Breast Cancer Statistics around the World

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According to World Health Organization (WHO) mortality estimates, cancer is the fourth ranked cause of death in the Eastern Mediterranean Region (EMR), after cardiovascular diseases, infectious/parasitic diseases and injuries [1-3]. The largest increase in cancer incidence among the WHO regions in the next 15 years is likely to be in the EMR where breast cancer (BC) is recorded as the commonest type of female malignancy in almost all national cancer registries [1-4]. In most countries in the EMR (eg., Iran and Iraq), in addition to being the most important cancer, there are other features that justify increasing efforts for BC control, including the tendency for this disease to affect younger women, the obvious rise in incidence rates and the prevalence of advanced stages at presentation associated with more aggressive tumor behavior resulting in greater fatality rates [6,7]. Although, survival of the patients depends on many determinants such as: age, race, genetic background, socioeconomic status and quality of care, two most important determinants of survival from BC in the EMR are early detection and adequacy of treatment [5-7]. Obviously, there is an urgent need for us to better understand the molecular events of the disease and to search for more effective biomarkers for BC prevention, early detection, drug development and personalized treatment.

BC is a complex genetic disease characterized by an accumulation of molecular alterations, resulting in a high clinical heterogeneity [8,9]. Different types of BC exhibit variable histopathological and biological features, different clinical outcome and different response to therapy. Based on such a high degree of heterogeneity and according to their growth patterns (histological t...

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...examinations of the validity of these GEP assays currently available in the USA and the EU and their validation for diverse populations is limited [22,23]. Due to significant differences in the histopathology (hormone receptor status, grading, and staging), demographic parameters, survival and other factors of BC in Asia compared to Caucasians, a great deal of effort has been spent in developing and validating a specific prognostic signature in these populations [5-7, 23-25]. With our best knowledge, there are a few studies assessing the GEP and clinical outcomes in Asia and only one of them has been conducted in the EMR where the GEP for Saudi women has been reported [24,25]. Based on this report, there is about 50% difference in the GEP between Western and Saudi populations, further underlining the importance of finding specific gene signatures in the EMR [25].

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