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BioMed Research International
Volume 2013 (2013), Article ID 831714, 10 pages
Research Article

Proliferative Activity in Libyan Breast Cancer with Comparison to European and Central African Patients

1Department of Pathology, University of Turku, Kiinamyllynkatu 10, 20520 Turku, Finland
2Department of Pathology, National Cancer Institute, Misurata, Libya
3Department of Surgical Oncology, National Cancer Institute, Misurata, Libya
4Center of Excellence in Genomic Medicine Research, King Abdul-Aziz University, P.O. Box 80216, Jeddah 21589, Saudi Arabia

Received 2 April 2013; Revised 10 July 2013; Accepted 16 July 2013

Academic Editor: Sonshin Takao

Copyright © 2013 Jamela Boder et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


Background. We evaluated the relation of proliferative indices with clinicopathological features and prognosis in breast cancer (BC) of Libyan female patients. The data were compared with corresponding results in Finland and Nigeria. Patients and Methods. Histological samples of breast cancer from 130 patients were retrospectively studied. Mitotic activity index (MAI) and standardized mitotic index (SMI) were estimated. Results. There were statistically significant correlations between the proliferative indices and most clinicopathological features, with the strongest association observed for histological grade ( for SMI and for MAI). The proliferative differences between Libyan, Nigerian, and Finnish population were prominent. The mean values of SMI and MAI in Libyan BC patients were 32.1 mitotic figures per square millimeter and 27.3 mitotic figures per 10 high-power fields, respectively. This is clearly lower than those in Nigeria but much higher than those in Finland. The differences between countries are seen in whole material and are also present in subgroups. The results indicated that mitotic activities can be reliable prognostic indicators in Libyan BCs, as they were among Finnish and Nigerian females. Univariate and multivariate analyses found at cut-offs of 19 and 44 mitosis/mm2 of SMI were the most significant prognostic factors. Conclusions. Proliferative indices with careful estimation of the MAI and SMI could be applied as quantitative criteria for Libyan BC to separate the patients into good, moderate, and bad prognosis groups.