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Breast Cancer Research and Treatment

, Volume 167, Issue 2, pp 425–437 | Cite as

Ethnicity and breast cancer characteristics in Kenya

  • Shahin Sayed
  • Zahir Moloo
  • Ronald Wasike
  • Peter Bird
  • Raymond Oigara
  • Faith Wambui Njoroge
  • Asim Jamal Shaikh
  • Satya Vara Prasad
  • Sudhir Vinayak
  • Gretchen L. Gierach
  • Sanford M. Dawsey
  • Maya Palakal
  • Shaoqi Fan
  • Maeve Mullooly
  • Rajendra Chauhan
  • Patricia Okiro
  • Samuel Gakinya
  • Ancent Nzioka
  • Catherine Kyobutungi
  • Shukri Mohamed
  • Tilahun Haregu
  • Mustafa Mussajee
  • Betty Bonass
  • Costa Mariwa
  • Omar Ali Sherman
  • Abdihakim Mohammed
  • Andrew Gachii
  • Joseph Githaiga
  • Joseph Karanu
  • Robert Nyagah
  • Richard Njoroge
  • Irene Muramba
  • James Obondi Otieno
  • Dan Omondi Raburu
  • Elizabeth B. Mwachiro
  • Innocent Abayo
  • Mansoor Saleh
Preclinical study

Abstract

Purpose

There are no published data from specific regions of sub-Saharan Africa describing the clinical and pathological characteristics and molecular subtypes of invasive breast cancer by ethnic group. The purpose of this study was to investigate these characteristics among the three major ethno-cultural groupings in Kenya.

Methods

The study included women with pathologically confirmed breast cancer diagnosed between March 2012 and May 2015 at 11 hospitals throughout Kenya. Sociodemographic, clinical, and reproductive data were collected by questionnaire, and pathology review and immunohistochemistry were performed centrally.

Results

The 846 cases included 661 Bantus (78.1%), 143 Nilotes (16.9%), 19 Cushites (2.3%), and 23 patients of mixed ethnicity (2.7%). In analyses comparing the two major ethnic groups, Bantus were more educated, more overweight, had an older age at first birth, and had a younger age at menopause than Nilotes (p < 0.05 for all comparisons). In analyses restricted to definitive surgery specimens, there were no statistically significant differences in tumor characteristics or molecular subtypes by ethnicity, although the Nilote tumors tended to be larger (OR for ≥ 5 cm vs. < 2 cm: 3.86, 95% CI 0.77, 19.30) and were somewhat more likely to be HER2 enriched (OR for HER2 enriched vs. Luminal A/B: 1.41, 95% CI 0.79, 2.49).

Conclusion

This case series showed no significant differences in breast cancer tumor characteristics or molecular subtypes, but significant differences in sociodemographic characteristics and reproductive factors, among the three major ethnic groups in Kenya. We suggest further evaluation of ethnic differences in breast cancer throughout the genetically and culturally diverse populations of sub-Saharan Africa.

Keywords

Breast cancer Kenya Ethnic differences Ethnicity Sub-Saharan Africa 

Notes

Acknowledgements

The authors would like to thank GSK-ERI for funding, administrative staff of Aga Khan University, all participating institutions, and all nurses and technologists at the participating sites. In addition, the authors would like to thank Angela Mutuku and Gaylord Mwangi (AKU) for their assistance in formatting and assistance with the illustrations in this manuscript. This study was supported in part by the Intramural Research Program of the Division of Cancer Epidemiology and Genetics of the U.S. National Cancer Institute.

Authors’ Contributions

SS, ZM, and MS conceived and carried out the study; SS, ZM, PO, and SG carried out the centralized laboratory work; IA, CK, TH, and SM performed data management; TH, SM, CK, GLG, SF, MM, and MP analyzed the data; RW, PB, RO, FWN, AJ, SVP, SV, RC, AZ, MM, BB, CM, OAS, AM, AG, JG, JK, RN, RN, IM, JOO, DOR, EBM, and IA contributed to data collection and/or data management. All authors were involved in writing/reviewing the manuscript. All authors gave final approval of the submitted version of the manuscript.

