Bangladeshi women with breast cancer frequently present at a younger age and advanced stage, with a substantial proportion of aggressive molecular subtypes, highlighting the need for early detection strategies and subtype-guided management in tertiary care settings.
Abstract
Introduction: Breast cancer in Bangladeshi women often presents at a younger age with advanced stage. The variable molecular characteristics influencing prognosis and treatment response. Local clinicopathological and subtype data remain limited in tertiary surgical settings. The aim of this study is to evaluate the clinicopathological features and molecular subtypes of breast cancer among Bangladeshi women in a tertiary level.
Methods: This prospective cohort study was conducted at Bangladesh Medical University (BMU), Dhaka, Bangladesh and East West Medical College Hospital (EWMCH), Dhaka, Bangladesh, from January 2019 to December 2022. A total of 147 histopathologically confirmed breast cancer patients were enrolled using purposive sampling. Demographic, clinical, histopathological, and immunohistochemical data Estrogen Receptor(ER), Progesterone Receptor(PR), Human Epidermal Growth Factor Receptor(HER2), Kiel 67(Ki-67) were recorded. Data were analyzed using SPSS version 23.0.
Results: Most patients were £50 years (62.6%) and presented with stage II–III disease (72.8%). Invasive ductal carcinoma predominated (88.4%). Tumors >2 cm (71.4%) and nodal metastasis (64.6%) were common. ER positivity was 55.1%, PR positivity was 49.0%, HER2 overexpression 27.2%, and high Ki-67 58.5%. Luminal A was most frequent (32.0%), followed by luminal B (26.5%), triple-negative (23.1%), and HER2-enriched (18.4%). Aggressive subtypes were significantly associated with higher grade and larger tumors (p<0.05).
Conclusion: Bangladeshi women with breast cancer frequently present at a younger age and advanced stage, with a substantial proportion of aggressive molecular subtypes. These findings highlight the need for early detection strategies and subtype-guided management in tertiary care settings.
Journal of Surgical Sciences 2024;28(1): 15-19
Longer symptom duration was associated with larger tumor size, and larger tumor size was significantly associated with nodal positivity, highlighting the importance of early diagnosis, timely referral, and breast cancer awareness programs to improve clinical outcomes.
Ovi Mra, MZ Rahman, MF Eastiak et al.· Journal of surgical sciences· 0 citations
Background: Breast cancer (BC) is the most globally diagnosed malignancy among women. However, information on clinicopathological patterns in Libyan and North African women remains limited. This study examined age-related differences in histological diagnosis, disease extent, tumor grade, and hormone-receptor status in hospitalized BC women. Methods: A retrospective cross-sectional analysis was conducted on 399 patients from 2023–2025. All participants were aged 13–39 years. Age was summarized continuously and categorized as ≤29, 30–34, and 35–39 years. Diagnoses were harmonized into major histological groups. Estrogen receptor (ER), progesterone receptor (PR), and HER2 results were normalized as positive, negative, or unknown. Disease extent was operationally classified from TNM fields as early (T1–T2/N0–N1/M0), locally advanced (T3–T4 or N2–N3/M0), metastatic (M1), or unclassified. Associations were evaluated using Pearson’s chi-square tests, with two-sided P<0.05 considered statistically significant. Results :showed that the Mean age was 32.9±4.5 years, and the median age was 34 years (IQR 30–37). Invasive ductal carcinoma accounted for 342 records (85.7%), although benign and non-epithelial diagnoses were also present. Grade II and III tumours represented 51.1% and 40.6%, respectively. ER, PR, and HER2 positivity were counted in 44.1%, 37.6%, and 41.6% of cases, respectively. Basal-like, luminal A, luminal B, and HER2-enriched subtypes were recorded for 32.6%, 24.6%, 21.8%, and 20.3%, respectively. Locally advanced disease predominated (61.4%), while 17.0% were metastatic. Histological composition differed across age categories (P<0.001), but age was not significantly associated with grade, ER, PR, HER2, or disease extent. Conclusion: This unusually young cohort showed a high burden of grade II–III and locally advanced disease in Libya. However, diagnostic heterogeneity limits generalizability. Registry standardization, pathology verification, and population-based studies are required.
Eman Elgusbi, Manal O. Abuagela, Fadwa Mahanay· Libyan journal of medical re...· 0 citations
Background: Triple-negative breast carcinoma (TNBC) lacks established hormonal targets, limiting therapeutic options. Androgen receptor (AR) expression has been proposed as a potential biomarker, though its clinicopathological relevance remains unclear.
Aims and Objectives: This study evaluated the prevalence of AR expression in TNBC and its association with clinicopathological parameters.
Materials and Methods: This retrospective cross-sectional study included 52 patients with TNBC treated at Tirunelveli Medical College (2017–2019). Primary TNBC cases with adequate formalin-fixed, paraffin-embedded tissue were included, while cases receiving neoadjuvant therapy or with inadequate tissue were excluded. AR expression was assessed by immunohistochemistry (≥1% nuclear staining=positive). Tumors were classified and graded according to the World Health Organization Classification of Breast Tumors and the Nottingham-modified Bloom–Richardson system, respectively. Associations with clinicopathological variables were analyzed using appropriate statistical tests, with P<0.05 considered significant.
