Histopathology of breast cancer in different populations: Comparative analysis for Finland and Africa

Offiong Francis Ikpatt, Paulina Kronqvist, Teijo Kuopio, Roland Ndoma-Egba, Yrjö Collan

Research output: Contribution to journalArticlepeer-review

2 Scopus citations

Abstract

Differences between Finnish and Nigerian breast cancers were studied. The Finnish cases (n = 285) were from years 1988-1991 and had a long follow-up. The Nigerian cases (n = 300) were from years 1983-1999. The follow-up was generally shorter than in the Finnish cases. Age. The average age among patients in Finland was 59.5 years, and in Nigeria 42.17 years. Age distributions were completely different. The lack of old patients in Nigeria can be explained by the fact that the average life expectancy in Nigeria is clearly lower than in Finland (51.6 years, and 77.4 years, respectively). Still the number of very young breast cancer patients in Nigeria is surprising, about 10 % of patients get breast cancer below the age of 27 years. Extension. Nigerian breast cancers at the diagnostic phase are larger (mean 4.8 cm versus 2.6 cm), have higher stage on average, and are often lymph node positive (79.1 % are LN + in contrast to 34.0 % in Finland). Histology and morphometry. Invasive ductal breast cancer is the most dominant variant in both countries, but in Nigerian cases the grade is higher on average. Tubular differentiation was less in Nigerian cancers than in Finnish cancers. On average, Nigerian breast cancer cell nuclei were larger than the Finnish breast cancer cell nuclei. Survival and epidemiological associations. Also survival is worse in Nigeria, although the difference is not dramatic after correction for grade. Breast cancer incidence is much lower in Nigeria (15.8 per 100000 versus 75.8 per 100000 in Finland). Nigerian patients have higher parity, and lower age at first pregnancy than the Finnish patients. Proliferation and apoptosis. Measurements based on standardized mitotic index showed that proliferative activity is higher in Nigerian tumours. Apoptotic index was higher in Nigeria, and the ratio of mitotic index and the apoptotic index was also higher. Necrosis was also more common. The differences between Finnish and Nigerian cases can, at least partly, be explained on the more advanced character of disease in Nigeria. The tumors are probably in a more progressed phase before treatment starts. Analysis of the prognostic value of different cancer features suggested that the most optimal grading could be different in Nigeria and in Europe. The study proves that population based differences may be so significant that they should be considered when the policy of breast cancer treatment is planned in Nigeria.

Original languageEnglish (US)
Pages (from-to)24011-24018
Number of pages8
JournalElectronic Journal of Pathology and Histology
Volume8
Issue number4
StatePublished - Dec 2002
Externally publishedYes

Keywords

  • Africa
  • Age
  • Apoptosis
  • Apoptotic counts
  • Breast cancer
  • Europe
  • Finland
  • Grade
  • Histopathology
  • MAI
  • Mitotic counts
  • Morphometry
  • Nigeria
  • Proliferation
  • SMI
  • Stage
  • Survival

ASJC Scopus subject areas

  • Anatomy
  • Histology

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