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Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival.
J Surg Res. 2007 Nov; 143(1):109-18.JS

Abstract

BACKGROUND

Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B.

OBJECTIVES

To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women.

DESIGN

A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), basal-like (ER-, PR-, HER2-), and Her-2/neu (ER-, PR-, and HER2+).

OUTCOME MEASURES

We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival.

RESULTS

The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes (P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome.

CONCLUSIONS

The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients.

Authors+Show Affiliations

Department of Surgery, Howard University Hospital, Washington, District of Columbia 20060, USA. emeka_ihemelandu@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

17950079

Citation

Ihemelandu, Chukwuemeka U., et al. "Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-specific Prevalence and Survival." The Journal of Surgical Research, vol. 143, no. 1, 2007, pp. 109-18.
Ihemelandu CU, Leffall LD, Dewitty RL, et al. Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival. J Surg Res. 2007;143(1):109-18.
Ihemelandu, C. U., Leffall, L. D., Dewitty, R. L., Naab, T. J., Mezghebe, H. M., Makambi, K. H., Adams-Campbell, L., & Frederick, W. A. (2007). Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival. The Journal of Surgical Research, 143(1), 109-18.
Ihemelandu CU, et al. Molecular Breast Cancer Subtypes in Premenopausal and Postmenopausal African-American Women: Age-specific Prevalence and Survival. J Surg Res. 2007;143(1):109-18. PubMed PMID: 17950079.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Molecular breast cancer subtypes in premenopausal and postmenopausal African-American women: age-specific prevalence and survival. AU - Ihemelandu,Chukwuemeka U, AU - Leffall,LaSalle D,Jr AU - Dewitty,Robert L, AU - Naab,Tammey J, AU - Mezghebe,Haile M, AU - Makambi,Kepher H, AU - Adams-Campbell,Lucile, AU - Frederick,Wayne A, PY - 2007/01/08/received PY - 2007/03/13/revised PY - 2007/03/29/accepted PY - 2007/10/24/pubmed PY - 2007/12/14/medline PY - 2007/10/24/entrez SP - 109 EP - 18 JF - The Journal of surgical research JO - J Surg Res VL - 143 IS - 1 N2 - BACKGROUND: Breast cancer is currently regarded as a heterogeneous disease classified into various molecular subtypes using gene expression analysis. These molecular subtypes include: basal cell-like, Her-2/neu, luminal A, and luminal B. OBJECTIVES: To analyze the prevalence and clinicopathologic associations for molecular breast cancer subtypes in premenopausal and postmenopausal African-American women. DESIGN: A retrospective analysis of all African-American women diagnosed with breast cancer from 1998 to 2005, who had assessable data for ER, PR, and Her-2/neu status. Molecular subtype classification was done based on immunohistochemical surrogates for ER, PR, and Her-2/neu status obtained from Howard University tumor registry for each patient. The molecular subtypes were defined as: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), basal-like (ER-, PR-, HER2-), and Her-2/neu (ER-, PR-, and HER2+). OUTCOME MEASURES: We analyzed the prevalence of molecular breast cancer subtypes in a population of African-American women and determined their associations with patient demographics and clinicopathologic variables: node status, tumor size, histological grade, p53 mutation status, and breast cancer-specific survival. RESULTS: The luminal A subtype was the most prevalent in our study sample (55.4%) compared with (11.8%) luminal B, (21.2%) basal cell-like, and (11.6%) Her-2/neu subtypes. The molecular subtypes did not differ by menopausal status. However, when stratified into age-specific groups, the basal cell-like subtype (57.1%) was the most prevalent in the age group <35 y compared with luminal A, luminal B, and Her-2/neu subtypes at 25.0%, 14.3%, and 3.6%, respectively. The basal cell-like subtype also showed an age-specific bimodal distribution with a peak in the <35 y and 51 to 65 y age groups. The basal cell-like and the Her-2/neu subtypes showed an increased association with clinicopathologic variables portending a more aggressive clinical course when compared with luminal A subtype. A paradoxical inverse relationship between the expression of p53 and Bcl-2 protooncoprotein was noted in the molecular subtypes. Breast cancer-specific survival differed significantly among the molecular subtypes (P < 0.04), with the basal cell-like and Her-2/neu subtypes having the poorest outcome. CONCLUSIONS: The high prevalence of the basal cell-like subtype in the young premenopausal African-American women aged <35 y could be a contributory factor to the poorer prognosis of breast cancer observed in this cohort of patients. SN - 0022-4804 UR - https://www.unboundmedicine.com/medline/citation/17950079/Molecular_breast_cancer_subtypes_in_premenopausal_and_postmenopausal_African_American_women:_age_specific_prevalence_and_survival_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0022-4804(07)00246-6 DB - PRIME DP - Unbound Medicine ER -