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Yadav S, Couch FJ, Domchek SM. Germline Genetic Testing for Hereditary Breast and Ovarian Cancer: Current Concepts in Risk Evaluation. Cold Spring Harb Perspect Med 2024; 14:a041318. [PMID: 38151326 PMCID: PMC11293548 DOI: 10.1101/cshperspect.a041318] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2023]
Abstract
Our understanding of hereditary breast and ovarian cancer has significantly improved over the past two decades. In addition to BRCA1/2, pathogenic variants in several other DNA-repair genes have been shown to increase the risks of breast and ovarian cancer. The magnitude of cancer risk is impacted not only by the gene involved, but also by family history of cancer, polygenic risk scores, and, in certain genes, pathogenic variant type or location. While estimates of breast and ovarian cancer risk associated with pathogenic variants are available, these are predominantly based on studies of high-risk populations with young age at diagnosis of cancer, multiple primary cancers, or family history of cancer. More recently, breast cancer risk for germline pathogenic variant carriers has been estimated from population-based studies. Here, we provide a review of the field of germline genetic testing and risk evaluation for hereditary breast and ovarian cancers in high-risk and population-based settings.
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Affiliation(s)
- Siddhartha Yadav
- Department of Oncology, Mayo Clinic, Rochester, Minnesota 55905, USA
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Minnesota 55901, USA
| | - Susan M Domchek
- Basser Center for BRCA, Abramson Cancer Center, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA
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Trivedi MS, Manley H, Yi H, Silverman T, Chung WK, Appelbaum PS, Starck R, Schecter I, Kukafka R, Crew KD. Pilot study of a decision aid on BRCA1/2 genetic testing among Orthodox Jewish women. Fam Cancer 2024:10.1007/s10689-024-00371-6. [PMID: 38609522 DOI: 10.1007/s10689-024-00371-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2023] [Accepted: 03/05/2024] [Indexed: 04/14/2024]
Abstract
INTRODUCTION Orthodox Jewish women face unique social, cultural, and religious factors that may influence uptake of BRCA1/2 genetic testing. We examined the impact of a web-based decision aid (DA) on BRCA1/2 genetic testing intention/completion among Orthodox Jewish women. We conducted a single-arm pilot study among 50 Orthodox Jewish women who were given access to a web-based DA entitled RealRisks and administered serial surveys at baseline and 1 and 6 months after exposure to the DA. Descriptive statistics were conducted for baseline characteristics and study measures. Comparisons were made to assess changes in study measures over time. Fifty Orthodox Jewish women enrolled in the study with a mean age of 43.9 years (standard deviation [SD] 14.6), 70% Modern Orthodox, 2% with personal history of breast cancer, and 68% and 16% with a family history of breast or ovarian cancer, respectively. At baseline, 27 (54%) participants intended to complete genetic testing. Forty-three participants (86%) completed RealRisks and the 1-month survey and 38 (76%) completed the 6-month survey. There was a significant improvement in BRCA1/2 genetic testing knowledge and decrease in decisional conflict after exposure to the DA. At 1 month, only 20 (46.5%) completed or intended to complete genetic testing (p = 0.473 compared to baseline). While the DA improved genetic testing knowledge and reduced decisional conflict, genetic testing intention/completion did not increase over time. Future interventions should directly address barriers to BRCA1/2 genetic testing uptake and include input from leaders in the Orthodox Jewish community. CLINICALTRIALS GOV ID NCT03624088 (8/7/18).
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Affiliation(s)
- Meghna S Trivedi
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue HIP 10, New York, NY, 10032, USA.
| | - Haley Manley
- College of Law, DePaul University, Chicago, IL, USA
| | - Haeseung Yi
- Department of Health and Behavior Studies, Teachers College, Columbia University, New York, NY, USA
| | - Thomas Silverman
- Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Wendy K Chung
- Department of Pediatrics, Boston Children's Hospital, Boston, MA, USA
| | - Paul S Appelbaum
- Department of Psychiatry, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Rebecca Starck
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, NY, USA
| | - Isaac Schecter
- Institute for Applied Research and Community Collaboration (ARCC), Spring Valley, NY, USA
- Achieve Behavioral Health, Monsey, NY, USA
| | - Rita Kukafka
- Department of Biomedical Informatics, Vagelos College of Physicians and Surgeons, Columbia University, New York, NY, USA
| | - Katherine D Crew
- Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University, 161 Fort Washington Avenue HIP 10, New York, NY, 10032, USA
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Kerr SM, Cowan E, Klaric L, Bell C, O'Sullivan D, Buchanan D, Grzymski JJ, van Hout CV, Tzoneva G, Shuldiner AR, Wilson JF, Miedzybrodzka Z. Clinical case study meets population cohort: identification of a BRCA1 pathogenic founder variant in Orcadians. Eur J Hum Genet 2023; 31:588-595. [PMID: 36927983 PMCID: PMC10172333 DOI: 10.1038/s41431-023-01297-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Revised: 12/20/2022] [Accepted: 01/18/2023] [Indexed: 03/18/2023] Open
Abstract
We multiply ascertained the BRCA1 pathogenic missense variant c.5207T > C; p.Val1736Ala (V1736A) in clinical investigation of breast and ovarian cancer families from Orkney in the Northern Isles of Scotland, UK. We sought to investigate the frequency and clinical relevance of this variant in those of Orcadian ancestry as an exemplar of the value of population cohorts in clinical care, especially in isolated populations. Oral history and birth, marriage and death registrations indicated genealogical linkage of the clinical cases to ancestors from the Isle of Westray, Orkney. Further clinical cases were identified through targeted testing for V1736A in women of Orcadian ancestry attending National Health Service (NHS) genetic clinics for breast and ovarian cancer family risk assessments. The variant segregates with female breast and ovarian cancer in clinically ascertained cases. Separately, exome sequence data from 2088 volunteer participants with three or more Orcadian grandparents, in the ORCADES research cohort, was interrogated to estimate the population prevalence of V1736A in Orcadians. The effects of the variant were assessed using Electronic Health Record (EHR) linkage. Twenty out of 2088 ORCADES research volunteers (~1%) carry V1736A, with a common haplotype around the variant. This allele frequency is ~480-fold higher than in UK Biobank participants. Cost-effectiveness of population screening for BRCA1 founder pathogenic variants has been demonstrated at a carrier frequency below the ~1% observed here. Thus we suggest that Orcadian women should be offered testing for the BRCA1 V1736A founder pathogenic variant, starting with those with known Westray ancestry.
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Affiliation(s)
- Shona M Kerr
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - Emma Cowan
- Department of Medical Genetics, Ashgrove House, NHS Grampian, Aberdeen, AB25 2ZA, UK
| | - Lucija Klaric
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - Christine Bell
- Department of Medical Genetics, Ashgrove House, NHS Grampian, Aberdeen, AB25 2ZA, UK
| | - Dawn O'Sullivan
- Department of Medical Genetics, Ashgrove House, NHS Grampian, Aberdeen, AB25 2ZA, UK
| | - David Buchanan
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
| | - Joseph J Grzymski
- Center for Genomic Medicine, Desert Research Institute, Reno, NV, USA
- Renown Health, Reno, NV, USA
| | - Cristopher V van Hout
- Regeneron Genetics Center, Tarrytown, NY, USA
- Laboratorio Internacional de Investigatión sobre el Genoma Humano, Campus Juriquilla de la Universidad Nacional Autónoma de México, Querétaro, Querétaro, 76230, México
| | | | | | - James F Wilson
- MRC Human Genetics Unit, University of Edinburgh, Institute of Genetics and Cancer, Western General Hospital, Crewe Road, Edinburgh, EH4 2XU, UK
- Centre for Global Health Research, Usher Institute, University of Edinburgh, Teviot Place, Edinburgh, EH8 9AG, UK
| | - Zosia Miedzybrodzka
- Department of Medical Genetics, Ashgrove House, NHS Grampian, Aberdeen, AB25 2ZA, UK.
