Receptor-Defined Subtypes of Breast Cancer in Indigenous Populations in Africa: A Systematic Review and Meta-Analysis
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{"title"=>"Receptor-Defined Subtypes of Breast Cancer in Indigenous Populations in Africa: A Systematic Review and Meta-Analysis", "type"=>"journal", "authors"=>[{"first_name"=>"Amanda", "last_name"=>"Eng", "scopus_author_id"=>"35236838400"}, {"first_name"=>"Valerie", "last_name"=>"McCormack", "scopus_author_id"=>"6603311343"}, {"first_name"=>"Isabel", "last_name"=>"dos-Santos-Silva", "scopus_author_id"=>"7003647992"}], "year"=>2014, "source"=>"PLoS Medicine", "identifiers"=>{"issn"=>"15491676", "scopus"=>"2-s2.0-84907961866", "pui"=>"600193982", "doi"=>"10.1371/journal.pmed.1001720", "sgr"=>"84907961866", "pmid"=>"25202974"}, "id"=>"e07230a9-3c07-3216-86d3-6c66709d767d", "abstract"=>"BACKGROUND: Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa.\\n\\nMETHODS AND FINDINGS: Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (n=12,284 women with breast cancer) and 26 from sub-Saharan Africa (n=4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I2>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I2>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%-17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%-17%) lower for those with ≥ 40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56-0.62) and 0.21 (0.17-0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study.\\n\\nCONCLUSIONS: The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost. Please see later in the article for the Editors' Summary.", "link"=>"http://www.mendeley.com/research/receptordefined-subtypes-breast-cancer-indigenous-populations-africa-systematic-review-metaanalysis-2", "reader_count"=>38, "reader_count_by_academic_status"=>{"Unspecified"=>3, "Student > Doctoral Student"=>3, "Researcher"=>5, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>3, "Other"=>4, "Student > Master"=>8, "Student > Bachelor"=>1, "Lecturer"=>2}, "reader_count_by_user_role"=>{"Unspecified"=>3, "Student > Doctoral Student"=>3, "Researcher"=>5, "Student > Ph. D. Student"=>9, "Student > Postgraduate"=>3, "Other"=>4, "Student > Master"=>8, "Student > Bachelor"=>1, "Lecturer"=>2}, "reader_count_by_subject_area"=>{"Unspecified"=>6, "Engineering"=>1, "Biochemistry, Genetics and Molecular Biology"=>4, "Nursing and Health Professions"=>1, "Medicine and Dentistry"=>18, "Agricultural and Biological Sciences"=>3, "Design"=>1, "Arts and Humanities"=>1, "Pharmacology, Toxicology and Pharmaceutical Science"=>1, "Business, Management and Accounting"=>1, "Social Sciences"=>1}, "reader_count_by_subdiscipline"=>{"Design"=>{"Design"=>1}, "Engineering"=>{"Engineering"=>1}, "Medicine and Dentistry"=>{"Medicine and Dentistry"=>18}, "Social Sciences"=>{"Social Sciences"=>1}, "Agricultural and Biological Sciences"=>{"Agricultural and Biological Sciences"=>3}, "Nursing and Health Professions"=>{"Nursing and Health Professions"=>1}, "Business, Management and Accounting"=>{"Business, Management and Accounting"=>1}, "Biochemistry, Genetics and Molecular Biology"=>{"Biochemistry, Genetics and Molecular Biology"=>4}, "Unspecified"=>{"Unspecified"=>6}, "Pharmacology, Toxicology and Pharmaceutical Science"=>{"Pharmacology, Toxicology and Pharmaceutical Science"=>1}, "Arts and Humanities"=>{"Arts and Humanities"=>1}}, "reader_count_by_country"=>{"United States"=>1, "Yemen"=>1}, "group_count"=>3}

Scopus | Further Information

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Figshare

  • {"files"=>["https://ndownloader.figshare.com/files/1667816"], "description"=>"<p>IBC, inflammatory breast cancer; N-IBC, non-inflammatory breast cancer; Nk, information not given in the original paper; SEER, Surveillance, Epidemiology, and End Results (SEER) Program of the National Cancer Institute, US (data downloaded from <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Surveillance1\" target=\"_blank\">[6]</a> using the same methods as in <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-McCormack1\" target=\"_blank\">[9]</a>); SSA, sub-Saharan Africa.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165773, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g010", "stats"=>{"downloads"=>2, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_International_and_ethnic_comparisons_in_the_proportion_of_ER_disease_/1165773", "title"=>"International and ethnic comparisons in the proportion of ER+ disease.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667815"], "description"=>"<p>Frequency of tumor subtypes by year of diagnosis, grade, and timing of receptor testing.