypes).
Conclusion: Overall, while there are limitations in our study based on sample size, our data shows that some molecular subtypes are associated with a higher risk of metastasis. Additionally, while not significant in our study, breast cancer subtypes are associated with different metastatic sites.
Keywords:
Breast cancer, Immunohistochemistry, Ibadan, Metastasis, pattern
Article Details
How to Cite
AYANDIPO, Omobolaji O. et al.
Characterizing the Pattern of Metastasis Based on Molecular Subtype in Breast Cancer Among Nigerian Women (Breast Cancer Molecular Subtypes and Metastasis in Nigerian Women).
Medical Research Archives, [S.l.], v. 10, n. 10, oct. 2022.
ISSN 2375-1924.
Available at: <https://esmed.org/MRA/mra/article/view/3130>. Date accessed: 19 apr. 2024.
doi: https://doi.org/10.18103/mra.v10i10.3130.
Section
Research Articles
The Medical Research Archives grants authors the right to publish and reproduce the unrevised contribution in whole or in part at any time and in any form for any scholarly non-commercial purpose with the condition that all publications of the contribution include a full citation to the journal as published by the Medical Research Archives.
References
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19. Ibrahim H, Umar AK. Pattern of patients presentation with metastatic breast cancer for palliative external beam radiotherapy in the University College Hospital Ibadan. Ann Trop Pathol [serial online] 2018 [cited 2022 May 27];9:131-4. Available from: https://www.atpjournal.org/text.asp?2018/9/2/131/245700
20. Jedy-Agba, Elima et al. Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer epidemiology vol. 36,5 (2012): e271-8. doi:10.1016/j.canep.2012.04.007
21. Dairo, M. D., Adamu, D. B., Onimode, Y. A., Ntekim, A., & Ayeni, O. (2018). Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria. International journal of breast cancer, 2018, 1597964. https://doi.org/10.1155/2018/1597964
22. Awofeso O, Roberts AA, Salako O, Balogun L, Okediji P. Prevalence and pattern of late-stage presentation in women with breast and cervical cancers in Lagos University Teaching Hospital, Nigeria. Niger Med J [serial online] 2018 [cited 2022 Jun 23];59:74-9. Available from: https://www.nigeriamedj.com/text.asp?2018/59/6/74/263070
23. Ikeri N, Z, Oguntunde O, A, Igbokwe U, Abdulkareem F, B, Banjo A, A: Breast Cancer in a Lagos Facility: Implications for the Institution of a Cancer Screening Programme. Pathobiology 2018;85:254-260. doi: 10.1159/000489933
24. Kene, T. S., Odigie, V. I., Yusufu, L. M., Yusuf, B. O., Shehu, S. M., & Kase, J. T. (2010). Pattern of presentation and survival of breast cancer in a teaching hospital in north Western Nigeria. Oman medical journal, 25(2), 104–107. https://doi.org/10.5001/omj.2010.29
25. Adeniji, A. A., Dawodu, O. O., Habeebu, M. Y., Oyekan, A. O., Bashir, M. A., Martin, M. G., Keshinro, S. O., & Fagbenro, G. T. (2020). Distribution of Breast Cancer Subtypes Among Nigerian Women and Correlation to the Risk Factors and Clinicopathological Characteristics. World journal of oncology, 11(4), 165–172. https://doi.org/10.14740/wjon1303
26. Julius Gbenga Olaogun et al. Socio-demographic, pattern of presentation and management outcome of breast cancer in a semi-urban tertiary health institution. Pan African Medical Journal. 2020;36(363). 10.11604/pamj.2020.36.363.17866
27. Paula B. Gordon, Wendie A. Berg, Corrections: Breast cancer screening guidelines for young women of color, Cancer, 10.1002/cncr.33988, 128, 4, (849-850), (2021).
28. Hendrick RE, Monticciolo DL, Biggs KW, Malak SF. Age distributions of breast cancer diagnosis and mortality by race and ethnicity in US women. Cancer. 2021;127:4384-4392.
29. Ogundiran TO, Ayandipo OO, Adedapo KS, et al. Bone Scintigraphy in Breast Cancer Patients in Ibadan, Nigeria. West African Journal of Medicine. 2014 Jul-Sep;33(3):172-177. PMID: 26070820.
30. Usman A, Iliyasu Y, Atanda AT. Molecular subtyping of carcinoma of the female breast in a tertiary teaching hospital in Northern Nigeria. Ann Trop Pathol 2019;10:20-6.