- Medical Genetics Group, School of Medicine, Medical Sciences, Nutrition and Dentistry, University of Aberdeen, Polwarth Building, Aberdeen, AB25 2ZD, UK.
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Abstract
Breast cancer screening has been highly successful in women in reducing mortality through early detection. In comparison, clinical detection of breast cancer remains the norm in men, and delay in diagnosis is reflected by a persistent survival disparity compared to women despite advances in modern therapy. Male breast cancer presents an interesting dilemma. While mammography is highly sensitive and specific for male breast cancer, routine screening is not justified by the overall low disease incidence. Yet there has been interest in leveraging mammography in targeted screening of men with identifiable risk factors to allow early detection, and early data may support this approach. The purpose of this article is to explore the potential utility of targeted breast cancer screening in men by examining unique clinical and biologic characteristics of male breast cancers that may lend themselves to mammographic detection. We will also discuss available evidence in screening outcomes in men and summarize recent updates in risk management recommendations in Society guidelines.
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Affiliation(s)
- Yiming Gao
- New York University-Langone, Department of Radiology, New York, NY, USA
| | - Samantha L Heller
- New York University-Langone, Department of Radiology, New York, NY, USA
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Frequency of germline genetic variants in women with a personal or family history of breast cancer from Brazil. Mol Biol Rep 2022; 49:9509-9520. [PMID: 35980532 DOI: 10.1007/s11033-022-07840-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Accepted: 08/03/2022] [Indexed: 01/10/2023]
Abstract
BACKGROUND About 5-10% of breast cancer cases are related to genetic and hereditary factors. The application of Next Generation Sequencing (NGS) in oncology has allowed the identification of genetic variants present in several genes related to the increased risk of breast cancer. This study aimed to determine the frequency of germline genetic variants in patients with a family and/or personal history of breast cancer. METHODS An analysis of positive reports from NGS panels was carried out in female individuals with a personal and/or family history of breast cancer, present in the database of a private laboratory in Brazil. RESULTS From about 2000 reports, 183 individuals presented 219 different germline genetic variants. The genes with the highest number of variants were BRCA2 (16.0%), ATM (15.0%) and BRCA1 (12.8%). Among the variants found, 78 were either pathogenic or probably pathogenic, accounting for 35% of all variants discovered. The gene with the highest proportion of pathogenic/probably pathogenic variants was TP53 (80%) and the most frequent pathogenic variant was also reported in this gene (c.1010G > A p.(Arg337His)). Furthermore, the study obtained a high proportion of variants of uncertain significance (VUS) (65%) and approximately 32% of the variants found were in genes of moderate penetrance. CONCLUSIONS Our results could improve the risk estimation and clinical follow-up of Brazilian patients with a history of breast cancer.
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Zimmer K, Kocher F, Puccini A, Seeber A. Targeting BRCA and DNA Damage Repair Genes in GI Cancers: Pathophysiology and Clinical Perspectives. Front Oncol 2021; 11:662055. [PMID: 34707985 PMCID: PMC8542868 DOI: 10.3389/fonc.2021.662055] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Accepted: 09/15/2021] [Indexed: 12/11/2022] Open
Abstract
Mutated germline alleles in the DNA damage repair (DDR) genes “breast cancer gene 1” (BRCA1) and BRCA2 have originally been identified as major susceptibility genes in breast and ovarian cancers. With the establishment and approval of more cost-effective gene sequencing methods, germline and somatic BRCA mutations have been detected in several cancers. Since the approval of poly (ADP)-ribose polymerase inhibitors (PARPi) for BRCA-mutated cancers, BRCA mutations gained rising therapeutic implications. The impact and significance of BRCA mutations have been evaluated extensively in the last decades. Moreover, other genes involved in the DDR pathway, such as ATM, ATR, or CHK1, have emerged as potential new treatment targets, as inhibitors of these proteins are currently under clinical investigation. This review gives a concise overview on the emerging clinical implications of mutations in the DDR genes in gastrointestinal cancers with a focus on BRCA mutations.
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Affiliation(s)
- Kai Zimmer
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Florian Kocher
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
| | - Alberto Puccini
- Medical Oncology Unit 1, Ospedale Policlinico San Martino Istituto di ricovero e cura a carattere scientifico (IRCCS), University of Genoa, Genoa, Italy
| | - Andreas Seeber
- Department of Hematology and Oncology, Comprehensive Cancer Center Innsbruck, Medical University of Innsbruck, Innsbruck, Austria
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Jain A, Sharma D, Bajaj A, Gupta V, Scaria V. Founder variants and population genomes-Toward precision medicine. ADVANCES IN GENETICS 2021; 107:121-152. [PMID: 33641745 DOI: 10.1016/bs.adgen.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Human migration and community specific cultural practices have contributed to founder events and enrichment of the variants associated with genetic diseases. While many founder events in isolated populations have remained uncharacterized, the application of genomics in clinical settings as well as for population scale studies in the recent years have provided an unprecedented push towards identification of founder variants associated with human health and disease. The discovery and characterization of founder variants could have far reaching implications not only in understanding the history or genealogy of the disease, but also in implementing evidence based policies and genetic testing frameworks. This further enables precise diagnosis and prevention in an attempt towards precision medicine. This review provides an overview of founder variants along with methods and resources cataloging them. We have also discussed the public health implications and examples of prevalent disease associated founder variants in specific populations.
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Affiliation(s)
- Abhinav Jain
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Disha Sharma
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Anjali Bajaj
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Vishu Gupta
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
| | - Vinod Scaria
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India; Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India.
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8
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Gomes R, Soares BL, Felicio PS, Michelli R, Netto CBO, Alemar B, Ashton-Prolla P, Palmero EI, Moreira MÂM. Haplotypic characterization of BRCA1 c.5266dupC, the prevailing mutation in Brazilian hereditary breast/ovarian cancer. Genet Mol Biol 2020. [PMID: 32453342 PMCID: PMC7250276 DOI: 10.1590//1678-4685-gmb-2019-0072] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Specific pathogenic mutations associated with breast cancer development can vary between ethnical groups. One example is BRCA1 c.5266dupC that was first described as a founder mutation in the Ashkenazi Jewish population, but was later also found in other populations. In Brazil, this mutation corresponds to 20% of pathogenic BRCA1 variants reported. Our objective was to investigate the haplotype component of a group of Brazilian families who inherited c.5266dupC in the BRCA1 gene and to verify the ancestry contribution from European, African, and Amerindian origins. Fourteen probands carrying c.5266dupC and 16 relatives (carriers and non-carriers) were investigated. The same haplotype was observed segregating within all the families analyzed, revealing no recombinants in a region of 0.68 Mb. Ancestry analysis demonstrated that the European component was predominant among probands. The BRCA1 c.5266dupC analysis indicates that there was a founder effect in the Brazilian population.