Compliance with ethical standards

Conflict of interest

All the authors have no competing interest to declare.

Ethical approval

Aga Khan University Hospital, Nairobi Research and Ethics Committee (REF: 2011/25), and the institutional review boards of all participating health facilities approved the study. Written informed consent was obtained from all study participants.

Supplementary material

10549_2017_4511_MOESM1_ESM.pdf (10 kb)
Supplementary material 1 (PDF 10 kb)

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Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Shahin Sayed
    • 1
  • Zahir Moloo
    • 1
  • Ronald Wasike
    • 2
  • Peter Bird
    • 3
  • Raymond Oigara
    • 4
    • 5
  • Faith Wambui Njoroge
    • 6
  • Asim Jamal Shaikh
    • 7
  • Satya Vara Prasad
    • 8
  • Sudhir Vinayak
    • 9
  • Gretchen L. Gierach
    • 10
  • Sanford M. Dawsey
    • 10
  • Maya Palakal
    • 10
  • Shaoqi Fan
    • 10
  • Maeve Mullooly
    • 10
  • Rajendra Chauhan
    • 2
  • Patricia Okiro
    • 1
  • Samuel Gakinya
    • 1
  • Ancent Nzioka
    • 11
  • Catherine Kyobutungi
    • 12
  • Shukri Mohamed
    • 12
  • Tilahun Haregu
    • 12
  • Mustafa Mussajee
    • 13
  • Betty Bonass
    • 14
  • Costa Mariwa
    • 15
  • Omar Ali Sherman
    • 16
  • Abdihakim Mohammed
    • 17
  • Andrew Gachii
    • 18
  • Joseph Githaiga
    • 13
  • Joseph Karanu
    • 4
  • Robert Nyagah
    • 4
  • Richard Njoroge
    • 19
  • Irene Muramba
    • 20
  • James Obondi Otieno
    • 21
  • Dan Omondi Raburu
    • 21
  • Elizabeth B. Mwachiro
    • 22
  • Innocent Abayo
    • 1
  • Mansoor Saleh
    • 23
  1. 1.Department of PathologyAga Khan University HospitalNairobiKenya
  2. 2.Department of SurgeryAga Khan University HospitalNairobiKenya
  3. 3.Department of SurgeryAIC Kijabe HospitalKijabeKenya
  4. 4.Department of SurgerySt. Mary’s Mission HospitalNairobiKenya
  5. 5.Kisii Referral HospitalKisiiKenya
  6. 6.Department of SurgeryNyeri Provincial General HospitalNyeriKenya
  7. 7.Department of Medical OncologyAga Khan University HospitalNairobiKenya
  8. 8.Department of PathologyAga Khan HospitalKisumuKenya
  9. 9.Department of RadiologyAga Khan University HospitalNairobiKenya
  10. 10.Division of Cancer Epidemiology and GeneticsNational Cancer InstituteBethesdaUSA
  11. 11.Department of PathologyAIC Kijabe HospitalKijabeKenya
  12. 12.EpidemiologyAfrican Population And Health Research Centre (APHRC)NairobiKenya
  13. 13.Division of SurgeryKenyatta National HospitalNairobiKenya
  14. 14.Department of RadiologyKenyatta National HospitalNairobiKenya
  15. 15.Department of SurgeryAga Khan HospitalKisumuKenya
  16. 16.Department of PathologyAga Khan HospitalMombasaKenya
  17. 17.Department of SurgeryAga Khan HospitalMombasaKenya
  18. 18.Department of Human PathologyKenyatta National HospitalNairobiKenya
  19. 19.Department of PathologyGarissa Provincial General HospitalGarissaKenya
  20. 20.Department of PathologyCoast Provincial General HospitalMombasaKenya
  21. 21.Department of SurgeryNew Nyanza Provincial General HospitalKisumuKenya
  22. 22.Department of SurgeryTenwek HospitalTenwekKenya
  23. 23.Division of Haematology & OncologyUniversity of Alabama at BirminghamBirminghamUSA

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