VIDEO: Efforts needed to address global disparities in breast cancer diagnosis
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CHICAGO — Healio spoke with Clement A. Adebamowo, MD, ScD, about his poster presentation at ASCO Annual Meeting regarding breast cancer subtype testing in Nigeria.
“Classically, we’ve often been told that the breast cancers from patients in low-resource environments lack hormone receptors, but previous studies have shown that this is probably a result of poor tissue handling and preanalytic factors rather than inherent biological difference,” Adebamowo, a professor in the department of epidemiology and public health and the associate director for population sciences for the Greenebaum Cancer Center at University of Maryland, Baltimore, said.
The study compared results from estrogen receptor and progesterone receptor subtyping using both immunohistochemistry — which faces barriers in low- and middle-income countries — and Cepheid GeneXpert RNA STRAT4 biomarker assays.
The study enrolled 1,000 patients with breast cancer across five sites in Nigeria. Researchers completed immunohistochemistry and Cepheid GeneXpert RNA STRAT4 biomarker assays in Nigeria and at University of Maryland.
Researchers found that, with both estrogen receptor and hormone receptor testing, there was a wide range of sensitivities, specificities and agreement between the immunohistochemistry results and the STRAT4 results.
“Findings suggest that we need to do more to characterize the molecular subtypes of breast cancer in low-resource centers,” he said. “We also need to be aware that the classical immunohistochemistry approach to establishing the molecular subtypes of breast cancer may not be ideal for low-resource environments because of infrastructural and personnel limitations.”
According to Adebamowo, additional research to develop similar methods used in the study “may actually reduce the multiple checkpoints that were identified in using immunohistochemistry for the molecular subtyping.”
He added that “further research on this is needed to improve the validation of the test and establish where precisely in the breast cancer care consortium we’ll want to locate this particular test and also determine how best to use it in this environment.”
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