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CharacterizationofBreast Cancer Subtypes andAssociated Clinico-Pathological Outcomes in Rwandan Women with Breast Cancer: A Retrospective Study

Clarisse Musanabaganwa1,14*, Hinda Ruton2 , Deogratias Ruhangaza3 , Nicaise Nsabimana3 , Emmanuel Kayitare3 , Thierry Zawadi Muvunyi4 , Muhammed Semakula1 , Faustin Ntirenganya5 , Musoni Emile5 , Jules Ndoli6 , Elisee Hategekimana6 , Angus Nassir7 , Francis Makhoha8 , Aline Uwimana9 , Joel Gasana1 , Pierre Celestin Munezero10, Laetitia Nyirazinyoye2

Background: Breast cancer subtypes were designed not only to guide decision regarding targeted therapy but also to evaluate the prognosis of the disease in conjunction with other pathological factors. This study aimed to determine the distribution of breast cancer molecular subtypes, and their association with clinical and pathological outcomes in Rwandan women diagnosed with breast cancer. Methodology: This retrospective study was designed to document clinical and pathological data from breast cancer patients in Rwanda from January 2014 to June 2021. Records of patients with confirmed breast cancer were reviewed Breast cancer subtypes were designed not only to guide decision regarding at 5 cancer centres: Butaro District Hospital (BDH), Rwanda Military Hospital (RMH), King Faisal Hospital (KFH), University teaching hospital of Kigali (CHUK) and University teaching hospital of Butare (CHUB). Results: Among the 1510 breast cancer patients, histological grade I, II and III accounted for 9.9%, 33.4% and 36.9%, respectively. Invasive ductal and lobular carcinoma constituted 83.9%, and 4.5% of cases, respectively, whith mixed ductal and lobular comprising 1.1%. The most prevalent pathological stages were pT3 (21.3%), pT2 (15.8%) and pT4 (15.6%). Lymphovascular invasion was observed in 10.1% of cases. Among the 491 patients who underwent testing for immune receptor profiles, the majority expressed oestrogen receptor (53.6%), followed by progesterone receptor (34.8%) and HER2 (34.2%). Luminal B was the most prevalent (29.3%), followed by TNBC (28.1%), luminal A (25.7%) and HER2-enriched (16.9%). These subtypes showed significant differences in relation to tumour side (p=0.019), histological grades (p=0.025) and pathological stages (p<0.001). Conclusion: This study highlighted the prevalence of luminal B and TNBC subtypes among breast cancer patients. The significant correlations observed between breast cancer subtypes, histological grades, and pathological stages underscore the significance of these variables as prognostic factors in women with breast cancer. To complement these findings, it will be essential to assess survival rates for different breast cancer subtypes in conjunction with BI-RADs classification, as well as the latest scientific evidence regarding therapies applied in the treatment of breast cancer patients.