title: Molecular breast cancer subtypes prevalence in an indigenous Sub Saharan African population.
abstract: BACKGROUND
  Sub-Saharan Africa is predicted to face an unprecedented growth of cancers including breast cancer. There are indications of a significant burden of aggressive and late stage breast disease among premenopausal women in sub-Saharan Africa; because hormonal status tests are not routinely done, many women are given anti-hormonal therapy empirically. There is paucity of data on breast cancer molecular subtypes and their characteristics among women in sub Saharan Africa. The objective is to determine the prevalence of breast cancer molecular phenotypes among Ugandan women.
  
  
  METHODS
  This was a cross sectional descriptive study, conducted at a tertiary hospital in Africa. Eligible participants' formalin fixed and paraffin embedded sections were evaluated. H & E stains and Immunochemistry (Estrogen Receptor (ER), Progesterone Receptor (PR), Human Epidermal growth factor Receptor (HER2)) were performed. Ethical approval was obtained.
  
  
  RESULTS
  A total of 226 patient samples were evaluated. The mean age was 45 years (SD 14);the prevalence of Triple Negative Breast Cancer (TNBC) was 34% (77/226), Luminal A 38% (83/226), HER2 positive was 22% (49/226), and Luminal B was 5% (13/226). High-grade (III) tumors were 68%, stage III and IV constituted 75% of presentations. Histological type was mostly invasive ductal carcinoma. Most patients (55%) were from rural areas.
  
  
  CONCLUSIONS
  Ugandan women had an over representation of TNBC and high-grade breast tumors. Underlying reasons ought to be investigated. The empirical use of tamoxifen (anti-hormonal therapy) should be reexamined.
authors.affiliation: Department of Surgery, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Moses
authors.initials: M
authors.lastname: Galukande
authors.affiliation: Department of Pathology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Henry
authors.initials: H
authors.lastname: Wabinga
authors.affiliation: Department of Obstetrics and Gynecology, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Florence
authors.initials: F
authors.lastname: Mirembe
authors.affiliation: Clinical Epidemiology Unit, College of Health Sciences, Makerere University, Kampala, Uganda.
authors.forename: Charles
authors.initials: C
authors.lastname: Karamagi
authors.affiliation: The Texas A & M Health Science Center College of Medicine, USA.
authors.forename: Alexzander
authors.initials: A
authors.lastname: Asea
mesh_terms: D000293:Adolescent; D000328:Adult; D001943:Breast Neoplasms / Q000453:epidemiology / Q000473:pathology*; D018270:Carcinoma, Ductal, Breast / Q000453:epidemiology* / Q000473:pathology; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D015995:Prevalence; D064726:Triple Negative Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology; D014454:Uganda / Q000453:epidemiology
keywords: Molecular subtypes; breast Cancer; triple negative breast cancer