“Quantitative Determination of Oestrogen Receptors in Human Breast Cancer Tissue; as a Guide to Surgeons in the Selection of Therapy for Breast Cancer”

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1998-02-14
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This work is the first to establish estrogen receptor status in human breast cancers in Ghana. In this study the average age at diagnosis for the breast cancer was 46.29 years (standard deviation of + or – 11.498 years; confidence interval of (+ or – 22.54 years) as compare to 60 years/women in Caucasians and 56 years in Africa – American black women. The youngest patient was 26 years, and the oldest was 80 years. During data collection it was observed that more than three – quarters of the patients presented tumours with dimensions 12.5cm x 2.5 x 2.5 or more. The late presentation of cases for treatment was due largely to low level of breast cancer awareness, poverty and downplaying the seriousness of the disease by patients during earlier stage of the disease when pain and deformity were virtually absent. Histopathological diagnosis revealed that 23(71.875%) of patients had infiltrating/invasive ductal carcinoma 3(9.375%) had infiltrating lobular carcinoma whiles 6(18.750%) had other types namely: micoid carcinoma, infiltrating mucinous carcinoma, mammary carcinoma, metaplstic carcinoma and medullary carcinoma. These figures conform and what has been observe in the studies on the incidence of histological types of breast cancer. Infiltrating lobular carcinoma and tubular type are however less common in geographical areas of low incidence of breast cancer. Estogen receptor analysis was perform on any surgical specimen where there was sufficient tissue for both pathological and receptor studies. The estrogen (and progesterone) receptor status (ER-status) assume major importance in the planning of patient management for several reason. In Ghana (KATH, KTH) it is common for breast cancer patients to be given chemotherapy after two to four weeks trail with Tamoxifen irrespective of their ER – status (which had never been done for any patient prior to this study). Estrogen binding studies performed on 32 human breast cancers ( 1 male and 31 female patients) indentified 6 estrogen – dependent tumour representing 18.75% and 26 estrogen independent tumours representing 81.25%. The only male patient’s tumour was estrogen independent. In all, 45.16% of patients were postmenopausal. 9.68% were perimenopausal symtoms of menopause at the time of diagnosis, and 45.61% were premenopausal. The estrogen – dependent tumours identified with estrogen receptor content ranging from 12.70 to 101.13 femtomoles/mg of cytosol protein are most likely to respond to hormonal therapy; the higher the estrogen receptor content(> or =10.00 femtomoles/mg of cytosol protein) the more likely the response to hormonal and anti – estrogen therapy.
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A thesis submitted to the Board of Postgraduate Studies, Kwame Nkrumah University of Science and Technology, Kumasi, in partial fulfilment of the requirement for the award of Master of Science in Clinical Biochemistry, 1998
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