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165772, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g009", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Frequency_of_tumor_subtypes_by_year_of_diagnosis_grade_and_timing_of_receptor_testing_/1165772", "title"=>"Frequency of tumor subtypes by year of diagnosis, grade, and timing of receptor testing.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667812"], "description"=>"<p>IBC, inflammatory breast cancer; LABC, non-IBC locally advanced breast cancer; N-IBC: non-inflammatory breast cancer. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165769, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g006", "stats"=>{"downloads"=>0, "page_views"=>17, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_disease_by_tumor_grade_North_and_sub_Saharan_Africa_/1165769", "title"=>"Proportion of ER+ disease by tumor grade, North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667810"], "description"=>"<p>IBC, inflammatory breast cancer; LABC, non-IBC locally advanced breast cancer; N-IBC, non-inflammatory breast cancer. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Abbas1\" target=\"_blank\">[29]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165767, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g004", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_disease_by_study_design_North_and_sub_Saharan_Africa_/1165767", "title"=>"Proportion of ER+ disease by study design, North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667811"], "description"=>"<p>IBC: inflammatory breast cancer; LABC: non-IBC locally advanced breast cancer; N-IBC: non-inflammatory breast cancer. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Abbas1\" target=\"_blank\">[29]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165768, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g005", "stats"=>{"downloads"=>0, "page_views"=>5, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_disease_by_year_of_diagnosis_North_and_sub_Saharan_Africa_/1165768", "title"=>"Proportion of ER+ disease by year of diagnosis, North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667823", "https://ndownloader.figshare.com/files/1667824", "https://ndownloader.figshare.com/files/1667825", "https://ndownloader.figshare.com/files/1667826", "https://ndownloader.figshare.com/files/1667827", "https://ndownloader.figshare.com/files/1667828", "https://ndownloader.figshare.com/files/1667829", "https://ndownloader.figshare.com/files/1667830", "https://ndownloader.figshare.com/files/1667831", "https://ndownloader.figshare.com/files/1667832", "https://ndownloader.figshare.com/files/1667833", "https://ndownloader.figshare.com/files/1667834", "https://ndownloader.figshare.com/files/1667835", "https://ndownloader.figshare.com/files/1667836", "https://ndownloader.figshare.com/files/1667837", "https://ndownloader.figshare.com/files/1667838"], "description"=>"<div><p>Background</p><p>Breast cancer is the most common female cancer in Africa. Receptor-defined subtypes are a major determinant of treatment options and disease outcomes but there is considerable uncertainty regarding the frequency of poor prognosis estrogen receptor (ER) negative subtypes in Africa. We systematically reviewed publications reporting on the frequency of breast cancer receptor-defined subtypes in indigenous populations in Africa.</p><p>Methods and Findings</p><p>Medline, Embase, and Global Health were searched for studies published between 1st January 1980 and 15th April 2014. Reported proportions of ER positive (ER+), progesterone receptor positive (PR+), and human epidermal growth factor receptor-2 positive (HER2+) disease were extracted and 95% CI calculated. Random effects meta-analyses were used to pool estimates. Fifty-four studies from North Africa (<i>n</i> = 12,284 women with breast cancer) and 26 from sub-Saharan Africa (<i>n</i> = 4,737) were eligible. There was marked between-study heterogeneity in the ER+ estimates in both regions (I<sup>2</sup>>90%), with the majority reporting proportions between 0.40 and 0.80 in North Africa and between 0.20 and 0.70 in sub-Saharan Africa. Similarly, large between-study heterogeneity was observed for PR+ and HER2+ estimates (I<sup>2</sup>>80%, in all instances). Meta-regression analyses showed that the proportion of ER+ disease was 10% (4%–17%) lower for studies based on archived tumor blocks rather than prospectively collected specimens, and 9% (2%–17%) lower for those with ≥40% versus those with <40% grade 3 tumors. For prospectively collected samples, the pooled proportions for ER+ and triple negative tumors were 0.59 (0.56–0.62) and 0.21 (0.17–0.25), respectively, regardless of region. Limitations of the study include the lack of standardized procedures across the various studies; the low methodological quality of many studies in terms of the representativeness of their case series and the quality of the procedures for collection, fixation, and receptor testing; and the possibility that women with breast cancer may have contributed to more than one study.