Results: AR expression was identified in 22 of 52 cases (42%). The mean age was 52.41±11.49 years in AR-positive cases and 49.80±10.76 years in AR-negative cases (P=0.701). Mean tumor size was comparable between AR-positive (4.04±2.06 cm) and AR-negative tumors (4.31±2.77 cm; P=0.405). No significant association was observed between AR expression and histological tumor type (P=0.722), tumor grade (P=0.332), tumor necrosis (P=0.879), stromal response (P=0.297), or lymph node status (P=0.281).
Conclusion: AR expression was present in 42% of TNBC cases and showed no significant association with clinicopathological parameters.
K. S, Johnraj Suresh M, Narayana Vadivoo R· Asian Journal of Medical Sci...· 0 citations
It is highlighted that the majority of patients present with advanced stages of breast cancer, with Stage II being the most common, and routine psychological evaluations into cancer care is recommended to improve patient outcomes.
H. Tayade, P. Tiwari, A. Kushwaha· Medical Journal of Dr. D.Y....· 0 citations
Background/Objectives: Lung cancer is increasingly recognized in young adults, but data specific to patients younger than 30 years remain scarce. We aimed to characterise the clinicopathological features, molecular profiles, and survival outcomes of lung cancer in adults younger than 30 years. Methods: A retrospective cohort study was conducted at the Department of Respiratory Disease, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, China. Patients aged 18 to 30 years with pathologically confirmed primary lung cancer, admitted between August 2011 and October 2021, were identified from the pathology and oncology databases of the study centre; eligibility and exclusion criteria and the resulting analytic cohort are summarized below (a screened/excluded patient count could not be reconstructed retrospectively; see Limitations). Demographics, histology, stage (eighth-edition TNM), driver mutations, and treatment were extracted, and the extent of missing data for each variable was assessed. Molecular testing was not performed prospectively for this study; rather, we report driver-mutation results that had already been generated as part of routine clinical care for patients in whom testing was clinically indicated and archived tissue was available. Overall survival (OS) was estimated using the Kaplan–Meier method and compared using the log-rank test; hazard ratios (HRs) were derived from univariate Cox regression and are reported as exploratory/descriptive given the non-randomized comparison (see Discussion). Results: Among 139 patients meeting eligibility criteria, the cohort was predominantly female (65.5%) and most individuals were never-smokers (92.8%), with adenocarcinoma predominating (93.5%). Stage I (61.2%) and stage IV (30.2%) were most common. Of 34 patients (24.5%) with available molecular testing results, 23 (67.6%) carried a driver mutation, of whom 19 (82.6%) had stage IV disease. Among mutation-positive patients—drawn from a selectively tested subcohort enriched for advanced-stage disease—ALK rearrangement was most frequent (13; 56.5%). In the stage IV subgroup, patients who received first-line tyrosine kinase inhibitors (TKIs) had a longer observed OS than those who did not (median, 88 vs. 24 months); this exploratory, non-randomized comparison is reported descriptively rather than as an adjusted treatment-effect estimate (see Limitations). Conclusions: In this single-centre retrospective cohort, adults aged <30 years with lung cancer were predominantly female never-smokers with adenocarcinoma. Among the selectively tested advanced-stage subgroup, ALK fusions were common. These data justify further multicentre study and broader contemporary molecular characterisation.
Jingchen Zhang, Jianya Zhou· Journal of Clinical Medicine· 0 citations
Objectives: Endometrial carcinoma (EC) is the most common malignancy of the female reproductive tract, with diverse clinicopathological and molecular characteristics. This study evaluates the gross pathological features of the tumour, histological subtypes, molecular findings, and demographic distribution in EC patients. Materials and Methods: A retrospective analysis of 150 cases assessed tumour size, myometrial invasion, Federation of Gynaecology and Obstetrics (FIGO) grade, lymph node invasion, histological subtypes, and molecular studies. Risk factors like obesity, diabetes, and nulliparity were documented. Results: Most patients were aged 50-69, with 86.6% of tumours <5 cm. Myometrial invasion was <50% in 59.1% of cases, with 51% graded as FIGO 1. Lymph node invasion occurred in 2%. Endometrioid adenocarcinoma was the most common subtype (40.3%), followed by serous carcinoma (10.1%). Molecular studies showed p53 mutations in 8.1% and microsatellite instability in 1.3%. Most tumours were diagnosed at FIGO Stage I. Conclusion: Endometrial carcinoma primarily affects postmenopausal women, with Endometrioid EC, FIGO grade 1 histology and stage 1 being the most common. Identifying high-risk factors like obesity and diabetes can aid early detection. Further research into molecular markers is recommended to enhance prognostication and therapy.
Kundhavai Krishna Kumar, Divya Dhanabal, Sandhya Sundaram· Indian Journal of Obstetrics...· 0 citations