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Affiliation(s)
- Renan Gomes
- Instituto Nacional de Câncer, Programa de Genética, Rio de Janeiro, RJ, Brazil
| | | | - Paula Silva Felicio
- Hospital de Cancer de Barretos, Centro de Pesquisa em Oncologia Molecular, Barretos, SP, Brazil
| | - Rodrigo Michelli
- Hospital de Cancer de Barretos, Centro de Pesquisa em Oncologia Molecular, Barretos, SP, Brazil
| | - Cristina B O Netto
- Hospital de Clínicas de Porto Alegre, Serviço de Genética Médica, Porto Alegre, RS, Brazil
| | - Barbara Alemar
- Hospital de Clínicas de Porto Alegre, Laboratório de Medicina Genômica, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Genética, Programa de Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
| | - Patrícia Ashton-Prolla
- Hospital de Clínicas de Porto Alegre, Laboratório de Medicina Genômica, Porto Alegre, RS, Brazil.,Universidade Federal do Rio Grande do Sul (UFRGS), Departamento de Genética, Programa de Pós-Graduação em Genética e Biologia Molecular, Porto Alegre, RS, Brazil
| | - Edenir Inêz Palmero
- Hospital de Cancer de Barretos, Centro de Pesquisa em Oncologia Molecular, Barretos, SP, Brazil.,Faculdade de Ciências de Saúde de Barretos Dr. Paulo Prata (FACISB), Barretos, SP, Brazil
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9
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Woods RW, Salkowski LR, Elezaby M, Burnside ES, Strigel RM, Fowler AM. Image-based screening for men at high risk for breast cancer: Benefits and drawbacks. Clin Imaging 2020; 60:84-89. [PMID: 31864206 PMCID: PMC7242122 DOI: 10.1016/j.clinimag.2019.11.005] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2019] [Revised: 11/15/2019] [Accepted: 11/18/2019] [Indexed: 02/07/2023]
Abstract
Male breast cancer is a rare malignancy. Due to low prevalence and limited data to support male breast cancer screening, there are currently no recommendations for image-based screening in asymptomatic men and few recommendations for men at high risk for breast cancer. However, symptomatically diagnosed cancers in men are typically advanced, suggesting that earlier detection may improve outcomes. In this article we briefly review the risk factors for male breast cancer, and discuss the potential benefits and possible drawbacks of routine image-based screening for men at high risk for breast cancer.
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Affiliation(s)
- Ryan W Woods
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA.
| | - Lonie R Salkowski
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Mai Elezaby
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Elizabeth S Burnside
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA
| | - Roberta M Strigel
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705, USA
| | - Amy M Fowler
- Department of Radiology, University of Wisconsin School of Medicine and Public Health, 600 Highland Avenue, Madison, WI 53792, USA; University of Wisconsin Carbone Cancer Center, 600 Highland Avenue, Madison, WI 53792, USA; Department of Medical Physics, University of Wisconsin School of Medicine and Public Health, 1111 Highland Avenue, Madison, WI 53705, USA
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Laitman Y, Friebel TM, Yannoukakos D, Fostira F, Konstantopoulou I, Figlioli G, Bonanni B, Manoukian S, Zuradelli M, Tondini C, Pasini B, Peterlongo P, Plaseska-Karanfilska D, Jakimovska M, Majidzadeh K, Zarinfam S, Loizidou MA, Hadjisavvas A, Michailidou K, Kyriacou K, Behar DM, Molho RB, Ganz P, James P, Parsons MT, Sallam A, Olopade OI, Seth A, Chenevix-Trench G, Leslie G, McGuffog L, Marafie MJ, Megarbane A, Al-Mulla F, Rebbeck TR, Friedman E. The spectrum of BRCA1 and BRCA2 pathogenic sequence variants in Middle Eastern, North African, and South European countries. Hum Mutat 2019; 40:e1-e23. [PMID: 31209999 DOI: 10.1002/humu.23842] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2019] [Revised: 05/25/2019] [Accepted: 06/12/2019] [Indexed: 12/22/2022]
Abstract
BRCA1 BRCA2 mutational spectrum in the Middle East, North Africa, and Southern Europe is not well characterized. The unique history and cultural practices characterizing these regions, often involving consanguinity and inbreeding, plausibly led to the accumulation of population-specific founder pathogenic sequence variants (PSVs). To determine recurring BRCA PSVs in these locales, a search in PUBMED, EMBASE, BIC, and CIMBA was carried out combined with outreach to researchers from the relevant countries for unpublished data. We identified 232 PSVs in BRCA1 and 239 in BRCA2 in 25 of 33 countries surveyed. Common PSVs that were detected in four or more countries were c.5266dup (p.Gln1756Profs), c.181T>G (p.Cys61Gly), c.68_69del (p.Glu23Valfs), c.5030_5033del (p.Thr1677Ilefs), c.4327C>T (p.Arg1443Ter), c.5251C>T (p.Arg1751Ter), c.1016dup (p.Val340Glyfs), c.3700_3704del (p.Val1234Glnfs), c.4065_4068del (p.Asn1355Lysfs), c.1504_1508del (p.Leu502Alafs), c.843_846del (p.Ser282Tyrfs), c.798_799del (p.Ser267Lysfs), and c.3607C>T (p.Arg1203Ter) in BRCA1 and c.2808_2811del (p.Ala938Profs), c.5722_5723del (p.Leu1908Argfs), c.9097dup (p.Thr3033Asnfs), c.1310_1313del (p. p.Lys437Ilefs), and c.5946del (p.Ser1982Argfs) for BRCA2. Notably, some mutations (e.g., p.Asn257Lysfs (c.771_775del)) were observed in unrelated populations. Thus, seemingly genotyping recurring BRCA PSVs in specific populations may provide first pass BRCA genotyping platform.
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Affiliation(s)
- Yael Laitman
- The Susanne Levy Gertner Oncogenetics Unit, The Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research Demokritos, Athens, Greece
| | - Gisella Figlioli
- Genome Diagnostics Program, IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, IEO, European Institute of Oncology IRCCS, Milan, Italy
| | - Siranoush Manoukian
- Unit of Medical Genetics, Department of Medical Oncology and Hematology, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - Monica Zuradelli
- Medical Oncology and Hematology Department, Humanitas Cancer Center, Milan, Italy
| | - Carlo Tondini
- Department of Medical Oncology, Ospedale Papa Giovanni XXIII, Bergamo, Italy
| | - Barbara Pasini
- Department of Medical Sciences, University of Turin, Turin, Italy
| | - Paolo Peterlongo
- Genome Diagnostics Program, IFOM, the FIRC Institute of Molecular Oncology, Milan, Italy
| | - Dijana Plaseska-Karanfilska
- Macedonian Academy of Sciences and Arts Research Centre for Genetic Engineering and Biotechnology, Skopje, Republic of Macedonia
| | - Milena Jakimovska
- Macedonian Academy of Sciences and Arts Research Centre for Genetic Engineering and Biotechnology, Skopje, Republic of Macedonia
| | - Keivan Majidzadeh
- Department of Genetics, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Shiva Zarinfam
- Department of Genetics, Breast Cancer Research Center, Motamed Cancer Institute, ACECR, Tehran, Iran
| | - Maria A Loizidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Andreas Hadjisavvas
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Kyriaki Michailidou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | - Kyriacos Kyriacou
- Department of Electron Microscopy/Molecular Pathology, The Cyprus Institute of Neurology and Genetics, The Cyprus School of Molecular Medicine, Nicosia, Cyprus
| | | | - Rinat Bernstein Molho
- The Institute of Oncology, Sheba Medical Center, Tel-Hashomer, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
| | - Patricia Ganz
- Schools of Medicine and Public Health, Division of Cancer Prevention & Control Research, Jonsson Comprehensive Cancer Centre, UCLA, Los Angeles, CA
| | - Paul James
- Parkville Familial Cancer Peter MacCallum Cancer Center, Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia
| | - Michael T Parsons
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland Institute of Medical Research, Brisbane, Australia
| | - Aminah Sallam
- Center for Clinical Cancer Genetics, The University of Chicago, Chicago, IL
| | | | - Arun Seth
- Department of Laboratory Medicine and Pathobiology, Faculty of Medicine, University of Toronto, Canada
| | - Georgia Chenevix-Trench
- Department of Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Queensland Institute of Medical Research, Brisbane, Australia
| | - Goska Leslie
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | - Lesley McGuffog
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, England
| | | | | | - Fahd Al-Mulla
- Department of Genetics and Bioinformatics, Dasman Diabetes Institute, Kuwait City, Kuwait
| | - Timothy R Rebbeck
- Dana-Farber Cancer Institute, Boston, MA
- Harvard T.H. Chan School of Public Health, Boston, MA
| | - Eitan Friedman
- The Susanne Levy Gertner Oncogenetics Unit, The Institute of Human Genetics, Sheba Medical Center, Tel-Hashomer, Israel
- The Sackler School of Medicine, Tel-Aviv University, Tel-Aviv, Israel
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Gao Y, Heller SL, Moy L. Male Breast Cancer in the Age of Genetic Testing: An Opportunity for Early Detection, Tailored Therapy, and Surveillance. Radiographics 2018; 38:1289-1311. [PMID: 30074858 DOI: 10.1148/rg.2018180013] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
In detection, treatment, and follow-up, male breast cancer has historically lagged behind female breast cancer. On the whole, breast cancer is less common among men than among women, limiting utility of screening, yet the incidence of male breast cancer is rising, and there are men at high risk for breast cancer. While women at high risk for breast cancer are well characterized, with clearly established guidelines for screening, supplemental screening, risk prevention, counseling, and advocacy, men at high risk for breast cancer are poorly identified and represent a blind spot in public health. Today, more standardized genetic counseling and wider availability of genetic testing are allowing identification of high-risk male relatives of women with breast cancer, as well as men with genetic mutations predisposing to breast cancer. This could provide a new opportunity to update our approach to male breast cancer. This article reviews male breast cancer demographics, risk factors, tumor biology, and oncogenetics; recognizes how male breast cancer differs from its female counterpart; highlights its diagnostic challenges; discusses the implications of the widening clinical use of multigene panel testing; outlines current National Comprehensive Cancer Network guidelines (version 1, 2018) for high-risk men; and explores the possible utility of targeted screening and surveillance. Understanding the current state of male breast cancer management and its challenges is important to shape future considerations for care. Shifting the paradigm of male breast cancer detection toward targeted precision medicine may be the answer to improving clinical outcomes of this uncommon disease. ©RSNA, 2018.