</p><p>Conclusions</p><p>The published data from the more appropriate prospectively measured specimens are consistent with the majority of breast cancers in Africa being ER+. As no single subtype dominates in the continent availability of receptor testing should be a priority, especially for young women with early stage disease where appropriate receptor-specific treatment modalities offer the greatest potential for reducing years of life lost.</p><p><i>Please see later in the article for the Editors' Summary</i></p></div>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165780, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>["https://dx.doi.org/10.1371/journal.pmed.1001720.s001", "https://dx.doi.org/10.1371/journal.pmed.1001720.s002", "https://dx.doi.org/10.1371/journal.pmed.1001720.s003", "https://dx.doi.org/10.1371/journal.pmed.1001720.s004", "https://dx.doi.org/10.1371/journal.pmed.1001720.s005", "https://dx.doi.org/10.1371/journal.pmed.1001720.s006", "https://dx.doi.org/10.1371/journal.pmed.1001720.s007", "https://dx.doi.org/10.1371/journal.pmed.1001720.s008", "https://dx.doi.org/10.1371/journal.pmed.1001720.s009", "https://dx.doi.org/10.1371/journal.pmed.1001720.s010", "https://dx.doi.org/10.1371/journal.pmed.1001720.s011", "https://dx.doi.org/10.1371/journal.pmed.1001720.s012", "https://dx.doi.org/10.1371/journal.pmed.1001720.s013", "https://dx.doi.org/10.1371/journal.pmed.1001720.s014", "https://dx.doi.org/10.1371/journal.pmed.1001720.s015", "https://dx.doi.org/10.1371/journal.pmed.1001720.s016"], "stats"=>{"downloads"=>77, "page_views"=>77, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Receptor_Defined_Subtypes_of_Breast_Cancer_in_Indigenous_Populations_in_Africa_A_Systematic_Review_and_Meta_Analysis_/1165780", "title"=>"Receptor-Defined Subtypes of Breast Cancer in Indigenous Populations in Africa: A Systematic Review and Meta-Analysis", "pos_in_sequence"=>0, "defined_type"=>4, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667820"], "description"=>"a<p>Adjusted for all other variables in the table except tumor grade (this variable was not included in the model because of potential for over-adjustment). The variable study design was not included in the final models because it was not associated with the frequency of ER+, PR+, or HER2+ in the crude or adjusted analyses.</p>b<p>Missing values were included as separate categories.</p>c<p>Defined according to the last year in which patient recruitment took place.</p>d<p>Mean or median age of study cases at the time of breast cancer diagnosis; for studies that provided only age categories the mean was estimated from the mid-point and frequency of each category.</p>e<p>These numbers are higher than the total number of North African studies included in the review (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed-1001720-t003\" target=\"_blank\">Table 3</a>) because one study <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boufettal1\" target=\"_blank\">[26]</a> presented separate ER+ and PR+ estimates for ages <35 y and 36–50 y and another <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Chaher1\" target=\"_blank\">[55]</a> presented separate ER+, PR+, and HER2+ estimates for inflammatory (IBC) and non-IBC locally advanced breast cancer (LABC).</p>f<p><i>p</i>-values for interaction between region and timing of receptor testing for ER+: <i>p</i><0.001 in the crude analysis, <i>p</i><0.001 in the adjusted analysis; PR+: <i>p</i> = 0.10 in the crude analysis, <i>p</i> = 0.17 in the adjusted analysis; HER2+: <i>p</i> = 0.37 in the crude analysis, <i>p</i> = 0.52 in the adjusted analysis.</p><p>Sources of between-study heterogeneity in the proportions of ER+, PR+, and HER2+ cases from meta-regression analyses.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165777, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.t004", "stats"=>{"downloads"=>1, "page_views"=>16, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Sources_of_between_study_heterogeneity_in_the_proportions_of_ER_PR_and_HER2_cases_from_meta_regression_analyses_/1165777", "title"=>"Sources of between-study heterogeneity in the proportions of ER+, PR+, and HER2+ cases from meta-regression analyses.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667805"], "description"=>"<p>Breast cancer ranking among women for (a) incidence and (b) mortality, Africa, 2012 <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-International1\" target=\"_blank\">[1]</a>.