According to mortality estimates from the World Health Organization (WHO), cancer is the fourth leading cause of death in the Eastern Mediterranean Region (EMR). ), after cardiovascular diseases, infectious/parasitic diseases and injuries [1-3]. The largest increase in cancer incidence among WHO regions over the next 15 years is likely to be in the EMR region, where breast cancer (BC) is recorded as the most common type of female malignancy. common in almost all national cancer registries [1-4]. In most countries in the EMR region (e.g. Iran and Iraq), in addition to being the most important cancer, there are other characteristics that justify increased efforts to combat B.C. British, notably the tendency of this disease to affect younger women, the evident increase in incidence rates and the prevalence of advanced stages at presentation associated with more aggressive tumor behavior leading to higher mortality rates [ 6.7]. Although patient survival depends on many determinants such as: age, race, genetics, socio-economic status and quality of care, the two most important determinants of survival in British Columbia in the 'EMR are early detection and adequacy of treatment [5-7]. . Clearly, there is an urgent need to better understand the molecular events of disease and search for more effective biomarkers for prevention, early detection, drug development and personalized treatment. BC is a complex genetic disease characterized by an accumulation of molecular molecules. alterations, leading to strong clinical heterogeneity [8,9]. Different types of BC exhibit variable histopathological and biological characteristics, different clinical outcomes, and different response to treatment. Based on such a degree of heterogeneity and based on their growth patterns (histological analysis...... middle of article ...... examinations of the validity of these GEP tests currently available to USA and EU and their validation for various populations is limited [22,23] due to significant differences in histopathology (hormone receptor status, grading and staging), demographic parameters, survival. and other factors of Asian BC compared to Caucasians, much effort is needed to develop and validate a specific prognostic signature in these populations [5-7, 23-25]. To our knowledge, there are a few studies evaluating GEP and clinical outcomes in Asia and only one of them was conducted in the EMR where GEP for Saudi women was reported [24,25]. Based on this report, there is an approximately 50% difference in GEP between Western and Saudi populations, further highlighting the importance of finding specific genetic signatures in EMR. [25].