Prevalence of triple negative breast cancer and its associated clinico-histopathological characteristics among women with primary breast cancer at Mulago hospital.

Abstract

Background Globally, breast cancer is the most frequently diagnosed life threatening cancer and leading cause of cancer death among women. In Uganda, breast cancer is the third most commonly diagnosed cancer after Kaposi’s sarcoma and Cancer of the Cervix with a peak age of 30-39years. Triple-negative breast cancer, characterized by tumours that do not express oestrogen receptor (ER), progesterone receptor (PR), or HER-2 genes, represent an important clinical challenge because these cancers do not respond to endocrine therapy or other available targeted agents. Objective The aim of this study was to determine the prevalence of triple negative breast cancer amongst women with primary breast cancer at Mulago hospital and describe its associated clinico-histopathological features Method In this cross-sectional study patients were consecutively recruited clinically evaluated and core biopsies taken from histologically confirmed breast cancer patients and their receptor status determined by immunohistochemistry were analysed using Stata 10.1. Frequency tables and cross tabulations were used to summarize the categorical variables and Means and Standard deviations were used to summarize the continuous variables. Multiple regression was used and P-values determined to test for associations. Results Prevalence of TNBC was 20.2% with ER+PR+HER2- having the highest prevalence of 28.9%. TNBC was found to be more in premenopausal women (73.9%) and associated with poor prognostic characteristics and therefore a more aggressive subtype of breast cancer. Conclusions There is a fairly high prevalence of triple negative breast cancer among Ugandan African women attending breast clinic at Mulago hospital. In this study TNBC was found to be associated with poor prognostic characteristics and therefore this finding throws more light on the need for treatment strategies to be better tailored to effectively manage patients with TNBC.