title: Comparative Analysis of Breast Cancer Phenotypes in African American, White American, and West Versus East African patients: Correlation Between African Ancestry and Triple-Negative Breast Cancer.
abstract: Triple-negative breast cancer (TNBC) is more common among African American (AA) and western sub-Saharan African breast cancer (BC) patients compared with White/Caucasian Americans (WA) and Europeans. Little is known about TNBC in east Africa.
  
  
  
  Invasive BC diagnosed 1998-2014 were evaluated: WA and AA patients from the Henry Ford Health System in Detroit, Michigan; Ghanaian/west Africans from the Komfo Anokye Teaching Hospital in Kumasi, Ghana; and Ethiopian/east Africans from the St. Paul's Hospital Millennium Medical College in Addis Ababa, Ethiopia. Histopathology and immunohistochemistry for estrogen receptor (ER), progesterone receptor (PR), and HER2/neu expression was performed in Michigan on formalin-fixed, paraffin-embedded samples from all cases.
  
  
  
  A total of 234 Ghanaian (mean age 49 years), 94 Ethiopian (mean age 43 years), 272 AA (mean age 60 years), and 321 WA (mean age 62 years; p = 0.001) patients were compared. ER-negative and TNBC were more common among Ghanaian and AA compared with WA and Ethiopian cases (frequency ER-negativity 71.1 and 37.1 % vs. 19.8 and 28.6 % respectively, p < 0.0001; frequency TNBC 53.2 and 29.8 % vs. 15.5 and 15.0 %, respectively, p < 0.0001). Among patients younger than 50 years, prevalence of TNBC remained highest among Ghanaians (50.8 %) and AA (34.3 %) compared with WA and Ethiopians (approximately 16 % in each; p = 0.0002).
  
  
  
  This study confirms an association between TNBC and West African ancestry; TNBC frequency among AA patients is intermediate between WA and Ghanaian/West Africans consistent with genetic admixture following the west Africa-based trans-Atlantic slave trade. TNBC frequency was low among Ethiopians/East Africans; this may reflect less shared ancestry between AA and Ethiopians.
authors.affiliation: University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA.|Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Evelyn
authors.initials: E
authors.lastname: Jiagge
authors.affiliation: Department of Pathology, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
authors.forename: Aisha Souleiman
authors.initials: AS
authors.lastname: Jibril
authors.affiliation: Department of Pathology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Dhananjay
authors.initials: D
authors.lastname: Chitale
authors.affiliation: Department of Surgery, Henry Ford Health System, Detroit, MI, USA.|International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Jessica M
authors.initials: JM
authors.lastname: Bensenhaver
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Baffour
authors.initials: B
authors.lastname: Awuah
authors.affiliation: In Vivo Animal Core, Unit for Laboratory Animal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA.
authors.forename: Mark
authors.initials: M
authors.lastname: Hoenerhoff
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Ernest
authors.initials: E
authors.lastname: Adjei
authors.affiliation: Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
authors.forename: Mahteme
authors.initials: M
authors.lastname: Bekele
authors.affiliation: Department of Surgery, St. Paul's Hospital Millennium Medical College, Addis Ababa, Ethiopia.
authors.forename: Engida
authors.initials: E
authors.lastname: Abebe
authors.affiliation: Department of Surgery, Henry Ford Health System, Detroit, MI, USA.|International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
authors.forename: S David
authors.initials: SD
authors.lastname: Nathanson
authors.affiliation: International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Kofi
authors.initials: K
authors.lastname: Gyan
authors.affiliation: International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Barbara
authors.initials: B
authors.lastname: Salem
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Joseph
authors.initials: J
authors.lastname: Oppong
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Francis
authors.initials: F
authors.lastname: Aitpillah
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Ishmael
authors.initials: I
authors.lastname: Kyei
authors.affiliation: Department of Oncology, Komfo Anokye Teaching Hospital, Kumasi, Ghana.
authors.forename: Ernest Osei
authors.initials: EO
authors.lastname: Bonsu
authors.affiliation: Department of Surgery, Henry Ford Health System, Detroit, MI, USA.|International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Erica
authors.initials: E
authors.lastname: Proctor
authors.affiliation: University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA.
authors.forename: Sofia D
authors.initials: SD
authors.lastname: Merajver
authors.affiliation: University of Michigan Comprehensive Cancer Center, Ann Arbor, MI, USA.
authors.forename: Max
authors.initials: M
authors.lastname: Wicha
authors.affiliation: Department of Pathology, Henry Ford Health System, Detroit, MI, USA.
authors.forename: Azadeh
authors.initials: A
authors.lastname: Stark
authors.affiliation: Department of Surgery, Henry Ford Health System, Detroit, MI, USA. lnewman1@hfhs.org.|International Center for the Study of Breast Cancer Subtypes, Henry Ford Health System, Detroit, MI, USA. lnewman1@hfhs.org.
authors.forename: Lisa A
authors.initials: LA
authors.lastname: Newman
mesh_terms: D000328:Adult; D001741:Black or African American / Q000706:statistics & numerical data; D005002:Ethiopia; D005260:Female; D005869:Ghana / Q000453:epidemiology; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D010641:Phenotype; D015995:Prevalence; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000378:metabolism; D011960:Receptors, Estrogen / Q000378:metabolism; D011980:Receptors, Progesterone / Q000378:metabolism; D064726:Triple Negative Breast Neoplasms / Q000208:ethnology* / Q000378:metabolism* / Q000473:pathology; D014481:United States / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; C508053:ERBB2 protein, human