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165762, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g001", "stats"=>{"downloads"=>1, "page_views"=>6, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Breast_cancer_ranking_among_women_for_a_incidence_and_b_mortality_Africa_2012_1_/1165762", "title"=>"Breast cancer ranking among women for (a) incidence and (b) mortality, Africa, 2012 [1].", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667818"], "description"=>"a<p>Only Series 1 (<i>n</i> = 378) was included in the review. Series 2 is a replicate sample (<i>n</i> = 129) which was excluded because of a) potential overlap with other studies included in the review; and b) the number of ER+, PR+ and HER2+ known was not reported.</p>b<p>Methods for PR and HER2 testing are provided in the paper but no estimates for these two receptors are given.</p><p>AJCC, American Joint Committee on Cancer; BC, Breast cancer; IBC, inflammatory breast cancer; IDC, invasive ductal carcinoma; ICH, immunocytochemistry; MR, medical records; n/a, not applicable; NK, not given in the paper; NOS, not otherwise specified.</p><p>Characteristics of the participating studies: Sub-Saharan Africa (26 studies).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165775, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.t002", "stats"=>{"downloads"=>1, "page_views"=>12, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_participating_studies_Sub_Saharan_Africa_26_studies_/1165775", "title"=>"Characteristics of the participating studies: Sub-Saharan Africa (26 studies).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667819"], "description"=>"a<p>Percentage of the number given in the total row (percentages for each variable do not always add to 100 because of rounding errors).</p>b<p>Includes four studies from Morocco (number of women with known ER, PR, and HER2 status: 1,451, 1,451, and 411, respectively), three from Libya (378, 378, 78, respectively), two from Sudan (162, 162, and 114, respectively), and two from Algeria (296, 296, and 296, respectively) (see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed-1001720-t001\" target=\"_blank\">Tables 1</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed-1001720-t002\" target=\"_blank\">2</a>).</p>c<p>Includes a multi-centric study <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Huo1\" target=\"_blank\">[8]</a> with several centres based in Nigeria and one in Senegal (number of women with known ER, PR, and HER2 status: 378, 378, and 378, respectively).</p>d<p>Includes two studies from Mali (number of women with known ER, PR, and HER2 status: 273, 272, and 113, respectively); four from Ghana (320, 293, and 258, respectively); two from Uganda (296, 183 and 183, respectively), two from Kenya (278, 158 and 192, respectively), two from Tanzania (125, 125 and 0, respectively), and one from Madagascar (75 and 77, respectively) (see <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed-1001720-t001\" target=\"_blank\">Tables 1</a> and <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed-1001720-t002\" target=\"_blank\">2</a>).</p>e<p>Defined according to the last year in which patient recruitment took place.</p>f<p>If information on menopausal status was not available women aged >50 years at diagnosis were classified as postmenopausal.</p><p>Summary of the characteristics of the 80 participating studies.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165776, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.t003", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Summary_of_the_characteristics_of_the_80_participating_studies_/1165776", "title"=>"Summary of the characteristics of the 80 participating studies.", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667817"], "description"=>"a<p>HER2 testing was performed but not included in the review because it was not possible to estimate the standard error as the sample size was NK.</p>b<p>Only HR+ (ER+ and/or PR+) estimates are provided.</p>c<p>Only HR+ (defined as subtypes Luminal A + Luminal B) estimates are provided.</p>d<p>Only the results from IHC (versus ICH) were included in the review.</p><p>AJCC, American Joint Committee on Cancer; BC, breast cancer; IBC, inflammatory breast cancer; IDC, invasive ductal carcinoma; ICH, immunocytochemistry; IgG, Immunoglobulin G; MR, medical records; n/a, not applicable; NK, not given in the paper; NOS, not otherwise specified.</p><p>Characteristics of the participating studies: North Africa (54 studies).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165774, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.t001", "stats"=>{"downloads"=>1, "page_views"=>11, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Characteristics_of_the_participating_studies_North_Africa_54_studies_/1165774", "title"=>"Characteristics of the participating studies: North Africa (54 studies).", "pos_in_sequence"=>0, "defined_type"=>3, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667814"], "description"=>"<p>IBC, inflammatory breast cancer; LABC, non-IBC locally advanced breast cancer; N-IBC, non-inflammatory breast cancer. North-Western Africa: Morocco, Algeria, and Tunisia; North-Eastern Africa: Egypt, Sudan, and Libya; Eastern Africa: Kenya, Uganda, Tanzania, and Madagascar; Western Africa: Ghana, Mali, Nigeria, and Senegal; Sothern Africa: South Africa. