ArticleCancer immunology research2023
Regional Variation in the Tumor Microenvironment, Immune Escape and Prognostic Factors in Breast Cancer in Sub-Saharan Africa.
Article in Cancer immunology research, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
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11 citing papers in PubMed, 21 citations in OpenAlex.
- Tumour-Derived sEVs Promote Triple-Negative Breast Cancer Progression Associated with HAVCR2 Upregulation in Macrophages.Oncology research · 2026Article
- Impact of Distinct Molecular and Immunological Features of Breast Cancer on the Effectiveness of Therapies in Ghana.Breast cancer : basic and clinical research · 2026Review
- Breast cancer overall survival, annual risks of death, and survival gap apportionment in sub-Saharan Africa (ABC-DO): 7-year follow-up of a prospective cohort study.The Lancet. Global health · 2025Article
- Quantitative analysis of T cell subsets in a population of Black women with invasive breast cancer.NPJ breast cancer · 2025Article
- HIV status alters immune cell infiltration and activation profile in women with breast cancer.Nature communications · 2025Article
- The role of ceRNAs in breast cancer microenvironmental regulation and therapeutic implications.Journal of molecular medicine (Berlin, Germany) · 2025Review
- Immune environment of high-TIL breast cancer: triple negative and hormone receptor positive HER2 negative.NPJ breast cancer · 2024Article
- PAM50 breast cancer subtypes and survival of patients in rural Ethiopia without adjuvant treatment: a prospective observational study.BMC cancer · 2024Observational
- CD163Breast cancer research : BCR · 2024Article
- Association of immune evasion in myeloid sarcomas with disease manifestation and patients' survival.Frontiers in immunology · 2024Article
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32 authors at 20 institutions in 15 countries.
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Abstract
The low overall survival rates of patients with breast cancer in sub-Saharan Africa (SSA) are driven by regionally differing tumor biology, advanced tumor stages at diagnosis, and limited access to therapy. However, it is not known whether regional differences in the composition of the tumor microenvironment (TME) exist and affect patients' prognosis. In this international, multicentre cohort study, 1,237 formalin-fixed, paraffin-embedded breast cancer samples, including samples of the "African Breast Cancer-Disparities in Outcomes (ABC-DO) Study," were analyzed. The immune cell phenotypes, their spatial distribution in the TME, and immune escape mechanisms of breast cancer samples from SSA and Germany (n = 117) were investigated using histomorphology, conventional and multiplex IHC, and RNA expression analysis. The data revealed no regional differences in the number of tumor-infiltrating lymphocytes (TIL) in the 1,237 SSA breast cancer samples, while the distribution of TILs in different breast cancer IHC subtypes showed regional diversity, particularly when compared with German samples. Higher TIL densities were associated with better survival in the SSA cohort (n = 400), but regional differences concerning the predictive value of TILs existed. High numbers of CD163+ macrophages and CD3+CD8+ T cells accompanied by reduced cytotoxicity, altered IL10 and IFNγ levels and downregulation of MHC class I components were predominantly detected in breast cancer samples from Western SSA. Features of nonimmunogenic breast cancer phenotypes were associated with reduced patient survival (n = 131). We therefore conclude that regional diversity in the distribution of breast cancer subtypes, TME composition, and immune escape mechanisms should be considered for therapy decisions in SSA and the design of personalized therapies. See related Spotlight by Bergin et al., p. 705.
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