Clinical profile, BRCA2 expression, and the androgen receptor CAG repeat region in Egyptian and Moroccan male breast cancer patients

Article type: Research Article

Authors: Gilbert, Samuel F.^a | Soliman, Amr S.^{a; *} | Karkouri, Mehdi^b | Quinlan-Davidson, Meaghen^a | Strahley, Ashley^a | Eissa, Mohab^a | Dey, Subhojit^a | Hablas, Ahmed^c | Seifeldin, Ibrahim A.^c | Ramadan, Mohamed^c | Benjaafar, Noureddine^d | Toy, Kathy^e | Merajver, Sofia D.^{f; g}

Affiliations: [a] Department of Epidemiology, University of Michigan School of Public Health, Ann Arbor, MI, USA | [b] Department of Pathology, Centre Hospitalier Universitaire Ibn Rochd, Casablanca, Morocco | [c] Gharbiah Cancer Society and Gharbiah Cancer Registry, Tanta, Egypt | [d] Department of Radiotherapy, National Institute of Oncology, Rabat, Morocco | [e] Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA | [f] Department of Internal Medicine, University of Michigan Medical School, Ann Arbor, MI, USA | [g] University of Michigan Center for Global Health, Ann Arbor, MI, USA

Correspondence: [*] Corresponding author: Amr S. Soliman, M.D., Ph.D.; Department of Epidemiology, University of Michigan School of Public Health, 5626 SPH I 1415 Washington Heights, Ann Arbor, Michigan 48109-2029, USA. Tel.: +1 734 764 5469; Fax: +1 734 764 3192; E-mail: asoliman@umich.edu

Abstract: Introduction:Male breast cancer (MBC) is a rare disease. Rates of MBC in Northern Africa vary by region. The age-standardized incidence for MBC is higher in Morocco than in Egypt, and the Egyptian rate is similar to the U.S of approximately 1/105. This study aimed at investigating the clinical and molecular characteristics of MBC in Egypt and Morocco. Methods:This case-case study included 211 cases from Egypt and 132 from Morocco. Tumor tissues were available for 47 Egyptian and 18 Moroccan patients. Medical record information was abstracted for patients’ demographics, medical history, and treatment. BRCA2 protein expression status was examined in Egyptian and Moroccan tumors. Androgen receptor CAG repeat length was analyzed using the tissue samples in Egyptian MBC tumors and controls. Limited amount of tissues from Morocco did not allow for the analysis of CAG repeats. Results:Egyptian MBC patients had a significantly lower age at diagnosis (Egypt: 57.5±15.1, Morocco: 63.9±14.4, P=0.0002) and a higher prevalence of liver cirrhosis (Egypt: 28.0%, Morocco: 0.8%, P=<0.0001). MBC patients also had higher tumor grades [I (0.9%), II (81.0%), III (18.1%)] in Egypt vs. [I (10.7%), II (81.0%), III (8.3%)] in Morocco (P=0.0017). The clinical and molecular characteristics of the groups from the 2 countries did not significantly differ. There was no significant difference with respect to BRCA2 expression amongst countries (Egypt: 28.9% non-wild type, Morocco: 27.8% non-wild type, P=0.9297) or CAG lengths amongst BRCA2 expression types in Egyptians (Wild type: 54.6% with CAG repeat lengths of 20+, Non-wild type: 50% with CAG repeat lengths of 20+, P=0.7947). Conclusions:Differences in MBC between Egypt and Morocco are more likely due to differences in other risk factors such as consanguinity and use of xenoestrogenic pesticides.

Keywords: Male breast cancer, breast cancer, Egypt, Morocco, developing countries

DOI: 10.3233/BD-2010-0323

Journal: Breast Disease, vol. 33, no. 1, pp. 17-26, 2012