31. Tanimowo MO, Abudu EK, Udo IA, Abdulkareem FB. Histopathological and Immunohistochemical Characteristics of Breast Carcinomas in Uyo, Subtropical Region of Africa. Med J Zambia 2019; 46 (2): 100 - 108
32. Adisa CA, Eleweke N, Alfred AA, Campbell MJ, Sharma R, Nseyo O, Tandon V, Mukhtar R, Greninger A, Di Risi J, Esserman LJ. Biology of breast cancer in Nigerian women: A pilot study. Annals of African medicine. 2012 Jul 1;11(3):169
33. Okoye JO. High prevalence of triple-negative breast cancer and poor survival outcome in Nigeria: A call for further molecular subtyping of triple-negative breast cancer. Ann Trop Pathol [serial online] 2020 [cited 2022 May 27];11:98-9. Available from: https://www.atpjournal.org/text.asp?2020/11/1/98/291716
2. Azubuike, S.O., Muirhead, C., Hayes, L. et al. Rising global burden of breast cancer: the case of sub-Saharan Africa (with emphasis on Nigeria) and implications for regional development: a review. World J Surg Onc 16, 63 (2018). https://doi.org/10.1186/s12957-018-1345-2
3. World Cancer Research Fund/American Institute for Cancer Research. Diet, nutrition, physical activity and breast cancer. Continuous Update Project Expert Report (2018). https://www.wcrf.org/dietandcancer/breast-cancer/
4. World Health Organization. 2020. Nigeria Cancer Country Profile 2020. [online] Available at: https://www.who.int/cancer/country-profiles/NGA_2020.pdf?ua=1
5. Black, E., Richmond, R. Improving early detection of breast cancer in sub-Saharan Africa: why mammography may not be the way forward. Global Health 15, 3 (2019). https://doi.org/10.1186/s12992-018-0446-6
6. Zheng Y, Walsh T, Gulsuner S, et al. Inherited Breast Cancer in Nigerian Women. J Clin Oncol. 2018;36(28):2820-2825. doi:10.1200/JCO.2018.78.3977
7. Xiao, W., Zheng, S., Yang, A., Zhang, X. et al. Breast cancer subtypes and the risk of distant metastasis at initial diagnosis: a population-based study. Cancer management and research, 10, 5329–5338 (2018). https://doi.org/10.2147/CMAR.S176763
8. Gong, Y., Liu, YR., Ji, P. et al. Impact of molecular subtypes on metastatic breast cancer patients: a SEER population-based study. Sci Rep 7, 45411 (2017). https://doi.org/10.1038/srep45411
9. Wang, Z., Chen, M., Pan, J., Wang, X. et al. Pattern of distant metastases in inflammatory breast cancer - A large-cohort retrospective study. Journal of Cancer, 11(2), 292–300 (2020). https://doi.org/10.7150/jca.34572
10. Duffy, S. W., Tabár, L., Yen, A. M., Dean, P. B., Smith, R. A., Jonsson, H., Törnberg, S., Chen, S. L., Chiu, S. Y., Fann, J. C., Ku, M. M., Wu, W. Y., Hsu, C. Y., Chen, Y. C., Svane, G., Azavedo, E., Grundström, H., Sundén, P., Leifland, K., Frodis, E., … Chen, T. H. (2020). Mammography screening reduces rates of advanced and fatal breast cancers: Results in 549,091 women. Cancer, 126(13), 2971–2979. https://doi.org/10.1002/cncr.32859
11. Blanks, R. G., Moss, S. M., McGahan, C. E., Quinn, M. J., & Babb, P. J. (2000). Effect of NHS breast screening programme on mortality from breast cancer in England and Wales, 1990-8: comparison of observed with predicted mortality. BMJ (Clinical research ed.), 321(7262), 665–669. https://doi.org/10.1136/bmj.321.7262.665
12. Wright, Nikita et al. Panoptic Overview of Triple-Negative Breast Cancer in Nigeria: Current Challenges and Promising Global Initiatives. Journal of global oncology vol. 4 (2018): 1-20. doi:10.1200/JGO.17.00116
13. Ferlay J, Ervik M, Lam F, Colombet M, Mery L, Piñeros M, et al. Global Cancer Observatory: Cancer Today. Lyon: International Agency for Research on Cancer; 2020 (https://gco.iarc.fr/today, accessed February 2021).
14. Wang, H., Zhang, C., Zhang, J., Kong, L., Zhu, H., & Yu, J. (2017). The prognosis analysis of different metastasis pattern in patients with different breast cancer subtypes: a SEER based study. Oncotarget, 8(16), 26368–26379. https://doi.org/10.18632/oncotarget.14300
15. Abha Soni, DO, MPH, Zhiyong Ren, MD, PhD, Omar Hameed, MD, Diptiman Chanda, PhD, Charity J. Morgan, PhD, Gene P. Siegal, MD, PhD, Shi Wei, MD, PhD, Breast Cancer Subtypes Predispose the Site of Distant Metastases, American Journal of Clinical Pathology, Volume 143, Issue 4, April 2015, Pages471-478 https://doi.org/10.1309/AJCPYO5FSV3UPEXS
16. Abur PP, Yusufu LM, Odigie VI. Pattern of visceral metastasis from breast cancer patients in Ahmadu Bello University Teaching Hospital, Zaria, North Western Nigeria. Arch Med Surg [serial online] 2019 [cited 2022 May 27];4:31-4. Available from: https://www.archms.org/text.asp?2019/4/2/31/276180
17. Odebode Timothy Olugbenga, Olatoke Samuel Adegboyega, Rahman Ganiyu Adebisi, Afolayan Enoch Abiodun Olakojo, Oyinloye Olalekan Ibukun, Agboola John Owoade. Breast Cancer Metastasis to the Cerebellum: A Rare Event in Our Setting, the Adverse Impact of Late Presentation- Case Report. ARC Journal of Clinical Case Reports.2017; 3(3):5-8. doi:dx.doi.org/10.20431/2455-9806.0303002.