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Affiliation(s)
- Yiming Gao
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
| | - Samantha L Heller
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
| | - Linda Moy
- From the Department of Radiology, New York University Langone Medical Center, 160 E 34th St, New York, NY 10016 (Y.G., S.L.H., L.M.); and the Center for Advanced Imaging Innovation and Research, New York University School of Medicine, New York, NY (L.M.)
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12
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Rybnikova N, Portnov BA. Population-level study links short-wavelength nighttime illumination with breast cancer incidence in a major metropolitan area. Chronobiol Int 2018; 35:1198-1208. [PMID: 29768068 DOI: 10.1080/07420528.2018.1466802] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Several population-level studies revealed a positive association between breast cancer (BC) incidence and artificial light at night (ALAN) exposure. However, the effect of short-wavelength illumination, implicated by laboratory research and small-scale cohort studies as the main driving force behind BC-ALAN association, has not been supported by any population-level study carried out to date. We investigated a possible link between BC and ALAN of different subspectra using a multi-spectral year-2011 satellite image, taken from the International Space Station, and superimposing it with year-2013 BC incidence data available for the Great Haifa Metropolitan Area in Israel. The analysis was performed using both ordinary least square (OLS) and spatial dependency models, controlling for socioeconomic and locational attributes of the study area. The study revealed strong associations between BC and blue and green light subspectra (B = 0.336 ± 0.001 and B = 0.335 ± 0.002, respectively; p < 0.01), compared to a somewhat weaker effect for the red subspectrum (B = 0.056 ± 0.001; p < 0.01). However, spatial dependency models, controlling for spatial autocorrelation of regression residuals, confirmed only a positive association between BC incidence and short-wavelength (blue) ALAN subspectrum (z = 2.462, p < 0.05) while reporting insignificant associations between BC and either green (z = 1.425, p > 0.1) or red (z = -0.604, p > 0.1) subspectra. The obtained result is in line with the results of laboratory- and small-scale cohort studies linking short-wavelength nighttime illumination with circadian disruption and melatonin suppression. The detected effect of blue lights on BC incidence may help to develop informed illumination policies aimed at minimizing the adverse health effects of ALAN exposure on human health.
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Affiliation(s)
- Nataliya Rybnikova
- a Department of Natural Resources and Environmental Management , University of Haifa , Haifa , Israel
| | - Boris A Portnov
- a Department of Natural Resources and Environmental Management , University of Haifa , Haifa , Israel
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13
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Gómez-Flores-Ramos L, Álvarez-Gómez RM, Villarreal-Garza C, Wegman-Ostrosky T, Mohar A. Breast cancer genetics in young women: What do we know? MUTATION RESEARCH-REVIEWS IN MUTATION RESEARCH 2017; 774:33-45. [PMID: 29173497 DOI: 10.1016/j.mrrev.2017.08.001] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Revised: 04/21/2017] [Accepted: 08/17/2017] [Indexed: 12/12/2022]
Abstract
Breast cancer (BC) in young women, generally defined in oncology as women who are 40 years of age or younger, represents 2 out of 10 BC cases in developing countries. Several research studies, including genetic cancer panel tests, genome-wide association studies, expression analyses and polymorphisms reports, have found that young women with BC exhibit a higher genetic susceptibility and specific genomic signature compared to postmenopausal women with BC. Thus, international guidelines recommend genetic counseling for this age population. This review presents the current state of the art of genetics and genomics with regards to young women with BC.
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Affiliation(s)
- Liliana Gómez-Flores-Ramos
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Mario de la Cueva, Coyoacán, Ciudad Universitaria, C.P. 04510, Mexico City, Mexico; Unidad de Investigación en Epidemiología, Subdivisión de Investigación Básica, Instituto Nacional de Cancerología, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Rosa María Álvarez-Gómez
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Cynthia Villarreal-Garza
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico; Centro de Cáncer de Mama, Tecnológico de Monterrey, Centro Médico Zambrano Hellion, 6° Piso Av. Batallón de San Patricio #112 Col. Real San Agustín, San Pedro Garza García C.P. 66278, Nuevo León, Mexico
| | - Talia Wegman-Ostrosky
- Clínica de Cáncer Hereditario, Subdivisión de Investigación Básica, Instituto Nacional de Cancerlogía, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico
| | - Alejandro Mohar
- Instituto de Investigaciones Biomédicas, Universidad Nacional Autónoma de México, Circuito Mario de la Cueva, Coyoacán, Ciudad Universitaria, C.P. 04510, Mexico City, Mexico; Unidad de Investigación en Epidemiología, Subdivisión de Investigación Básica, Instituto Nacional de Cancerología, Av. San Fernando # 22, Col. Sección XVI, Delegación Tlalpan, C.P. 14080, Mexico City, Mexico.
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14
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Bitzur R, Brenner R, Maor E, Antebi M, Ziv-Baran T, Segev S, Sidi Y, Kivity S. Metabolic syndrome, obesity, and the risk of cancer development. Eur J Intern Med 2016; 34:89-93. [PMID: 27545645 DOI: 10.1016/j.ejim.2016.08.019] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Revised: 07/10/2016] [Accepted: 08/10/2016] [Indexed: 10/21/2022]
Abstract
BACKGROUND Metabolic syndrome and its components are severe global health issues that are increasing in frequency as the prevalence of obesity increases. Various studies have established a correlation between metabolic syndrome and diseases including, diabetes mellitus, non-alcoholic fatty liver disease, cirrhosis, and cardiovascular disease. In recent years, correlations have also been detected between obesity and metabolic syndrome and the prevalence of certain types of cancer. The current study examines whether obesity and metabolic syndrome components are risk factors for cancer among the adult population in Israel. METHODS A cohort study analysis was performed of 24,987 initially healthy men and women who underwent yearly medical assessments at the Institute for Medical Screening in the Sheba Medical Center. Data from the Institute for Medical Screening database was correlated with that from the Israel Cancer Center in the Ministry of Health updated to December 2013. The correlation between metabolic syndrome, obesity, and the overall risk of cancer as well as the risks of specific types of cancer were examined. RESULTS Of 20,444 subjects for whom complete data were available, 1535 were diagnosed with cancer during the mean follow-up time of 104.3months. In a multi-variant analysis, no significant correlation was found between metabolic syndrome or obesity and the incidence of cancer. When the data were stratified by gender and cancer type, however, a significant association between metabolic syndrome and breast cancer in women was observed (P=0.03, HR=1.67, 95% CI=1.05-2.67). CONCLUSION Metabolic syndrome correlates with higher than expected breast cancer incidence in women.
