title: Molecular subtype analysis determines the association of advanced breast cancer in Egypt with favorable biology.
abstract: BACKGROUND
  Prognostic markers and molecular breast cancer subtypes reflect underlying biological tumor behavior and are important for patient management. Compared to Western countries, women in North Africa are less likely to be prognosticated and treated based on well-characterized markers such as the estrogen receptor (ER), progesterone receptor (PR) and Her2. We conducted this study to determine the prevalence of breast cancer molecular subtypes in the North African country of Egypt as a measure of underlying biological characteristics driving tumor manifestations.
  
  
  METHODS
  To determine molecular subtypes we characterized over 200 tumor specimens obtained from Egypt by performing ER, PR, Her2, CK5/6, EGFR and Ki67 immunohistochemistry.
  
  
  RESULTS
  Our study demonstrated that the Luminal A subtype, associated with favorable prognosis, was found in nearly 45% of cases examined. However, the basal-like subtype, associated with poor prognosis, was found in 11% of cases. These findings are in sharp contrast to other parts of Africa in which the basal-like subtype is over-represented.
  
  
  CONCLUSIONS
  Egyptians appear to have favorable underlying biology, albeit having advanced disease at diagnosis. These data suggest that Egyptians would largely profit from early detection of their disease. Intervention at the public health level, including education on the benefits of early detection is necessary and would likely have tremendous impact on breast cancer outcome in Egypt.
authors.affiliation: Integrated Cancer Genomics Division, Translational Genomics Research Institute, 445 N Fifth Street, Phoenix, AZ 85004, USA. bsalhia@tgen.org
authors.forename: Bodour
authors.initials: B
authors.lastname: Salhia
authors.forename: Coya
authors.initials: C
authors.lastname: Tapia
authors.forename: Elia A
authors.initials: EA
authors.lastname: Ishak
authors.forename: Salwa
authors.initials: S
authors.lastname: Gaber
authors.forename: Bree
authors.initials: B
authors.lastname: Berghuis
authors.forename: Khateeb H
authors.initials: KH
authors.lastname: Hussain
authors.forename: Rachelle A
authors.initials: RA
authors.lastname: DuQuette
authors.forename: James
authors.initials: J
authors.lastname: Resau
authors.forename: John
authors.initials: J
authors.lastname: Carpten
mesh_terms: D000328:Adult; D001943:Breast Neoplasms / Q000175:diagnosis / Q000208:ethnology* / Q000235:genetics* / Q000473:pathology; D042241:Early Diagnosis; D004534:Egypt / Q000453:epidemiology; D066246:ErbB Receptors / Q000378:metabolism; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D007150:Immunohistochemistry; D053555:Keratin-5 / Q000378:metabolism; D053553:Keratin-6 / Q000378:metabolism; D019394:Ki-67 Antigen / Q000378:metabolism; D008875:Middle Aged; D009367:Neoplasm Staging; D015995:Prevalence; D011379:Prognosis; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D012307:Risk Factors
chemical_list: D053555:Keratin-5; D053553:Keratin-6; D019394:Ki-67 Antigen; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D066246:ErbB Receptors