Ashley Burson

An Exploratory Study of Inflammatory Breast Cancer in Tanzania


Clinical and Epidemiologic Profile of Breast Cancer in Tanzania (pdf)

Summer internship experience abstract

BACKGROUND: Inflammatory breast cancer (IBC) is a rare, invasive, rapidly developing, and very lethal form of breast cancer. It accounts for approximately 1 to 5 % of all cancer cases in the United States1 and has only a 42% three-year survival rate compared to an 85% survival rate for other types of breast cancer. The prevalence of IBC worldwide is uncertain, as the condition is often misdiagnosed or left untreated. Early signs of IBC may imitate inflammatory processes such as acute mastitis. However, because IBC is not truly an inflammatory state, systemic symptoms, such as fever, should not be present.

In parts of North Africa and the Middle East the frequency of IBC is as much as 10% of all breast cancer cases. While the exact cause of this increased frequency isn’t fully understood, it has been shown through research in the U.S. that African-American women are at a particularly higher risk of developing IBC than their Caucasian counterparts. Additionally, this type of breast cancer tends to affect women at a younger age than non-inflammatory breast cancer.

Despite the fact that IBC disproportionately affects those in developing countries, there has little research examining the frequency of IBC internationally. In Africa, populations in North Africa, such as Tunisia, Egypt, and Morocco, have been studied while much of the rest of Africa has been ignored. One study in Egypt reported that Egyptian women have a much higher proportion of IBC cases than the U.S. and that these women have a much earlier onset with the mean age at 46.9 years. It was also reported that tumors of IBC patients had a much higher expression of the oncogene protein, RhoC. Additionally, IBC cases had more tumor emboli present, tended to have fewer children, and were less likely to present with a distinguishable mass than the non-IBC patients.2 While studies like this are invaluable in adding to the scientific body of knowledge regarding IBC, it has yet to be determined if these findings are generalizable to other African countries, particularly those in the Sub-Saharan region. The purpose of the present study is to determine the proportion of inflammatory breast cancer in Tanzania, a population that has thus far not been researched.

AIMS & METHODS: I will be traveling to Dar Es Salaam, Tanzania, where I will be working at the Ocean Road Cancer Institute with Dr. Twalib Ngoma. My primary aim is to identify the frequency of inflammatory breast cancer in Tanzania within the past 5 years. I will review medical records of breast cancer cases and abstract demographic and clinical information from these records based on priority of being IBC. Tumor tissues will be obtained for a sample of the subjects from the Muhimbili medical school. Slides will be cut and specimens will be brought back to the US, where they will be analyzed for tumor emboli and Rho-C overexpression.

LEARNING OBJECTIVES: This internship will provide me with invaluable field and laboratory experience in an international setting. I will learn about the challenges of epidemiological research in developing countries and devise strategies to overcome them. This internship will give also give me the opportunity to work on data analysis after my return from Tanzania and it will give me experience related to the process of publishing research findings. This study will increase the general knowledge of IBC in Africa and it will specifically provide insight into the proportion of IBC cases in Tanzania. Because IBC has a higher incidence among African-American women in the US, it will have implications to the U.S. population.