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Affiliation(s)
- Rafael Bitzur
- The Bert W. Strassburger Lipid Center, Sheba Medical Center, 5265601 Tel Hashomer, Israel; Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Ronen Brenner
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Institute of Oncology, Wolfson Medical Center, Holon, Israel
| | - Elad Maor
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Leviev Heart Institute, The Chaim Sheba Medical Center, Tel Hashomer, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2013, Sheba Medical Center, Tel Hashomer, Israel
| | - Maayan Antebi
- Department of Internal Medicine D, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Tomer Ziv-Baran
- Department of Epidemiology and Preventive Medicine, School of Public Health, Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel
| | - Shlomo Segev
- Institute for Medical Screening, Sheba Medical Center, Israel
| | - Yechezkel Sidi
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; Department of Internal Medicine C, The Chaim Sheba Medical Center, Tel Hashomer, Israel
| | - Shaye Kivity
- Sackler Faculty of Medicine, Tel-Aviv University, Ramat-Aviv, Israel; The Dr. Pinchas Borenstein Talpiot Medical Leadership Program 2013, Sheba Medical Center, Tel Hashomer, Israel; Department of Internal Medicine A, The Chaim Sheba Medical Center, Tel Hashomer, Israel.
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15
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The frequency of BRCA1 founder mutation c.5266dupC (5382insC) in breast cancer patients from Ukraine. Hered Cancer Clin Pract 2015; 13:19. [PMID: 26468334 PMCID: PMC4605451 DOI: 10.1186/s13053-015-0040-3] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Accepted: 10/07/2015] [Indexed: 01/31/2023] Open
Abstract
Germ-line mutations in several genes, such as BRCA1 and BRCA2, are known to increase the risk of breast cancer. These heritable mutations are unequally represented among populations with different ethnic background due to founder effects and thereby contribute to differences in breast cancer rates in different populations. The BRCA1 mutation c.5266dupC (also known as 5382insC or 5385insC) was detected in a sample of 193 breast cancer patients in Ukraine by multiplex mutagenically separated PCR using published specific primers. Nine BRCA1 mutations 5382insC were detected (4.7 %). The difference in age of diagnosis (35 years in 5382insC carriers versus 45 years in non-carriers) we observed is consistent with other reports indicating that the 5382insC mutation is a factor of genetic predisposition to breast cancer, which is consistent with reports from other countries.
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16
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Molecular testing for the BRCA1 and BRCA2 Ashkenazi Jewish founder mutations: a report on the College of American Pathologists proficiency testing surveys. Genet Med 2014; 17:58-62. [PMID: 24946157 DOI: 10.1038/gim.2014.77] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2014] [Accepted: 05/22/2014] [Indexed: 11/09/2022] Open
Abstract
PURPOSE The purpose of this study was to analyze laboratory performance on proficiency testing surveys offered jointly by the College of American Pathologists/American College of Medical Genetics and Genomics biannually for the three common Ashkenazi Jewish founder mutations in the BRCA1 and BRCA2 genes. METHODS Survey responses were analyzed for accuracy of genotype determination and the associated clinical interpretation. Data on an individual laboratory's participation over time, number of samples tested, turnaround time, and test methodology were also reviewed. RESULTS Between 2003 and 2012, 23 US laboratories and 39 international laboratories participated. There were six genotyping errors, with a corresponding analytical sensitivity of 99.0% (479/484 challenges; 95% confidence interval: 97.6-99.7%) and an analytic specificity of 99.9% (870/871; 95% confidence interval: 99.4-99.9%). Among the 1,325 clinical interpretations, 92.5% (1,226/1,325; 95% confidence interval: 91.0-93.9%) matched the intended response. Most of the 99 discrepancies-81% (80/99)-incorrectly interpreted the risk for a negative test result as having a lifetime risk of breast cancer "that is the same as that in the general population" instead of "that cannot be determined without BRCA mutation testing of the affected relative." CONCLUSION Clinical laboratories demonstrated excellent analytical sensitivity and specificity. The clinical interpretation requires additional education, focusing on the clinical interpretation of negative test results for these three mutations.
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Abstract
It is known that mortality of Jews is different from the mortality of the populations that surround them. However, the existence of commonalities in mortality of different Jewish communities across the world has not received scholarly attention. This paper aims to identify common features of the evolution of Jewish mortality among Jews living in Israel and the Diaspora. In the paper the mortality of Jews in Israel is systematically compared with the mortality of the populations of developed countries, and the findings from the earlier studies of mortality of Jews in selected Diaspora communities are re-examined. The outcome is a re-formulation and extension of the notion of the 'Jewish pattern of mortality'. The account of this pattern is based on the consistently low level of behaviourally induced mortality, the migration history of Jewish populations and the enduring influence of early-life conditions on mortality at older ages.
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18
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Lu KH, Wood ME, Daniels M, Burke C, Ford J, Kauff ND, Kohlmann W, Lindor NM, Mulvey TM, Robinson L, Rubinstein WS, Stoffel EM, Snyder C, Syngal S, Merrill JK, Wollins DS, Hughes KS. American Society of Clinical Oncology Expert Statement: collection and use of a cancer family history for oncology providers. J Clin Oncol 2014; 32:833-40. [PMID: 24493721 PMCID: PMC3940540 DOI: 10.1200/jco.2013.50.9257] [Citation(s) in RCA: 176] [Impact Index Per Article: 17.6] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- Karen H. Lu
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Marie E. Wood
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Molly Daniels
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Cathy Burke
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - James Ford
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Noah D. Kauff
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Wendy Kohlmann
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Noralane M. Lindor
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Therese M. Mulvey
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Linda Robinson
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Wendy S. Rubinstein
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Elena M. Stoffel
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Carrie Snyder
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Sapna Syngal
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Janette K. Merrill
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Dana Swartzberg Wollins
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
| | - Kevin S. Hughes
- Karen H. Lu, Molly Daniels, and Cathy Burke, MD Anderson Cancer Center, Houston; Linda Robinson, Simmons Comprehensive Cancer Center, Dallas, TX; Marie E. Wood, University of Vermont, Burlington, VT; James Ford, Stanford University Medical Center, Stanford, CA; Noah D. Kauff, Memorial Sloan-Kettering Cancer Center, New York, NY; Wendy Kohlmann, Huntsman Cancer Institute, University of Utah, Salt Lake City, UT; Noralane M. Lindor, Mayo Clinic, Scottsdale, AZ; Therese M. Mulvey, Southcoast Centers for Cancer Care, Fall River; Sapna Syngal, Dana-Farber Cancer Institute, Brigham and Women's Hospital; Kevin S. Hughes, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, Boston, MA; Wendy Rubinstein, National Center for Biotechnology Information, National Library of Medicine, National Institutes of Health, Bethesda, MD; Elena M. Stoffel, University of Michigan, Ann Arbor, MI; Carrie Snyder, Creighton University, Omaha, NE; and Janette K. Merrill and Dana Swartzberg Wollins, American Society of Clinical Oncology, Alexandria, VA
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Rinella ES, Shao Y, Yackowski L, Pramanik S, Oratz R, Schnabel F, Guha S, LeDuc C, Campbell CL, Klugman SD, Terry MB, Senie RT, Andrulis IL, Daly M, John EM, Roses D, Chung WK, Ostrer H. Genetic variants associated with breast cancer risk for Ashkenazi Jewish women with strong family histories but no identifiable BRCA1/2 mutation. Hum Genet 2013; 132:523-36. [PMID: 23354978 DOI: 10.1007/s00439-013-1269-4] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2012] [Accepted: 01/13/2013] [Indexed: 01/26/2023]
Abstract
The ability to establish genetic risk models is critical for early identification and optimal treatment of breast cancer. For such a model to gain clinical utility, more variants must be identified beyond those discovered in previous genome-wide association studies (GWAS). This is especially true for women at high risk because of family history, but without BRCA1/2 mutations. This study incorporates three datasets in a GWAS analysis of women with Ashkenazi Jewish (AJ) homogeneous ancestry. Two independent discovery cohorts comprised 239 and 238 AJ women with invasive breast cancer or preinvasive ductal carcinoma in situ and strong family histories of breast cancer, but lacking the three BRCA1/2 founder mutations, along with 294 and 230 AJ controls, respectively. An independent, third cohort of 203 AJ cases with familial breast cancer history and 263 healthy controls of AJ women was used for validation. A total of 19 SNPs were identified as associated with familial breast cancer risk in AJ women. Among these SNPs, 13 were identified from a panel of 109 discovery SNPs, including an FGFR2 haplotype. In addition, six previously identified breast cancer GWAS SNPs were confirmed in this population. Seven of the 19 markers were significant in a multivariate predictive model of familial breast cancer in AJ women, three novel SNPs [rs17663555(5q13.2), rs566164(6q21), and rs11075884(16q22.2)], the FGFR2 haplotype, and three previously published SNPs [rs13387042(2q35), rs2046210(ESR1), and rs3112612(TOX3)], yielding moderate predictive power with an area under the curve (AUC) of the ROC (receiver-operator characteristic curve) of 0.74. Population-specific genetic variants in addition to variants shared with populations of European ancestry may improve breast cancer risk prediction among AJ women from high-risk families without founder BRCA1/2 mutations.
