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Elevated pre-treatment systemic immuno-inflammatory indices, triple-negative breast cancer, and P53 mutation are associated with early-onset breast cancer in south-eastern Nigeria

J.O. Okoye
D.O Samuel
K.S. Ezidiegwu
M.E. Chiemeka
O.A. Okoye
G.U. Eleje


Background: In West Africa, breast cancer (BC) patients have a mortality rate that is three times higher than those in North America and  Northwestern Europe.

Aim: This study aimed to identify high-risk patients by evaluating the pre-treatment systemic inflammatory indices,  p53, and BRCA2 expressions in molecular sub-types of BC in South-Eastern Nigeria.

Methods: This retrospective cohort study included 152 BC tissues, diagnosed between January 2017 and December 2022. The tissue  sections were immunohistochemically stained for p53, BRCA2, hormone receptors, and human epidermal growth factor receptor 2  (HER2), scored, and analyzed accordingly. Statistical significance was set at p≤ 0.05.

Results: The frequency of early-onset BC ( 49 years) was 58.6% while the frequency of early-onset BC among patients with a family  history of cancer was 76.5%. The frequency of late-stage BC was 84.9%. The frequency of luminal A and triple-negative BC (TNBC) was 1.7  times higher in early-onset BC. In comparison, the frequency of Luminal B/B-like and HER2-enriched BC was 1.9 times higher in late-onset  BC (p= 0.022). The frequency of p53 and BRCA2 mutation was 1.6 times and 1.2 times higher in early-onset BC than in late-onset BC  (p= 0.003 and p= 0.843, respectively). Significant differences in pretreatment systemic inflammatory index were observed between  patients with early-onset and late-onset BC, and 6 months survival and > 12 months survival (p< 0.05).

Conclusion: This study found a  high incidence of early-onset BC, p53 mutation, and TNBC. Additionally, it suggests that pre-treatment systemic inflammatory indices can   identify high-mortality-risk patients and early-onset BC.