Reviewer ’s report  
 
Title:  First report on molecular breast cancer subtypes and their clinico -pathological 
characteristics in Eastern Morocco: series of 2260 cases  
 
Version: 0 Date: 22 Jul 2016 
 
Reviewer:  P. D.  Moerland  
 
Reviewer’s report:  
 
This manuscript describes the results of a population -based study on breast cancer among 
women in Eastern Morocco with a special focus on molecular subtypes. The study is well 
described and the presentation of the results is easy to follow. The study repor ts on one of the 
largest breast cancer cohorts in a non -Western country and might have important implications for 
more appropriate screening and treatment in  Eastern Morocco. Below I list one major and 
several minor comments to be addressed and a list of  corrections (English syntax and grammar):  
 
 
Major comments:  
 
- The definition of surrogate subtypes based on clinico -pathological characteristics has been 
subject of quite some discussion. The authors refer to Goldhirsch et al. for their definition. 
However, there seem to be some discrepancies between the classifica tion used by the authors 
(Methods section) and the classification of Goldhirsch et al. For example according to 
Goldhirsch et al. the Luminal A subtype always has PR>20% and Ki -67<14%, which is not the 
case in the definition used by the authors. Also the Luminal B subtype is defined differently than 
in Goldhirsch et al. Please explain why different definitions were chosen and provide recent 
references for these.  
  
 
Minor comments  
 
- The pie chart in Figure 1 does not provide any new information with respect to what is already 
mentioned in the text (p.5,l.52 -57). It could be left out and percentages could be added to the 
header of Table 2.  
 
- In four cases (p.5, lines 40,46,53,60) a post -hoc analysis result is given on a subset of the 
columns of a contingency t able, while the overall test on the entire contingency table was not 
significant. This is not valid and the post -hoc results together with their p -values should be 
removed. It is fine to discuss these findings qualitatively in the discussion (as is already  done 
now for some of these cases).  
 
- Table 2:  
 
 * For histological type: some of the frequencies are very low. Are the chi -square conditions 
satisfied?: 1) At most 20% of the expected counts are allowed to be less than 5;  
 
2) The minimum expected count is a t least equal to 1. If not a Fisher exact test should be 
performed.  
 
* Tumor size: the p -value for 'Mean size' is missing and should be 0.097 (p.6,l.20) and the p -
value for the contingency table should be 0.005 (p.6,l.24).  
 
 
Corrections  
 
- p.2,l.48: anti -HRE 2 -> anti -HER2  
 
- p.3,l.18: profile -> profiles  
 
- p.5,l.28: lymph node -> lymph node status  
 
- p.6,l.1: differed significant -> differed significantly  
 
- p.6 (several times): put 'p -value' in normal font not in italics  
 
- p.7,l.53: Fez -> Fez (Morocco)  
 
- p.8,l.23: highlight -> highlights  
 
- p.8,l.36: HR has not yet been defined  
 
- p.10,l.5: 68.7 -5% -> 68.7 -75% 
 
- p.10,l.24: 14.2 -> 14.2%  
 
- p.11,l.9: These are consistent -> These findings are consistent  
 
- p.11,l.39: Previous study has -> Previous studies have  
 
- p.12,l.16: Molecular subtypes analyzes -> Molecular subtype analyses  
 
- p.12,l.20: Compared with the Triple Negative, HER2 subtype in our study tend -> Compared 
with the Triple Negative subtype, the HER2 subtype in our study tends  
 
- p.12,l.24: anti -HRE2 -> ant i-HER2  
 
Are the methods appropriate and well described?  
If not, pl ease specify what is required in your comments to the authors.  
 
No 
 
Does the work include the necessary controls?  
If not, please specify which controls are required in your comments to the authors.  
 
Yes 
 
Are the conclusions drawn adequately supported by t he data shown?  
If not, please explain in your comments to the authors.  
 
Yes 
 
Are you able to assess any statistics in the manuscript or would you recommend an 
additional statistical review?  
If an additional statistical review is recommended, please specify  what aspects require further 
assessment in your comments to the editors.  
 
I am able to assess the statistics  
 
Quality of written English  
Please indicate the quality of language in the manuscript:  
 
Needs some language corrections before being published  
 
Declaration of competing interests  
Please complete a declaration of competing interests, considering the following questions:  
 
1. Have you in the past five years received reimbursements, fees, funding, or salary from an 
organisation that may in any way gain or lose financially from the publica tion of this 
manuscript, either now or in the future?  
 
2. Do you hold any stocks or shares in an organisation that may in any way gain or lose 
financially from the publication of this manuscript, either now or in the future?  
 
3. Do you hold or are you currently applying for any patents relating to the content of the 
manuscript?  
 
4. Have you received reimbursements, fees, funding, or salary from an organization that 
holds or has applied for patents relating to the content of the manuscript?  
 
5. Do you have any other fin ancial competing interests?  
 
6. Do you have any non -financial competing interests in relation to this paper?  
 
If you can answer no to all of the above, write 'I declare that I have no competing interests' 
below. If your reply is yes to any, please give detail s below.  
I declare that I have no competing interests  
 
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