Molecular Profiling of Breast Carcinoma in Almadinah, KSA: Immunophenotyping and Clinicopathological Correlation

  • Elkablawy, Mohamed A (Department of Pathology, Faculty of Medicine, Taibah University) ;
  • Albasry, Abdelkader M (Department of Pathology, Faculty of Medicine, Taibah University) ;
  • Hussainy, Akbar S (Department of Pathology, Faculty of Medicine, Taibah University) ;
  • Nouh, Magdy M (Department of Pathology, Faculty of Medicine, Taibah University) ;
  • Alhujaily, Ahmed (Department of Pathology, King Fahd Hospital)
  • Published : 2015.12.03


Purpose: To subtype breast cancer (BC) in Saudi women according to the recent molecular classification and to correlate these subtypes with available clinicopathological parameters. Materials and Methods: Estrogen receptor (ER), progesterone receptor (PR) and human epidermal growth factor receptor (Her2/neu) immunostaining was semi-quantitatively assessed to define molecular subtypes of luminal A and B, HER-2 and triple negative (basal-like) in BC paraffin embedded sections from 115 Saudi female patients diagnosed between 2005 to 2015 at the Department of Pathology, King Fahd Hospital, Almadinah, Saudi Arabia. Results: The most common subtypes were luminal A (47%), followed by luminal B (27.8%) and basal like subtypes (18.3%), whereas HER-2 was the least common subtype (6.9%). Luminal A was predominantly found in the old age group, with low tumor grade (p<0.001) and small tumor size, whereas HER-2 and basal-like subtypes were significantly associated with young age, high tumor grade, lymph node metastasis and lymphovascular invasion (p<0.03, 0.004, 0.05 and 0.04 respectively). All subtypes showed advanced clinical stage at the time of presentation. Conclusions: Molecular subtypes of Saudi BC patients in Almadinah region are consistent with most of the worldwide subtyping. The biological behaviour of each molecular subtype could be expected based on its characteristic clinicopathological features. Along with other prognostic indicators, molecular subtyping would be helpful in predicting prognosis and management of our BC patients. We recommend screening and early diagnosis of BC in our population.


