Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study
ABSTRACT Background and Aims Breast cancer is the most common cause of female cancer‐related death in Iraq. This study aimed to classify breast cancer molecular subtypes in the Iraqi population, and investigate the association with clinicopathology parameters, and predict survival outcomes. Methods...
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Wiley
2025-05-01
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| Online Access: | https://doi.org/10.1002/hsr2.70553 |
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| author | Alaa Salah Jumaah Roaa Ali Shaker Zainab Al‐Ali Kaswer Musa Jaafar Altoriah Aseel Al‐Quzweni Salam Salah Jumaah Akeel Abed Yasseen Katherine Ann McAllister Haider J. Al Shiblawi |
| author_facet | Alaa Salah Jumaah Roaa Ali Shaker Zainab Al‐Ali Kaswer Musa Jaafar Altoriah Aseel Al‐Quzweni Salam Salah Jumaah Akeel Abed Yasseen Katherine Ann McAllister Haider J. Al Shiblawi |
| author_sort | Alaa Salah Jumaah |
| collection | DOAJ |
| description | ABSTRACT Background and Aims Breast cancer is the most common cause of female cancer‐related death in Iraq. This study aimed to classify breast cancer molecular subtypes in the Iraqi population, and investigate the association with clinicopathology parameters, and predict survival outcomes. Methods This cross‐sectional study collected breast cancer samples that included: tumor size, grade, lymph node involvement, and LVI. Cases were stained for estrogen (ER) and progesterone (PR) receptors, HER2, and Ki‐67 for IHC subtyping. HER2 score 3 cases were further evaluated by SISH. Molecular profile classification used the St Gallen consensus. The tumor profiles were modelled with treatment combinations using the PREDICT decision making tool of up to 10‐year OS outcomes; > 5% differences were deemed clinically relevant. Results The mean age of patients was 50.16 ± 12.28 years. ER and PR positivity was high (81.8% and 73.7%) relative to HER2 (20.8%). Significant clinicopathology associations occurred between ER expression and tumor type and grade (p = 0.001, 0.027); HER2 with histology (p = 0.044). Ki‐67 high expression (26.8%) was associated with LVI (p = 0.006). Molecular classification (IHC subtypes) identified Luminal A (Luminal‐A‐like) tumors in most cases (61.7%), followed by Luminal B (Luminal‐B‐like) (20.0%), HER2 (9.5%) and basal‐like (triple negative breast cancer (TNBC)) at 8.7%. By selecting the right treatment adjuvant to tumor profile, PREDICT modelling estimated that most post‐surgery patients (85.7%, ER+; 100%, ER‐) would have clinically relevant overall survival (OS) benefit. Conclusion St Gallen molecular characterisation of breast tumors is critical for refining triage of healthcare patients in Iraq. Molecular classification using IHC subtypes identified a high prevalence of favorable Luminal‐A‐like type, and the lowest worldwide rates of poor prognostic TNBC cancer. The use of immunohistochemistry‐based cancer subtyping is further strengthened in clinical practice with online prognostication tools that assist the treatment selection process. |
| format | Article |
| id | doaj-art-cc76390e5dac4ddba759f3abc96c5ca4 |
| institution | DOAJ |
| issn | 2398-8835 |
| language | English |
| publishDate | 2025-05-01 |
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| spelling | doaj-art-cc76390e5dac4ddba759f3abc96c5ca42025-08-20T02:55:05ZengWileyHealth Science Reports2398-88352025-05-0185n/an/a10.1002/hsr2.70553Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional StudyAlaa Salah Jumaah0Roaa Ali Shaker1Zainab Al‐Ali2Kaswer Musa Jaafar Altoriah3Aseel Al‐Quzweni4Salam Salah Jumaah5Akeel Abed Yasseen6Katherine Ann McAllister7Haider J. Al Shiblawi8Department of Pathology and Forensic Medicine, Faculty of Medicine University of Kufa Kufa IraqAl‐Kufa Board Training center, Iraqi Board for medical specialization Kufa IraqDepartment of Pathology and Forensic Medicine, Faculty of Medicine University of Kerbala Kerbala IraqDepartment of Pathology and Forensic Medicine, Faculty of Medicine University of Kufa Kufa IraqSadder teaching hospital Najaf Governorate Kufa IraqEuphrates cancer hospital Kufa IraqDepartment of Pathology and Forensic Medicine, Faculty of Medicine University of Kufa Kufa IraqSchool of Biomedical Sciences Ulster University Coleraine Northern Ireland UKEuphrates cancer hospital Kufa IraqABSTRACT Background and Aims Breast cancer is the most common cause of female cancer‐related death in Iraq. This study aimed to classify breast cancer molecular subtypes in the Iraqi population, and investigate the association with clinicopathology parameters, and predict survival outcomes. Methods This cross‐sectional study collected breast cancer samples that included: tumor size, grade, lymph node involvement, and LVI. Cases were stained for estrogen (ER) and progesterone (PR) receptors, HER2, and Ki‐67 for IHC subtyping. HER2 score 3 cases were further evaluated by SISH. Molecular profile classification used the St Gallen consensus. The tumor profiles were modelled with treatment combinations using the PREDICT decision making tool of up to 10‐year OS outcomes; > 5% differences were deemed clinically relevant. Results The mean age of patients was 50.16 ± 12.28 years. ER and PR positivity was high (81.8% and 73.7%) relative to HER2 (20.8%). Significant clinicopathology associations occurred between ER expression and tumor type and grade (p = 0.001, 0.027); HER2 with histology (p = 0.044). Ki‐67 high expression (26.8%) was associated with LVI (p = 0.006). Molecular classification (IHC subtypes) identified Luminal A (Luminal‐A‐like) tumors in most cases (61.7%), followed by Luminal B (Luminal‐B‐like) (20.0%), HER2 (9.5%) and basal‐like (triple negative breast cancer (TNBC)) at 8.7%. By selecting the right treatment adjuvant to tumor profile, PREDICT modelling estimated that most post‐surgery patients (85.7%, ER+; 100%, ER‐) would have clinically relevant overall survival (OS) benefit. Conclusion St Gallen molecular characterisation of breast tumors is critical for refining triage of healthcare patients in Iraq. Molecular classification using IHC subtypes identified a high prevalence of favorable Luminal‐A‐like type, and the lowest worldwide rates of poor prognostic TNBC cancer. The use of immunohistochemistry‐based cancer subtyping is further strengthened in clinical practice with online prognostication tools that assist the treatment selection process.https://doi.org/10.1002/hsr2.70553breast cancerclinicopathologyimmunohistochemistrymolecular subtypingsurvival |
| spellingShingle | Alaa Salah Jumaah Roaa Ali Shaker Zainab Al‐Ali Kaswer Musa Jaafar Altoriah Aseel Al‐Quzweni Salam Salah Jumaah Akeel Abed Yasseen Katherine Ann McAllister Haider J. Al Shiblawi Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study Health Science Reports breast cancer clinicopathology immunohistochemistry molecular subtyping survival |
| title | Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study |
| title_full | Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study |
| title_fullStr | Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study |
| title_full_unstemmed | Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study |
| title_short | Immunohistochemical Breast Cancer Profiling Among Iraqi Women: Molecular Subtype Classification, Clinicopathology Associations, and Treatment‐Decision Making Tools: A Cross‐Sectional Study |
| title_sort | immunohistochemical breast cancer profiling among iraqi women molecular subtype classification clinicopathology associations and treatment decision making tools a cross sectional study |
| topic | breast cancer clinicopathology immunohistochemistry molecular subtyping survival |
| url | https://doi.org/10.1002/hsr2.70553 |
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