Triple negative and basal-like breast cancer in East Africa

Interest in identifying populations with triple negative (TN) and basal-like breast cancer stems from the poor prognosis associated with this breast cancer subtype (1–3). Gene expression profiling analysis is the gold standard for diagnosing basal-like breast cancer; however, this technology is often inaccessible or not feasible in most global clinical settings. Therefore, in clinical practice, the absence of the estrogen and progesterone receptor (ER and PR) determined by immunohistochemistry (IHC), and the absence of HER-2 receptor over expression determined by IHC or fluorescent in situ hybridization (FISH) (i.e., the ‘‘triple negative’’ phenotype) is used as a surrogate for diagnosing basal-like breast cancer, although both are not entirely synonymous. The prevalence of basal-like and TN breast cancer has been shown to be higher among BRCA1 mutation carriers (4–6), African-American women (7–9), and in women from regions of West Africa (9,10) compared with estimates of TN and basal-like disease among western, Caucasian women, which ranges approximately between 11% and 16% (3,7,9)