Subsequent to the May 2004 workshop on trends in the management of breast and cervical cancers, the Healthy Life for All Foundation provided the support for the establishment of an immunohistochemistry laboratory at the Institute for Medical Research and Training, University of Ibadan in January 2005. During the workshop, estrogen and progesterone receptor (ER and PR) status as well as HER-2/neu overexpression were highlighted as pathologic features with tremendous implications for breast carcinoma patients’ prognosis and response to treatment.
The estrogen receptor (ER) status of breast carcinomas was one of the first molecular prognostic factors recognized in a solid tumor and it was the earliest clinically useful predictive factor. Most PR positive breast carcinomas are also ER positive and thus far only 10% of PR positive tumors are ER negative. ER and PR positivity correlates with improved survival and responsiveness to hormonal therapy.
HER-2/neu overexpression also aids in predicting breast carcinoma patients’ response to treatment. The overexpression of the gene (commonly noted as HER-2 or HER-3 ) has been associated with better response to high dose chemotherapy with doxorubicin, cyclophosphamide and fluorouracil. More recently, trastuzumab (Herceptin), an immunotherapy-based treatment, was approved for use in patients with metastatic disease who overexpress HER-2/neu protein. This is a considerable advance in therapies for breast carcinomas and hopefully more innovations are forthcoming.
Given the importance of determining ER/PR status and HER-2/neu overexpression, the immunohistochemistry laboratory in the University College Hospital, Ibadan was much needed. Dr. O.F. Ikpatt of the University of Chicago designed and implemented the laboratory from January to March 2005. Both the Healthy Life for All Foundation and the Ralph and Marion Medical Research Trust served as sponsors of the establishment, the first of its kind in Nigeria and Sub-Saharan Africa.
The laboratory aims to provide superior services to institutions treating breast cancer patients in Nigeria and other African countries. Thus far, samples are regularly received from regions throughout Nigeria. We currently collaborate with clinicians in University College Hospital (Ibadan), Obafemi Awolowo University Teaching Hospital (Ile-Ife), University of Calabar, Ebonyi State University (Abakaliki) and Uthman Danfodio University (Sokoto). We anticipate that many more centers will avail themselves of our services within a year. Ultimately, we hope to usher in a new era of scientific and clinical progress in Africa’s developing nations.
Professor A.G. Falusi currently directs the laboratory’s activities. Dr. A.O. Oluwasola serves as the consultant histopathologist while Mr. Abayomi Odetunde and Miss Dorcas Atagana both work as medical laboratory scientists. Miss Onyinye Offor, a graduate of Harvard University in the United States of America is currently receiving training in immunohistochemistry techniques in the laboratory as part of her mentored one-year internship program in Nigeria.
HLF is committed to providing continued support for the essential services rendered by the immunohistochemistry laboratory. The research laboratory will be providing vital support for the upcoming clinical trial that will involve the use of an oral chemotherapeutic agent in the treatment of Breast cancer in Nigerian women.