18. T.N. Elumelu, A.A. Adenipekun, A.A. Abdus-salam, A.D. Bojude. Pattern of Breast Cancer Metastasis at the Radiotherapy Clinic, Ibadan - A Ten Year Review.Journal of American Science 2011; 7(7):906-912]. (ISSN: 1545-1003). http://www.americanscience.org
19. Ibrahim H, Umar AK. Pattern of patients presentation with metastatic breast cancer for palliative external beam radiotherapy in the University College Hospital Ibadan. Ann Trop Pathol [serial online] 2018 [cited 2022 May 27];9:131-4. Available from: https://www.atpjournal.org/text.asp?2018/9/2/131/245700
20. Jedy-Agba, Elima et al. Cancer incidence in Nigeria: a report from population-based cancer registries. Cancer epidemiology vol. 36,5 (2012): e271-8. doi:10.1016/j.canep.2012.04.007
21. Dairo, M. D., Adamu, D. B., Onimode, Y. A., Ntekim, A., & Ayeni, O. (2018). Characteristics and Determinants of Patients Discontinuation of Breast Cancer Follow-Up Care at the Radiation Oncology Department, University College Hospital, Ibadan, Nigeria. International journal of breast cancer, 2018, 1597964. https://doi.org/10.1155/2018/1597964
22. Awofeso O, Roberts AA, Salako O, Balogun L, Okediji P. Prevalence and pattern of late-stage presentation in women with breast and cervical cancers in Lagos University Teaching Hospital, Nigeria. Niger Med J [serial online] 2018 [cited 2022 Jun 23];59:74-9. Available from: https://www.nigeriamedj.com/text.asp?2018/59/6/74/263070
23. Ikeri N, Z, Oguntunde O, A, Igbokwe U, Abdulkareem F, B, Banjo A, A: Breast Cancer in a Lagos Facility: Implications for the Institution of a Cancer Screening Programme. Pathobiology 2018;85:254-260. doi: 10.1159/000489933
24. Kene, T. S., Odigie, V. I., Yusufu, L. M., Yusuf, B. O., Shehu, S. M., & Kase, J. T. (2010). Pattern of presentation and survival of breast cancer in a teaching hospital in north Western Nigeria. Oman medical journal, 25(2), 104–107. https://doi.org/10.5001/omj.2010.29
25. Adeniji, A. A., Dawodu, O. O., Habeebu, M. Y., Oyekan, A. O., Bashir, M. A., Martin, M. G., Keshinro, S. O., & Fagbenro, G. T. (2020). Distribution of Breast Cancer Subtypes Among Nigerian Women and Correlation to the Risk Factors and Clinicopathological Characteristics. World journal of oncology, 11(4), 165–172. https://doi.org/10.14740/wjon1303
26. Julius Gbenga Olaogun et al. Socio-demographic, pattern of presentation and management outcome of breast cancer in a semi-urban tertiary health institution. Pan African Medical Journal. 2020;36(363). 10.11604/pamj.2020.36.363.17866
27. Paula B. Gordon, Wendie A. Berg, Corrections: Breast cancer screening guidelines for young women of color, Cancer, 10.1002/cncr.33988, 128, 4, (849-850), (2021).
28. Hendrick RE, Monticciolo DL, Biggs KW, Malak SF. Age distributions of breast cancer diagnosis and mortality by race and ethnicity in US women. Cancer. 2021;127:4384-4392.
29. Ogundiran TO, Ayandipo OO, Adedapo KS, et al. Bone Scintigraphy in Breast Cancer Patients in Ibadan, Nigeria. West African Journal of Medicine. 2014 Jul-Sep;33(3):172-177. PMID: 26070820.
30. Usman A, Iliyasu Y, Atanda AT. Molecular subtyping of carcinoma of the female breast in a tertiary teaching hospital in Northern Nigeria. Ann Trop Pathol 2019;10:20-6.
31. Tanimowo MO, Abudu EK, Udo IA, Abdulkareem FB. Histopathological and Immunohistochemical Characteristics of Breast Carcinomas in Uyo, Subtropical Region of Africa. Med J Zambia 2019; 46 (2): 100 - 108
32. Adisa CA, Eleweke N, Alfred AA, Campbell MJ, Sharma R, Nseyo O, Tandon V, Mukhtar R, Greninger A, Di Risi J, Esserman LJ. Biology of breast cancer in Nigerian women: A pilot study. Annals of African medicine. 2012 Jul 1;11(3):169
33. Okoye JO. High prevalence of triple-negative breast cancer and poor survival outcome in Nigeria: A call for further molecular subtyping of triple-negative breast cancer. Ann Trop Pathol [serial online] 2020 [cited 2022 May 27];11:98-9. Available from: https://www.atpjournal.org/text.asp?2020/11/1/98/291716