Shahin Sayed1, Zahir Moloo2, Ronald Wasike3, Peter Bird4, Raymond Oigara5,6, Faith Wambui Njoroge7, Asim Jamal Shaikh8, Satya Vara Prasad9, Sudhir Vinayak10, Gretchen L Gierach11, Sanford M Dawsey11, Maya Palakal11, Shaoqi Fan11, Maeve Mullooly11, Rajendra Chauhan3, Patricia Okiro2, Samuel Gakinya2, Ancent Nzioka12, Catherine Kyobutungi13, Shukri Mohamed13, Tilahun Haregu13, Mustafa Mussajee14, Betty Bonass15, Costa Mariwa16, Omar Ali Sherman17, Abdihakim Mohammed18, Andrew Gachii19, Joseph Githaiga14, Joseph Karanu5, Robert Nyagah5, Richard Njoroge20, Irene Muramba21, James Obondi Otieno22, Dan Omondi Raburu22, Elizabeth B Mwachiro23, Innocent Abayo2, Mansoor Saleh24. 1. Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya. shaheen.sayed@aku.edu. 2. Department of Pathology, Aga Khan University Hospital, Nairobi, Kenya. 3. Department of Surgery, Aga Khan University Hospital, Nairobi, Kenya. 4. Department of Surgery, AIC Kijabe Hospital, Kijabe, Kenya. 5. Department of Surgery, St. Mary's Mission Hospital, Nairobi, Kenya. 6. Kisii Referral Hospital, Kisii, Kenya. 7. Department of Surgery, Nyeri Provincial General Hospital, Nyeri, Kenya. 8. Department of Medical Oncology, Aga Khan University Hospital, Nairobi, Kenya. 9. Department of Pathology, Aga Khan Hospital, Kisumu, Kenya. 10. Department of Radiology, Aga Khan University Hospital, Nairobi, Kenya. 11. Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA. 12. Department of Pathology, AIC Kijabe Hospital, Kijabe, Kenya. 13. Epidemiology, African Population And Health Research Centre (APHRC), Nairobi, Kenya. 14. Division of Surgery, Kenyatta National Hospital, Nairobi, Kenya. 15. Department of Radiology, Kenyatta National Hospital, Nairobi, Kenya. 16. Department of Surgery, Aga Khan Hospital, Kisumu, Kenya. 17. Department of Pathology, Aga Khan Hospital, Mombasa, Kenya. 18. Department of Surgery, Aga Khan Hospital, Mombasa, Kenya. 19. Department of Human Pathology, Kenyatta National Hospital, Nairobi, Kenya. 20. Department of Pathology, Garissa Provincial General Hospital, Garissa, Kenya. 21. Department of Pathology, Coast Provincial General Hospital, Mombasa, Kenya. 22. Department of Surgery, New Nyanza Provincial General Hospital, Kisumu, Kenya. 23. Department of Surgery, Tenwek Hospital, Tenwek, Kenya. 24. Division of Haematology & Oncology, University of Alabama at Birmingham, Birmingham, AL, USA.
Abstract
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.
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 Nilotetumors 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.
Entities:
Keywords:
Breast cancer; Ethnic differences; Ethnicity; Kenya; Sub-Saharan Africa
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