Breast cancer;molecular;subtyping;ER;PR;Her2/neu;KSA


  1. Akbar M, Akbar K, Naveed D (2014). Frequency and correlation of molecular subtypes of breast cancer with clinicopathological features. J Ayub Med Coll Abbottabad, 26, 290-3.
  2. Al Tamimi DM, Shawarby MA, Ahmed A, et al (2010). Protein expression profile and prevalence pattern of the molecular classes of breast cancer - a Saudi population based study. BMC Cancer, 10, 223-35.
  3. Albasri A, Hussainy AS, Sundkji I, et al (2014). Histopathological features of breast cancer in Al-Madinah region of Saudi Arabia. Saudi Med J, 35, 1489-93.
  4. Alghamdi IG, Hussain II, Alghamdi MS, et al (2013). The incidence rate of female breast cancer in Saudi Arabia: an observational descriptive epidemiological analysis of data from Saudi Cancer Registry 2001-2008. Breast Cancer (Dove Med Press), 5, 103-9.
  5. Ben Abdelkrim S, Trabelsi A, Missaoui N, et al (2010). Distribution of molecular breast cancer subtypes among Tunisian women and correlation with histopathologicalparameters: a study of 194 patients. Pathol Res Pract, 206, 772-5.
  6. Bhargava R, Striebel J, Beriwal S, et al (2009). Prevalence, morphologic features and proliferation indices of breast carcinoma molecular classes using immunohistochemical surrogate markers. Int J Clin Exp Pathol, 2, 444-55.
  7. Caldarella A, Buzzoni C, Crocetti E, et al (2013). Invasive breast cancer: a significant correlation between histological types and molecular subgroups. J Cancer Res Clin Oncol, 139, 617-23.
  8. Cancer Research UK (2014): Breast cancer incidence statistics 2011 [Online]. Cancer Research UK. Available: http://www. incidence/uk-breast-cancer-incidence-statistics. [Accessed on 28 January 2015].
  9. Carey LA, Perou CM, Livasy CA, et al (2006). Race, breast cancer subtypes, and survival in the Carolina Breast Cancer Study. JAMA, 295, 2492-502.
  10. Cheang MC, Chia SK, Voduc D, et al (2009). Ki67 index, HER2 status, and prognosis of patients with luminal B breast cancer. J Natl Cancer Inst, 101, 736-50.
  11. Cherbal F, Gaceb H, Mehemmai C, et al (2015). Distribution of molecular breast cancer subtypes among Algerian women and correlation with clinical and tumor characteristics: A population-based study. Breast Dis, 35, 95-102.
  12. de Kruijf EM, Bastiaannet E, Ruberta F, et al (2014). Comparison of frequencies and prognostic effect of molecular subtypes between young and elderly breast cancer patients. Mol Oncol, 8, 1014-25.
  13. de Macedo Andrade AC, Ferreira Junior CA, Dantas Guimaraes B, et al (2014). Molecular breast cancer subtypes and therapies in a public hospital of Northeastern Brazil. BMC Women's Health, 14, 110-18.
  14. Elesawy BH, Abd El hafez A, Shawky Ael-A, et al (2014). Immunohistochemistry-based subtyping of breast carcinoma in Egyptian women: a clinicopathologic study on 125 patients. Ann Diagn Pathol, 18, 21-6.
  15. El-Hawary AK, Abbas AS, Elsayed AA, et al (2012). Molecular subtypes of breast carcinoma in Egyptian women: clinicopathological features. Pathol Res Pract, 208, 382-6.
  16. Elkablawy MA, Albasri AM (2015). High quality tissue miniarray technique using a conventional TV/Radio telescopic antenna. Asian Pac J Cancer Prev, 16, 1129-133.
  17. Ferlay J, Soerjomataram I, Ervik M, et al (2015). Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer, 136, 359-86.
  18. Goldhirsch A, Ingle JN, Gelber RD, et al (2009). Thresholds for therapies: highlights of the St Gallen International Expert Consensus on the primary therapy of early breast cancer 2009. Ann Oncol, 20, 1319-29.
  19. Howlader N, Noone AM, Krapcho M, et al (2013). SEER Cancer Statistics Review, 1975-2011, National Cancer Institute. Bethesda, MD,, based on November 2013 SEER data submission, posted to the SEER web site, April 2014.
  20. Huo D, Ikpatt F, Khramtsov A, et al (2009). Population differences in breast cancer: survey in indigenous African women reveals over-representation of triple-negative breast cancer. J Clin Oncol, 27, 4515-21.
  21. Perou CM, Sorlie T, Eisen MB, et al (2000). Molecular portraits of human breast tumours. Nature, 406, 747-52.
  22. Pusztai L, Mazouni C, Anderson K, et al (2006). Molecular classification of breast cancer: limitations and potential. Oncologist, 11, 868-77.
  23. Pusztai L (2008). Current status of prognostic profiling in breast cancer. Oncologist, 13, 350-60.
  24. Salhia B, Tapia C, Ishak EA, et al (2011). Molecular subtype analysis determines the association of advanced breast cancer in Egypt with favorable biology. BMC Womens Health, 11, 44-52.
  25. Saudi Cancer Registry (2014). Cancer incidence report Saudi Arabia 2010 [Online]. Saudi Cancer Registry. Available: [Accessed on 26 January 2015].
  26. Shibuta K, Ueo H, Furusawa H, et al (2011). The relevance of intrinsic subtype to clinicopathological features and prognosis in 4,266 Japanese women with breast cancer. Breast Cancer, 18, 292-8.
  27. Shomaf M, Masad J, Najjar S, et al (2013). Distribution of breast cancer subtypes among Jordanian women and correlation with histopathological grade: molecular subclassification study. JRSM Short Rep, 4, 1-6.
  28. Zheng S, Song QK, Ren Y, et al (2014). The characteristics of breast cancer subtypes: Implications for treatment guidelines and individualized treatment strategies in China. Appl Immunohistochem Mol Morphol, 22, 383-9.
  29. Zhu X , Ying J, Wang F, et al (2014). Estrogen receptor, progesterone receptor, and human epidermal growth factor receptor 2 status in invasive breast cancer: a 3,198 cases study at National Cancer Center, China. Breast Cancer Res Treat, 147, 551-5.

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