The Use of Multiplex Immunohistochemistry for Precision Breast Cancer Diagnosis in a Low-Resourced Environment: A Focus on Nigeria

Abstract

Introduction In 2023, there were over 53,500 new instances of breast cancer in Nigeria, a 542.9% rise since 1990. Due to its increasing incidence, frequent late-stage presentation, and comparatively high prevalence of aggressive tumour subtypes, which contribute to poor clinical outcomes, breast cancer remains a significant public health concern in the nation. Precision oncology relies heavily on accurate biomarker assessment; however, the standard method for characterising breast cancer, conventional immunohistochemistry (IHC), is limited in its ability to assess multiple biomarkers at once and fully characterise the tumour microenvironment. An alternate method is provided by multiplex immunohistochemistry (mIHC), which allows the simultaneous detection of several biomarkers within a single tissue section while maintaining the spatial linkages between immune cells and tumours. Methods This review synthesises published literature on multiplex immunohistochemistry for precision breast cancer diagnosis, analysing evidence from peer-reviewed studies and grey literature to evaluate its clinical applications, implementation challenges, and future prospects in Nigeria and other low-resource settings. Results The potential role of mIHC in Nigerian breast cancer detection and treatment is examined in this review. According to research on breast cancer, mIHC may enhance patient classification for precision medicine, molecular subtyping, tumour microenvironment characterisation, biomarker identification, and prognostic evaluation. The evaluation also takes into account potential implementation options within the Nigerian health system, such as current infrastructure for histopathology, new initiatives in digital pathology, telepathology platforms, research partnerships, and workforce development programs. Conclusion However, there are still significant obstacles to adoption. These include high equipment and reagent costs, a lack of technical know-how, infrastructure limitations, difficulties with quality assurance, and limited patient affordability. Based on the information that is currently available, this analysis suggests a phased implementation plan that focuses on international alliances, technology transfer, workforce training, research-driven adoption, and specific centers of excellence. The gradual development of precision breast cancer care in Nigeria and other low-resource settings may be supported by mIHC, even though traditional IHC is expected to remain essential for the foreseeable future.