Evidence map›Paper›PMID 33020218›Full record

ArticleESMO open2020

Breast cancer subtypes: implications for the treatment and survival of patients in Africa-a prospective cohort study from Mozambique.

Mariana Brandão, Assucena Guisseve, Genoveva Bata, Matos Alberto, Josefo Ferro, Carlos Garcia, Clésio Zaqueu, Cesaltina Lorenzoni, Dina Leitão, Jotamo Come and 6 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in ESMO open, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 27% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it, 28 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Observational
  11. Navigating the Nexus: HIV and Breast Cancer-A Critical Review.International journal of molecular sciences · 2024
    Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Review
  17. Article
  18. Article
  19. Article
  20. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

16 authors at 3 institutions in 4 countries.

Mariana BrandãoEPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Academic Trials Promoting Team, Institut Jules Bordet, Bruxelles, Belgium.
Assucena GuisseveDepartment of Pathology, Faculty of Medicine, University of Eduardo Mondlane, Maputo, Mozambique; Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.
Genoveva BataOncology Unit, Maputo Central Hospital, Maputo, Mozambique.
Matos AlbertoDepartment of Pathology, Maputo Central Hospital, Maputo, Mozambique.
Josefo FerroDepartment of Pathology, Beira Central Hospital, Beira, Mozambique.
Carlos GarciaDepartment of Pathology, Beira Central Hospital, Beira, Mozambique.
Clésio ZaqueuDepartment of Pathology, Nampula Central Hospital, Nampula, Mozambique.
Cesaltina LorenzoniDepartment of Pathology, Faculty of Medicine, University of Eduardo Mondlane, Maputo, Mozambique; Department of Pathology, Maputo Central Hospital, Maputo, Mozambique.
Dina LeitãoDepartment of Pathology, São João University Hospital Center, Porto, Portugal; Department of Pathology and Oncology, Faculty of Medicine, University of Porto, Porto, Portugal.
Jotamo ComeSurgical Department, Maputo Central Hospital, Maputo, Mozambique.
Otília SoaresOncology Unit, Maputo Central Hospital, Maputo, Mozambique.
Alberto Gudo-MoraisOncology Unit, Maputo Central Hospital, Maputo, Mozambique; Radiotherapy Unit, Maputo Central Hospital, Maputo, Mozambique.
Fernando SchmittDepartment of Pathology and Oncology, Faculty of Medicine, University of Porto, Porto, Portugal; Institute of Molecular Pathology and Immunology, University of Porto, Porto, Portugal.
Satish TulsidásEPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Oncology Unit, Maputo Central Hospital, Maputo, Mozambique.
Carla CarrilhoDepartment of Pathology, Faculty of Medicine, University of Eduardo Mondlane, Maputo, Mozambique; Department of Pathology, Maputo Central Hospital, Maputo, Mozambique. Electronic address: carrilhocarla@hotmail.com.
Nuno LunetEPIUnit, Instituto de Saúde Pública, Universidade do Porto, Porto, Portugal; Department of Public Health and Forensic Sciences and Medical Education, Faculty of Medicine, University of Porto, Porto, Portugal.
Maputo Central Hospital · MZUniversidade do Porto · PTEduardo Mondlane University · MZ

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundData regarding breast cancer epidemiology, treatment and survival in Africa are scarce. We aimed to assess the distribution of breast cancer subtypes in Mozambique and its impact on patients' treatment and survival. The concordance of biomarker assessment between cytological and histological samples was also evaluated.

methodsProspective cohort study including 210 patients diagnosed between January 2015 and August 2017, followed to November 2019. Clinicopathological characteristics, treatment, 3-year overall survival (OS) and disease-free survival (DFS) were compared across classic tumour subtypes (oestrogen receptor (ER)-positive/human epidermal growth factor receptor 2 (HER2)-negative, HER2-positive and triple-negative breast cancer (TNBC)) and surrogate intrinsic subtypes (St. Gallen classification). Concordance was measured using Cohen's κ statistics.

resultsA total of 51% of patients had ER-positive/HER2-negative tumours, 24% HER2-positive and 25% TNBC. Concordance between cytological and histological samples regarding ER and HER2 status was substantial (κ=0.762 and κ=0.603, respectively). There were no significant differences across subtypes regarding clinical characteristics and treatment, except for HIV positivity and high histological grade (more prevalent among TNBC) or endocrine therapy (higher use among ER-positive/HER2-negative and HER2-positive patients). Three-year OS was 52.5% (95% CI, 44.3% to 60.0%), being higher in ER-positive/HER2-negative (61.1%) compared with HER2-positive (53.2%) and TNBC (31.9%) patients. Adjusted HRs were 1.96 (95% CI, 1.13 to 3.39) among HER2-positive and 3.10 (95% CI, 1.81 to 5.31) among TNBC versus ER-positive/HER2-negative patients. Three-year DFS was 46.6% (95% CI, 38.0% to 54.8%), being lower among TNBC versus ER-positive/HER2-negative patients (HR 2.91; 95% CI, 1.64 to 5.16). Results were similar between surrogate intrinsic subtypes.

conclusionThere was a high proportion of HER2-positive and TNBC among Mozambican patients and their survival was poor compared with ER-positive/HER2-negative patients, partly due to the limited treatment options. A systematic assessment of ER, PR and HER2 status is feasible and may help tailoring and optimise the treatment of patients with breast cancer in low-resource settings, potentially leading to survival gains in this underserved population.

Indexed as

Receptors, ProgesteroneTriple Negative Breast NeoplasmsHumansMozambiqueProspective StudiesReceptors, EstrogenReceptors, EstrogenReceptors, Progesteronebiomarkersbreast neoplasmsglobal healthsub-Saharan Africasurvival analysis

Identifiers

PMID33020218
PMCPMC7537337
OpenAlexW3091765173

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.