Breast cancer in Tanzanian, black American, and white American women: An assessment of prognostic and predictive features, including tumor infiltrating lymphocytes

Autoři: Alex Mremi aff001;  Gloria Broadwater aff002;  Kahima Jackson aff003;  Patrick Amsi aff001;  Cosmas Mbulwa aff003;  Terry Hyslop aff002;  Cecilia Ong aff004;  Allison Hall aff005
Působiště autorů: Department of Pathology, Kilimanjaro Christian Medical University College, Moshi, Tanzania aff001;  Department of Biostatistics and Bioinformatics, Duke University Medical Center, Durham, North Carolina, United States of America aff002;  Department of Pathology, Bugando Medical Centre, Mwanza, Tanzania aff003;  Department of Surgery, Duke University Medical Center, Durham, North Carolina, United States of America aff004;  Department of Pathology, Duke University Medical Center, Durham, North Carolina, United States of America aff005
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224760



Breast cancer is a major cause of morbidity and mortality for women in Sub-Saharan Africa and for black American women. There is evidence that the pathologic characteristics of breast cancers in both African women and black American women may differ from their counterparts of European ancestry. However, despite the great burden of disease, data on pathologic features of breast carcinoma in Sub-Saharan Africa is limited and often contradictory. This lack of information makes it difficult to prioritize resource use in efforts to improve breast cancer outcomes in the region.


We examined consecutive cases of breast cancer in Tanzanian women (n = 83), black American women (n = 120), and white American women (n = 120). Each case was assessed for tumor type, grade, mitotic count, ER and HER2 status, and tumor infiltrating lymphocyte involvement.


The Tanzanian subjects were younger and had higher stage tumors than the subjects in either American group. Breast cancers in the Tanzanian and black American groups were more likely to be high grade (p = 0.008), to have a high mitotic rate (p<0.0001), and to be ER-negative (p<0.001) than the tumors in the white American group. Higher levels of tumor infiltrating lymphocyte involvement were seen among Tanzanian and black American subjects compared to white American subjects (p = 0.0001). Among all subjects, tumor infiltrating lymphocyte levels were higher in tumors with a high mitotic rate. Among Tanzanian and black American subjects, tumor infiltrating lymphocyte levels were higher in ER-negative tumors. These findings have implications for treatment priorities for breast cancer in Tanzania and other Sub-Saharan African countries.

Klíčová slova:

Africa – Biomarkers – Breast cancer – Cancer chemotherapy – Carcinomas – Europe – Oncology – Tumor-infiltrating lymphocytes


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2019 Číslo 11