Prospective observational study in early breast cancer at University Hospital of Tlemcen

Abstract

Background: Breast cancer is the first cancer in women in Algeria. It affects a significant proportion of young women. Stage at diagnosis is made with a positive, massive, and often lymph node involvement. The objective of this study is to determine the clinicopathological and histological features of patients treated for invasive breast carcinoma.

Methods: This is an observational prospective study from January 2006 to December 2011 done at the medical oncology department at the University Hospital Center of Tlemcen: 103 patients with early breast cancer were included.

Results: Extreme age is between 29 and 70 years; 50% of patients are under 47 years. The average age at diagnosis of 46.45 ± 0.90 years; 54% are stage T2; 17% are stage T3 and 4% stage T4; stage III is the most frequent with 50.4%. Half of patients have four to nine nodes with relatively wide tumor size, and only one patient was stage I; 10% had more than 10 positive nodes. The infiltrating ductal carcinoma is the most common histological types (83.5%), followed by atypical carcinoma (5.82%). Note the predominance of grade II of Scarf Bloom and Richardson (58.25%), followed by grade III (36.89%) and grade I (1.91%). Over 50% of patients had a tumor size of 35.41 ± 1.82 mm. Hormone receptors were positive in 65% of patients (ER + PR +) and negative in 35%. HER2 status was determined in 82 patients, 12% expressed a positive score, and 67% of were negative. The luminal profile is the most common in our study population with 57.3%, followed by triple negative tumors or basal-like with 26.8%. Conservative surgical treatment was realized in 2.9% and an astectomy in most patients at 97%. Radiotherapy was performed in 83.5% of patients, and 65% of patients received hormone therapy according to hormone positivity.

Conclusion: The clinical and histological profiles of the patients in our study population are different from Western populations by the average age of diagnosis of 46 years, 10 years higher for Western women, and the stage is more advanced for our population. The majority are at stage III, while Western women are diagnosed at stage I or II through screening. Given the Algerian profile, women should be offered screening at aged 40 years for earlier diagnosis and improved survival rate.