Reviewer’s report
Title: 
BREAST CANCER IN TOGOLESE
WOMEN:IMMUNOHISTOCHEMISTRY SUBTYPES
Version: 
0 
Date: 
13 Sep 2020
Reviewer's report:
Congratulation! The authors present the breast cancer subtype incidence in
Togolese is the first conducted in Togo. The percentage of ER+, PR+ and HER2
positive tumors was 50.4%, 37.6% and 15.4% respectively. The predominant
molecular subtype was Luminal A (42.7%) followed by Triple negative (41.9%),
Luminal B subtype (9.4%) and HER2 enriched (6%). 
And their classification of breast cancer subtype is as below:
Luminal A (ER+ and/or PR+, HER2-), 
Luminal B (ER+ and/or PR+, HER2+), 
HER2 enriched (ER-, PR-, HER2+), 
Triple negative (ER-, PR-, HER2-).
Here, I have some question for the authors, 
Q1: The author's classification for breast cancer subtype is different from the
general one, which was 
Luminal A (ER+ and/or PR+, HER2-), 
low Ki67 (or Gr. 1 or 2 tumor grading). 
Luminal B (ER+ and/or PR+, HER2 +/-), high Ki67 (or Gr. 3).
HER2 enriched (ER-, PR-, HER2+), 
Triple negative (ER-, PR-, HER2-).
Also, this is not a general population incidence, because most of breast cancer
patients presented with locally advanced, more than 50 % of patients were stage
III and IV. 
Otherwise, the different classification may induce different distribution of breast
cancer subtype, and they did not perform FISH test for HER2 IHC 2+. This
situation, may interfere the incidence.
Q2: Another remarkable finding in this study is the high proportion of TNBC
which accounted for 
41.9%. 
The new definition of triple negative is ER<1%, PR:
<1% expression, In author's classification, may increase the incidence rate. And
some TNBC group may include the HER2 2+, FISH positive cases.
Q3: Even low ER/PR expression, some patients still suitable for hormonal
therapy.
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