Response to chemotherapy and association with three tumour markers in breast cancer patients in Ghana
Purpose: Oestrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor 2 (HER2/neu) expression in breast cancer patients predict response to chemotherapy though recorded extent vary. This retrospective study aimed to investigate the relationship between ER, PR and HER2/neu expression and response of breast cancer to chemotherapy at a tertiary hospital in Ghana.
Methods: Records of all breast cancer cases seen from 2009 through 2011 were reviewed. Their receptor status, first line treatment [4 cycles of Adriamycin (60mg/m2) + Cyclophosphamide (600mg/m2)], second line treatment [Capecitabine (1g/m2) + Paclitaxel (170mg/m2)] and clinical response were extracted.
Results: Complete remission after first and second line treatments were observed in 36 (38.3%, 95% CI: 28.5 to 48.9) and 34 (58.6%, 95% CI: .44.9 to 71.4) respectively. After both first and second line treatment 70 (74.5%, 95% CI: 64.4 - 82.9) had gone into remission. Prevalence of ER, PR, HER2/neu and Triple negative breast cancer (TNBC) were 34.0% (95% CI: 24.6 to 44.5), 20.2% (95% CI: 12.6 to 29.7), 8.5% (95% CI: 3.7 to 16.1) and 59.6% (95%CI: 48.9 to 69.6) respectively. ER and PR positivity were independently associated with complete remission after first line treatment while TNBC was associated with non-remission. Conversely ER was independently associated with non-remission after second line treatment while TNBC was associated with complete remission.
Conclusion: ER and TNBC status are significant predictors of complete remission and non-remission respectively after chemotherapy for breast cancer patient in Ghana.
Cite this article as:
Amankwaa-Frempong E, Yeboah FA, Nguah SB, Afriyie OO. Response to chemotherapy and association with three tumour markers in breast cancer patients in Ghana. Int J Cancer Ther Oncol 2014; 2(3):02034. DOI: 10.14319/ijcto.0203.4
Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011; 61:69-90.
Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55:74-108.
Mettlin C. Global breast cancer mortality statistics. CA Cancer J Clin 1999; 49:138-44.
Parkin DM. Cancer in developing countries. Cancer Surv 1994; 19-20:519-61.
Clegg-Lamptey J, Hodasi W. A study of breast cancer in korle bu teaching hospital: assessing the impact of health education. Ghana Med J 2007; 41:72-7.
Clegg-Lamptey JN, Dakubo JC, Attobra YN. Psychosocial aspects of breast cancer treatment in Accra, Ghana. East Afr Med J 2009; 86:348-53.
Ohene-Yeboah MO. An audit of excised breast lumps in Ghanaian women. West Afr J Med 2005; 24:252-5.
Barret-Lee PJ. Growth factor signalling in clinical breast cancer and its impact on response to conventional therapies: a review of chemotherapy. Endocr Relat Cancer 2005; 12 Suppl 1: S125-33.
Muss HB, Thor AD, Berry DA, et al. c-erbB-2 expression and response to adjuvant therapy in women with node-positive early breast cancer. N Engl J Med 1994, 330:1260-6.
Slamon DJ, Clark GM, Wong SG, et al. Human breast cancer: correlation of relapse and survival with amplification of the HER-2/neu oncogene. Science 1987; 235:177-82.
Willsher PC, Pinder SE, Gee JM, et al. C-erbB2 expression predicts response to preoperative chemotherapy for locally advanced breast cancer. Anticancer Res 1998; 18:3695-8.
Gregory RK, Powles TJ, Salter J, et al. Prognostic relevance of cerbB2 expression following neoadjuvant chemotherapy in patients in a randomised trial of neoadjuvant versus adjuvant chemoendocrine therapy. Breast Cancer Res Treat 2000; 59:171-5.
Thor AD, Berry DA, Budman DR, et al. erbB-2, p53, and efficacy of adjuvant therapy in lymph node-positive breast cancer. J Natl Cancer Inst 1998; 90:1346-60.
Ellis IO, Dowsett M, Bartlett J, et al. Recommendations for HER2 testing in the UK. J Clin Pathol 2000; 53:890-2.
International Breast Cancer Study Group (IBCSG). Endocrine responsiveness and tailoring adjuvant therapy for postmenopausal lymph node-negative breast cancer: a randomized trial. J Natl Cancer Inst 2002; 94:1054-65.
