It is possible that variations in LEPR polymorphisms and other low penetrance genes may contribute to the marked worldwide variation in breast cancer incidence, with the highest age-standardized incidence rate (ASR) in North America (ASR, 99.4 per 100,000) and the lowest age-standardized incidence rates in sub-Saharan Africa (ASR, 27.8 per 100,000 in West Africa, 19.5 per 100,000 in East Africa and 16.5 per 100,000 in Central Africa) [44]. This evidence concerns the gene LEPR and breast carcinoma.