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Affiliation(s)
- Erica S Rinella
- Department of Surgery, New York University Langone Medical Center, New York, NY, USA
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20
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Stecklein SR, Jensen RA. Identifying and exploiting defects in the Fanconi anemia/BRCA pathway in oncology. Transl Res 2012; 160:178-97. [PMID: 22683426 DOI: 10.1016/j.trsl.2012.01.022] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2011] [Revised: 01/18/2012] [Accepted: 01/19/2012] [Indexed: 01/07/2023]
Abstract
Defects in components of DNA repair pathways are responsible for numerous hereditary cancer syndromes and are also common in many sporadic malignancies. Inherited mutations in the breast cancer susceptibility genes BRCA1 and BRCA2 or components of the Fanconi anemia (FA) complex incite genomic instability and predispose to malignancy. The products of the BRCA and FA genes participate in a conserved DNA damage repair pathway that is responsible for repairing interstrand crosslinks and double-strand DNA breaks by homologous recombination. While the genetic instability resulting from FA/BRCA dysfunction contributes to cancer pathogenesis, deficiency of these genes also lends to therapeutic exploitation. Crosslinking agents and ionizing radiation induce damage in cancer cells that requires the FA/BRCA pathway to be resolved; thus cancers that are deficient in BRCA1, BRCA2, or any other component of the FA/BRCA pathway are hypersensitive to these agents. Moreover, emerging synthetic lethal strategies offer opportunities to selectively target cancer cells with defects in homologous recombination. Conversely, enhanced activity of the FA/BRCA pathway is responsible for acquired resistance to specific therapeutic agents, suggesting that both dysfunction and hyperfunction of the FA/BRCA repair machinery are rational targets for cancer therapy. Selection of specific cytotoxic agents based on repair capacity may improve responses and enable personalized cytotoxic chemotherapy. This article reviews the FA/BRCA pathway and current approaches to identify deficiencies within it, discusses synthetic lethality and enhanced repair capacity as causes of therapeutic hypersensitivity and resistance, respectively, and highlights recent studies that have linked FA/BRCA pathway function with therapeutic efficacy.
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Affiliation(s)
- Shane R Stecklein
- Department of Pathology and Laboratory Medicine and The University of Kansas Cancer Center, University of Kansas Medical Center, Kansas City, KS, USA
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21
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Kwong A, Wong CHN, Suen DTK, Co M, Kurian AW, West DW, Ford JM. Accuracy of BRCA1/2 mutation prediction models for different ethnicities and genders: experience in a southern Chinese cohort. World J Surg 2012; 36:702-13. [PMID: 22290208 PMCID: PMC3299960 DOI: 10.1007/s00268-011-1406-y] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
Background BRCA1/2 mutation prediction models (BRCAPRO, Myriad II, Couch, Shattuck-Eidens, BOADICEA) are well established in western cohorts to estimate the probability of BRCA1/2 mutations. Results are conflicting in Asian populations. Most studies did not account for gender-specific prediction. We evaluated the performance of these models in a Chinese cohort, including males, before BRCA1/2 mutation testing. Methods The five risk models were used to calculate the probability of BRCA mutations in probands with breast and ovarian cancers; 267 were non-BRCA mutation carriers (247 females and 20 males) and 43 were BRCA mutation carriers (38 females and 5 males). Results Mean BRCA prediction scores for all models were statistically better for carriers than noncarriers for females but not for males. BRCAPRO overestimated the numbers of female BRCA1/2 mutation carriers at thresholds ≥20% but underestimated if <20%. BRCAPRO and BOADICEA underestimated the number of male BRCA1/2 mutation carriers whilst Myriad II underestimated the number of both male and female carriers. In females, BRCAPRO showed similar discrimination, as measured by the area under the receiver operator characteristic curve (AUC) for BRCA1/2 combined mutation prediction to BOADICEA, but performed better than BOADICEA in BRCA1 mutation prediction (AUC 93% vs. 87%). BOADICEA had the best discrimination for BRCA1/2 combined mutation prediction (AUC 87%) in males. Conclusions The variation in model performance underscores the need for research on larger Asian cohorts as prediction models, and the possible need for customizing these models for different ethnic groups and genders.
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Affiliation(s)
- Ava Kwong
- Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, China.
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22
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Finkelman BS, Rubinstein WS, Friedman S, Friebel TM, Dubitsky S, Schonberger NS, Shoretz R, Singer CF, Blum JL, Tung N, Olopade OI, Weitzel JN, Lynch HT, Snyder C, Garber JE, Schildkraut J, Daly MB, Isaacs C, Pichert G, Neuhausen SL, Couch FJ, van't Veer L, Eeles R, Bancroft E, Evans DG, Ganz PA, Tomlinson GE, Narod SA, Matloff E, Domchek S, Rebbeck TR. Breast and ovarian cancer risk and risk reduction in Jewish BRCA1/2 mutation carriers. J Clin Oncol 2012; 30:1321-8. [PMID: 22430266 PMCID: PMC3341145 DOI: 10.1200/jco.2011.37.8133] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2011] [Accepted: 12/15/2011] [Indexed: 12/31/2022] Open
Abstract
PURPOSE Mutations in BRCA1/2 dramatically increase the risk of both breast and ovarian cancers. Three mutations in these genes (185delAG, 5382insC, and 6174delT) occur at high frequency in Ashkenazi Jews. We evaluated how these common Jewish mutations (CJMs) affect cancer risks and risk reduction. METHODS Our cohort comprised 4,649 women with disease-associated BRCA1/2 mutations from 22 centers in the Prevention and Observation of Surgical End Points Consortium. Of these women, 969 were self-identified Jewish women. Cox proportional hazards models were used to estimate breast and ovarian cancer risks, as well as risk reduction from risk-reducing salpingo-oophorectomy (RRSO), by CJM and self-identified Jewish status. RESULTS Ninety-one percent of Jewish BRCA1/2-positive women carried a CJM. Jewish women were significantly more likely to undergo RRSO than non-Jewish women (54% v 41%, respectively; odds ratio, 1.87; 95% CI, 1.44 to 2.42). Relative risks of cancer varied by CJM, with the relative risk of breast cancer being significantly lower in 6174delT mutation carriers than in non-CJM BRCA2 carriers (hazard ratio, 0.35; 95% CI, 0.18 to 0.69). No significant difference was seen in cancer risk reduction after RRSO among subgroups. CONCLUSION Consistent with previous results, risks for breast and ovarian cancer varied by CJM in BRCA1/2 carriers. In particular, 6174delT carriers had a lower risk of breast cancer. This finding requires additional confirmation in larger prospective and population-based cohort studies before being integrated into clinical care.