Berry DA, Cirrincione C, Henderson IC, et al. Estrogen-receptor status and outcomes of modern chemotherapy for patients with node-positive breast cancer. Jama 2006; 295:1658-67.
Colleoni M, Viale G, Zahrieh D, et al. Chemotherapy is more effective in patients with breast cancer not expressing steroid hormone receptors: a study of preoperative treatment. Clin Cancer Res 2004; 10:6622-8.
Gianni L, Zambetti M, Clark K, et al. Gene expression profiles in paraffin-embedded core biopsy tissue predict response to chemotherapy in women with locally advanced breast cancer. J Clin Oncol 2005; 23: 7265-77.
Buzdar AU, Valero V, Theriault RL, et al. Pathological complete response to chemotherapy is related to hormone receptor status [abstract]. Breast Cancer Res Treat 2003; 85:2.
MacGrogan G, Mauriac L, Durand M, et al. Primary chemotherapy in breast invasive carcinoma: predictive value of the immunohistochemical detection of hormonal receptors, p53, c-erbB-2, MiB1, pS2 and GST pi. Br J Cancer 1996; 74: 1458-65.
Colleoni M, Orvieto E, Nolé F, et al. Prediction of response to primary chemotherapy for operable breast cancer. Eur J Cancer 1999; 35: 574-9.
Irvin WJ Jr, Carey LA. What is triple-negative breast cancer? Eur J Cancer 2008; 44:799-805.
Rouzier R, Perou CM, Symmans WF, et al. Breast cancer molecular subtypes respond differently to preoperative chemotherapy. Clin Cancer Res 2005; 11:5678-85.
Carey LA, Dees EC, Sawyer L, et al. The triple negative paradox: primary tumor chemosensitivity of breast cancer subtypes. Clin Cancer Res 2007; 13: 2329-34.
Liedtke C, Mazouni C, Hess KR, et al. Response to neoadjuvant therapy and long-term survival in patients with triple-negative breast cancer. J Clin Oncol 2008; 26:1275-81.
Therasse P, Arbuck SG, Eisenhauer EA, et al. New guidelines to evaluate the response to treatment in solid tumors. European Organization for Research and Treatment of Cancer, National Cancer Institute of the United States, National Cancer Institute of Canada. J Natl Cancer Inst 2000; 92: 205-16.
Ohene-Yeboah M, Adjei E. Breast cancer in Kumasi, Ghana. Ghana Med J 2012; 46: 8-13.
Christina Davies, Hongchao Pan, Jon Godwin, et al. and for the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) Collaborative Group† Long-term effects of continuing adjuvant tamoxifen to 10 years versus stopping at 5 years after diagnosis of oestrogen receptor-positive breast cancer: ATLAS, a randomised trial 2013; 381:805-16.
Yarney J, Vanderpuye V, Clegg Lamptey JN. Hormone receptor and Her-2 expression in breast cancers among sub-Saharan African women. Breast J 2008; 14: 510-11.
Fregene A, Newman LA. Breast cancer in sub-Saharan Africa: how does it relate to breast cancer in African-American women? Cancer 2005; 103:1540-50.
Allegra JC, Lippman ME, Simon R, et al. Association between steroid hormone receptor status and disease-free interval in breast cancer. Cancer Treat Rep 1979; 63:1271-7.
Al-Dujaily EA, Al-Janabi AA, Pierscionek T, Yasseen AA. High prevalence of HER-2/neu overexpression in female breast cancer among an Iraqi population exposed to depleted uranium. J Carcinog 2008; 7:8.
Sughayer MA, Al-Khawaja MM, Massarweh S, Al-Masri M. Prevalence of hormone receptors and HER2/neu in breast cancer cases in Jordan. Pathol Oncol Res 2006; 12:83-6.
Sawaki M, Ito Y, Akiyama F, et al. High prevalence of HER-2/neu and p53 overexpression in inflammatory breast cancer. Breast Cancer 2006; 13:172-8.
Tokatli F, Altaner S, Uzal C, et al. Association of HER-2/neu overexpression with the number of involved axillary lymph nodes in hormone receptor positive breast cancer patients. Exp Oncol 2005; 27:145-9.
Pegram MD, Finn RS, Arzoo K, et al. The effect of HER-2/neu overexpression on chemotherapeutic drug sensitivity in human breast and ovarian cancer cells. Oncogene1997; 15:537-47.
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