Cancer of the breast histopathology:-
Cancer of the breast histopathology:-
According to histology, ductal carcinoma is the most frequent form of breast cancer in women in Africa and Europe, with a frequency that is comparable [5, 17]. Mucinous and medullary carcinomas, however, are more prevalent in Africa than in Europe. Additionally, there are more grade 3 tumours in women in Africa than in Europe. For instance, Tanzania has 56.4% of tumours with a histological grade 3 [5], while Nigeria has 45.1% of grade 3 tumours. On the other hand, just 15.8% of Finnish women had a grade 3 tumour. Most women in Europe present with a grade 1 or 2 tumour [17]. In addition, African-American women are significantly more likely than white women to have high grade nuclear atypical, grade 3 tumours, a higher number of positive nodes, and greater necrosis [19–21].
Compared to white British women, black British women have greater rates of grade 3 tumours and lymph node-positive illness [9]. This could explain why African women experience a more rapid progression of breast cancer than European women. Different subtypes of breast cancer have been identified using gene expression analysis. Luminal Aluminal B, basal-like, HER2+/ER, and unclassified are some of them. Compared to postmenopausal African-American and non-African-American women, premenopausal African-American individuals have a significantly greater incidence of basal-like breast tumours [22]. Six. Presentation stage European ladies and their African equivalents are staged very differently at the time of presentation. When a woman in Africa first gets sick, it's usually already advanced. More than 70% of the patients in a study conducted in East Africa presented at stage III or IV [5]. More than half of the patients in trials conducted in Libya and Nigeria were in stages III or IV [17, 18]. Women are more likely than men to manifest with the disease in its early stages in Europe, albeit [23]. 39 percent of the patients in a Nigerian research had fun gating tumours, and 13 percent had clinical signs of systemic metastasis [4].
Breast Cancer Genes (BRCA1 and BRCA2):-
The absence of health care coverage, particularly in isolated rural regions, and poverty may be the causes of the advanced presentation in Africa, as most nations do not provide free healthcare. Contrarily, healthcare is widely available and cost-free throughout most of Europe. Additionally, there is a lot of public awareness and screening is accessible in the majority of European nations. 7. Genetics of breast cancer (BRCA1 and BRCA2) Breast cancer susceptibility genes 1 and 2 (BRCA1 and BRCA2) are tumour suppressor genes, and mutations in these genes have been linked to a higher risk of breast cancer. It has been established that these genes raise European women's risk of developing breast cancer. According to a Swedish study, case patients who had one first-degree relative with breast cancer or more than one first- or second-degree relatives with the disease were more likely to have the BRCA mutations than those who did not have this level of family history (P0.001) [24]. BRCA mutations were also statistically significantly more prevalent in women with bilateral breast cancer than in those with unilateral breast cancer (P=0.002) [24]. Even more research has indicated that BRCA1 mutation carriers likely to have breast cancer at a younger age than BRCA2 mutation carriers [25]. The idea of a hereditary predisposition to breast cancer in native African women on the African continent has, regrettably, not been the subject of extensive research.
Many women could undergo breast conserving surgery because breast cancer is frequently diagnosed early in Europe (BCT). For instance, in Poland, from 57 percent in 1984 to 81 percent in 2003, more tumours with diameters less than 5 cm were seen [26]. On the other hand, only 52% of patients in Africa have tumours less than 6 cm [5]. The majority of women in Africa undergo mastectomy, adjuvant hormonal therapy, or chemotherapy, similar to how cancer is treated, while many others just receive palliative care if the tumour is advanced and inoperable.
In areas with historically low incidence of the disease, breast cancer is on the rise. Comparatively speaking, Africa still has a low rate of cancer compared to Europe. The majority of this has been attributed to a protective reproductive history, which includes late menarche, early menopause, and high parity with prolonged breastfeeding, irregular menses, and fewer ovulatory cycles [27]. However, it has been noted that African women typically show earlier and exhibit a more aggressive form of the disease than their European counterparts. There may be a genetic propensity for this. However, some research has been done on their counterparts in African-Americans. Unfortunately, little genetic research has been done on non-immigrant African women. In a U.S. research, BRCA2 mutations were more common in African-American patients than BRCA1 mutations in the white cohort [28]. According to the study, compared to only 12% of the white cohort, nearly 50% of African-American women carried variations of unknown significance [28]. Additionally, Black women in Europe show a pattern of disease more comparable to African women than to white women in Europe, indicating that genetics may be more important in this situation. Basal-like breast tumours are more common while luminal breast tumours are less common. Young African-American women with breast cancer may have a worse prognosis due to tumours. The ability to do research on the genetics of breast cancer in African women in diverse parts of the African continent would be of enormous benefit. Such investigation may even find out alterations that are currently unknown.
Previous Blog Post Links:-
https://www.linkedin.com/pulse/breast-cancer-epidemiology-europe-africa-sweta-pradhan
https://www.linkedin.com/pulse/breast-cancer-epidemiology-europe-africa-dr-priya-pujhari
https://drandreaross.blogspot.com/2022/07/breast-cancer-epidemiology-in-europe.html
https://sites.google.com/view/breastcancerepidemiology/home
https://kikoxp.com/posts/13761
https://medium.com/@BreastPathology/breast-cancer-epidemiology-in-europe-africa-8339b2059507
https://www.tumblr.com/blog/view/breastpathology/690731100211986432?source=share