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Affiliation(s)
| | | | - Sue Friedman
- Author affiliations appear at the end of this article
| | | | | | | | | | | | | | - Nadine Tung
- Author affiliations appear at the end of this article
| | | | | | | | - Carrie Snyder
- Author affiliations appear at the end of this article
| | | | | | - Mary B. Daly
- Author affiliations appear at the end of this article
| | | | | | | | | | | | | | | | | | | | | | | | - Ellen Matloff
- Author affiliations appear at the end of this article
| | - Susan Domchek
- Author affiliations appear at the end of this article
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23
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A founder mutation in the Ashkenazi Jewish population affecting messenger RNA splicing of the CCM2 gene causes cerebral cavernous malformations. Genet Med 2011; 13:662-6. [PMID: 21543988 DOI: 10.1097/gim.0b013e318211ff8b] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
PURPOSE Cerebral cavernous malformations can occur sporadically or are caused by mutations in one of three identified genes. Cerebral cavernous malformations often remain clinically silent until a mutation carrier suffers a stroke or seizure. Presymptomatic genetic testing has been valuable to follow and manage cerebral cavernous malformation mutation carriers. During routine diagnostic testing, we identified a two base pair change in seven unrelated people of Ashkenazi Jewish heritage. Because of the location of the variant beyond the invariant splice donor sequence, the change was reported as a variant of unknown significance. In this study, we determined whether this change was a disease-causing mutation and whether it represents a founder mutation in the Ashkenazi Jewish population. METHODS Transcripts arising from the normal and mutant alleles were examined by reverse transcription-polymerase chain reaction from affected and unaffected Ashkenazi Jewish cerebral cavernous malformation family members. A synthetic splicing system using a chimeric exon was used to visualize the effects of the change on splice donor site utilization. RESULTS The two base pair change in CCM2, c.30 + 5_6delinsTT, segregated with affected status in the study families. Reverse transcription-polymerase chain reaction revealed loss of the transcript allele that was in phase with the mutation. The two base pair change, when tested in an in vitro synthetic splicing system, altered splice donor site utilization. Resequencing of the genomic region proximal and distal to the CCM2 gene mutation revealed a common single-nucleotide polymorphism haplotype in affected individuals. CONCLUSIONS The two base pair change in CCM2, c.30 + 5_6delinsTT, disrupted proper splice donor utilization leading to a degraded transcript. Single nucleotide polymorphism haplotype analysis demonstrated that this mutation was due to a founder in the Ashkenazi Jewish population. These data have the potential to simplify genetic testing for cerebral cavernous malformation in the Ashkenazi Jewish population.
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Greenwood CMT, Sun S, Veenstra J, Hamel N, Niell B, Gruber S, Foulkes WD. How old is this mutation? - a study of three Ashkenazi Jewish founder mutations. BMC Genet 2010; 11:39. [PMID: 20470408 PMCID: PMC2889843 DOI: 10.1186/1471-2156-11-39] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 05/14/2010] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several founder mutations leading to increased risk of cancer among Ashkenazi Jewish individuals have been identified, and some estimates of the age of the mutations have been published. A variety of different methods have been used previously to estimate the age of the mutations. Here three datasets containing genotype information near known founder mutations are reanalyzed in order to compare three approaches for estimating the age of a mutation. The methods are: (a) the single marker method used by Risch et al., (1995); (b) the intra-allelic coalescent model known as DMLE, and (c) the Goldgar method proposed in Neuhausen et al. (1996), and modified slightly by our group. The three mutations analyzed were MSH2*1906 G->C, APC*I1307K, and BRCA2*6174delT. RESULTS All methods depend on accurate estimates of inter-marker recombination rates. The modified Goldgar method allows for marker mutation as well as recombination, but requires prior estimates of the possible haplotypes carrying the mutation for each individual. It does not incorporate population growth rates. The DMLE method simultaneously estimates the haplotypes with the mutation age, and builds in the population growth rate. The single marker estimates, however, are more sensitive to the recombination rates and are unstable. Mutation age estimates based on DMLE are 16.8 generations for MSH2 (95% credible interval (13, 23)), 106 generations for I1037K (86-129), and 90 generations for 6174delT (71-114). CONCLUSIONS For recent founder mutations where marker mutations are unlikely to have occurred, both DMLE and the Goldgar method can give good results. Caution is necessary for older mutations, especially if the effective population size may have remained small for a long period of time.
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Affiliation(s)
- Celia M T Greenwood
- Genetics and Genome Biology, Hospital for Sick Children Research Institute, Toronto, Ontario, Canada
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25
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Polton GA, Mowat V, Lee HC, McKee KA, Scase TJ. Breed, gender and neutering status of British dogs with anal sac gland carcinoma. Vet Comp Oncol 2009; 4:125-31. [PMID: 19754809 DOI: 10.1111/j.1476-5829.2006.00100.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
This study details the breed, gender and neutering status of a large cohort of British canine patients suffering from histologically confirmed anal sac gland carcinoma. Estimates of the relative risk for the development of this disease attributable to these factors are calculated. To reduce the impact of sampling errors, cases were selected from veterinary histopathology laboratories rather than referral hospital databases, and multiple estimates of the general British canine population were used. The weaknesses of the statistical assumptions made are discussed. There was no evidence to support a gender predisposition for the development of this condition. English cocker spaniels are significantly over-represented, with a mean relative risk estimate of 7.3. The mean relative risk estimate associated with being neutered was 1.4; the effect of neutering appeared to be more significant in male dogs compared with that in female dogs.
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Affiliation(s)
- G A Polton
- Davies Veterinary Specialists, Higham Gobion, Herts, UK.
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26
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PERRY CS, OTERO JC, PALMER JL, GROSS AS. Risk factors for breast cancer in East Asian women relative to women in the West. Asia Pac J Clin Oncol 2009. [DOI: 10.1111/j.1743-7563.2009.01242.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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27
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MacDonald DJ, Sarna L, Weitzel JN, Ferrell B. Women's perceptions of the personal and family impact of genetic cancer risk assessment: focus group findings. J Genet Couns 2009; 19:148-60. [PMID: 19902342 DOI: 10.1007/s10897-009-9267-3] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2009] [Accepted: 10/07/2009] [Indexed: 01/07/2023]
Abstract
Women with a personal or family history of breast or ovarian cancer are increasingly presenting for genetic cancer risk assessment (GCRA). To explore the personal and family impact of GCRA, four focus groups were conducted of women seen for risk assessment. Participants were 22 primarily non-Latina White women with a personal or family history of breast or ovarian cancer. Analysis of the data identified new themes related to balancing time to assimilate risk information with the need to make timely healthcare decisions, physicians' lack of sufficient genetic knowledge, and concern for daughters regardless of the daughters' age. Other themes related to protecting others, knowledge as empowerment, reassessing personal attribution of cancer risk, managing uncertainty, reappraising body image, and experiencing divergent family responses to communication of cancer risk and healthcare decisions. Understanding the personal and family impact of GCRA may enable genetics professionals to tailor their counseling efforts to better meet the needs of these women. Additional research is needed to extend these findings and identify interventions to support positive outcomes of GCRA.