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Abbas1\" target=\"_blank\">[29]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>). **Lower limit of 95% confidence interval for I<sup>2</sup> statistic truncated at 0.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165771, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g008", "stats"=>{"downloads"=>0, "page_views"=>15, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_disease_by_sub_regions_within_North_and_sub_Saharan_Africa_/1165771", "title"=>"Proportion of ER+ disease by sub-regions within North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667813"], "description"=>"<p>IBC, inflammatory breast cancer; LABC, non-IBC locally advanced breast cancer; N-IBC, non-inflammatory breast cancer. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Abbas1\" target=\"_blank\">[29]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>).</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165770, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g007", "stats"=>{"downloads"=>0, "page_views"=>9, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_disease_by_timing_of_receptor_testing_North_and_sub_Saharan_Africa_/1165770", "title"=>"Proportion of ER+ disease by timing of receptor testing, North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667808"], "description"=>"<p>IBC, inflammatory breast cancer; LABC, non-IBC locally advanced breast cancer; N-IBC, non-inflammatory breast cancer. *These studies provided only a combined HR estimate for tumors that were either ER+ or PR+ <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-ElHawary1\" target=\"_blank\">[33]</a> or ER+ and/or PR+ (<a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Abbas1\" target=\"_blank\">[29]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Zeeneldin1\" target=\"_blank\">[43]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Hussein2\" target=\"_blank\">[52]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Boder1\" target=\"_blank\">[63]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Bouzid1\" target=\"_blank\">[64]</a>; <a href=\"http://www.plosmedicine.org/article/info:doi/10.1371/journal.pmed.1001720#pmed.1001720-Salama1\" target=\"_blank\">[71]</a>). These HR estimates were included in both the ER+ and PR+ plots.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165765, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g003", "stats"=>{"downloads"=>0, "page_views"=>3, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Proportion_of_ER_PR_and_HER2_disease_ranked_by_increasing_magnitude_North_and_sub_Saharan_Africa_/1165765", "title"=>"Proportion of ER+, PR+, and HER2+ disease (ranked by increasing magnitude), North and sub-Saharan Africa.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}
  • {"files"=>["https://ndownloader.figshare.com/files/1667807"], "description"=>"<p>Many abstracts could fit into more than one exclusion category; these were allocated to the first eligible category in the order listed here.</p>", "links"=>[], "tags"=>["prognosis estrogen receptor", "North Africa", "subtype", "April 2014. Reported proportions", "receptor testing", "pr", "1 st January 1980", "er", "ci", "her", "breast cancer", "archived tumor blocks"], "article_id"=>1165764, "categories"=>["Uncategorised"], "users"=>["Amanda Eng", "Valerie McCormack", "Isabel dos-Santos-Silva"], "doi"=>"https://dx.doi.org/10.1371/journal.pmed.1001720.g002", "stats"=>{"downloads"=>0, "page_views"=>7, "likes"=>0}, "figshare_url"=>"https://figshare.com/articles/_Flow_diagram_detailing_study_identification_screening_and_eligibility_/1165764", "title"=>"Flow diagram detailing study identification, screening, and eligibility.", "pos_in_sequence"=>0, "defined_type"=>1, "published_date"=>"2014-09-09 02:56:00"}

PMC Usage Stats | Further Information

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Relative Metric

{"start_date"=>"2014-01-01T00:00:00Z", "end_date"=>"2014-12-31T00:00:00Z", "subject_areas"=>[{"subject_area"=>"/Medicine and health sciences", "average_usage"=>[285]}, {"subject_area"=>"/People and places", "average_usage"=>[302]}, {"subject_area"=>"/People and places/Geographical locations", "average_usage"=>[298]}, {"subject_area"=>"/People and places/Population groupings", "average_usage"=>[300]}]}
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