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Affiliation(s)
- Deborah J MacDonald
- Division of Clinical Cancer Genetics, City of Hope Comprehensive Cancer Center, 1500 E. Duarte Rd., Duarte, CA 91010-3000, USA.
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28
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Geffen DB, Amir N, Sion-Vardy N, Ariad S, Kachko L, Bayme M, Delgado B, Dyomin V, Argov S, Koretz M. Stage I breast cancer in a regional oncology practice in Israel 2002-2006: clinicopathologic features, risk estimation and planned therapy of 328 consecutive patients. Breast 2009; 18:316-21. [PMID: 19819143 DOI: 10.1016/j.breast.2009.08.004] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2009] [Revised: 07/30/2009] [Accepted: 08/31/2009] [Indexed: 12/19/2022] Open
Abstract
We present the clinicopathologic features and treatment plans of 328 consecutive stage I (T1N0M0) breast cancer patients seen at a regional medical center in Israel. Predicted 10-year mortality risk was calculated using the Adjuvant! Online website. The 21-gene recurrence score (RS) (OncotypeDx) was obtained on a minority of patients. Eighty-nine per cent of patients had estrogen receptor (ER) and/or progesterone receptor (PgR) positive tumors. In 43.3% of patients history of an invasive malignancy was reported in a first degree relative and in 15.5% specifically breast and/or ovarian cancer was reported. Chemotherapy was added to endocrine therapy in 59 ER/PgR positive patients, decreasing predicted 10-year mortality risk by a median of 1.8%. Individualized risk estimation by genetic analysis may further decrease the use of chemotherapy in stage I patients. Breast cancer screening may provide an opportunity to identify cancer prone families.
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Affiliation(s)
- D B Geffen
- Department of Oncology, Soroka University Medical Center, Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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Rubinstein WS, Jiang H, Dellefave L, Rademaker AW. Cost-effectiveness of population-based BRCA1/2 testing and ovarian cancer prevention for Ashkenazi Jews: A call for dialogue. Genet Med 2009; 11:629-39. [DOI: 10.1097/gim.0b013e3181afd322] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023] Open
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Ott JJ, Paltiel AM, Becher H. Noncommunicable disease mortality and life expectancy in immigrants to Israel from the former Soviet Union: country of origin compared with host country. Bull World Health Organ 2009; 87:20-9. [PMID: 19197401 DOI: 10.2471/blt.07.045138] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2007] [Accepted: 03/27/2008] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To assess the influence of country of origin effects and of adjustment and selection processes by comparing noncommunicable disease mortality and life expectancy among migrants to Israel from the former Soviet Union (FSU) with noncommunicable disease mortality and life expectancy among Israelis and the population of the Russian Federation. METHODS Data from 926,870 FSU-immigrants who migrated to Israel between 1990 and 2003 (study cohort) were analysed. Life expectancy was calculated for the study cohort, all Israelis, and the population of the Russian Federation. Age-standardized death rates were calculated for grouped causes of death. FSU immigrants were additionally compared with other Israelis and with inhabitants of the Russian Federation using cause-specific standardized mortality ratios (SMRs). FINDINGS Life expectancy at age 15 years in 2000-2003 was 61.0 years for male and 67.0 years for female FSU immigrants to Israel. Age-standardized death rates for FSU immigrants in Israel were similar to those of other Israelis and much lower than those of inhabitants of the Russian Federation. Relative to Israelis, the study cohort had a higher SMR for neoplasms, and particularly for stomach cancer. Mortality from brain cancer was higher when immigrants were compared to the Russian Federation (SMR: 1.71, 95% confidence interval, CI: 1.50-1.94 for males; SMR: 1.77, 95% CI: 1.56-2.02 for females), whereas mortality from stomach cancer was lower among immigrants relative to the Russian Federation (SMR: 0.43, 95% CI: 0.40-0.47 for males; SMR: 0.56, 95% CI: 0.52-0.61 for females). Mortality from external causes was lower among immigrants relative to the population of the Russian Federation (SMR: 0.20, 95% CI: 0.19-0.21 for males; SMR: 0.35, 95% CI: 0.33-0.37 for females) but significantly higher relative to other Israelis (SMR: 1.41, 95% CI: 1.35-1.47 for males; SMR: 1.08, 95% CI: 1.02-1.15). CONCLUSION Noncommunicable disease mortality among FSU immigrants to Israel is lower than in the population of the Russian Federation. Mortality rates in FSU immigrants, particularly from circulatory diseases, have rapidly adjusted and have become similar to those of the destination country. However, immigrants from the FSU have considerably higher mortality than other Israelis from external causes and some noncommunicable diseases such as cancer. Mortality rates in these diaspora migrants show a mixed picture of rapid assimilation together with persistent country of origin effects, as well as the effects of adjustment hardships.
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Unusually small sex differentials in mortality of Israeli Jews: What does the structure of causes of death tell us? DEMOGRAPHIC RESEARCH 2009. [DOI: 10.4054/demres.2009.20.11] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
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Cumulative survival in early-onset unilateral and bilateral breast cancer: an analysis of 1907 Taiwanese women. Br J Cancer 2009; 100:563-70. [PMID: 19190627 PMCID: PMC2653740 DOI: 10.1038/sj.bjc.6604898] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022] Open
Abstract
As the epidemiological pattern of breast cancer in modernising Asian countries differs greatly from that in Western countries, it is worthwhile to investigate the long-term prognoses of unilateral and bilateral breast cancer in these nations. A retrospective cohort study composed of 1907 Taiwanese women was conducted to follow 1863 unilateral and 44 bilateral cases of breast cancer. Time-dependent Cox regression was used to assess the risk of breast cancer death by considering the time course of unilateral and bilateral tumour development. The 15-year survival rates were 68.37, 62.63, and 26.42% for unilateral, synchronous bilateral, and metachronous bilateral breast cancer, respectively. Differences among types were most apparent after 5 years of follow-up. After adjusting for significant prognostic factors, the risk of death for overall bilateral breast cancer was 2.50-fold greater (95% CI, 1.43-4.37) compared to unilateral breast cancer. The corresponding figures were 1.12-fold (95% CI, 0.42-3.02) and 6.11-fold (95% CI, 3.14-11.89) for synchronous and metachronous bilateral breast cancer, respectively. Taiwanese women, who are frequently diagnosed with breast cancer before 50 years of age, showed poorer survival for metachronous bilateral than for synchronous bilateral or unilateral breast cancer. Survival was markedly poorer compared to recent data from Sweden.
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Abstract
Breast cancer risk factors have been studied for the past three decades, and the single most important risk factor is age. Hormonally linked adult reproductive and anthropometric risk factors contribute to the etiology of postmenopausal breast cancer. The risk of breast cancer increases among women older than 50 years of age who have benign breast disease, especially those with atypical ductal or lobular hyperplasia. Lobular carcinoma in situ increases risk significantly, as do a family history of breast cancer in first-degree relatives and the presence of BRCA1 or BRCA2 mutations. Diet, exercise, and environmental factors play a very small role in overall risk. Mammographic breast density increases relative risk fivefold among women with the highest density, and breast cancer risk is two to three times greater in women with elevated serum levels of estradiol or testosterone. Multivariate risk models allow determination of composite relative risks and cumulative lifetime risk, although improved models for African American women are required. For postmenopausal women, newer risk models are being developed and validated that include age, breast density, race, ethnicity, family history of breast cancer, a previous breast biopsy, body mass index, age at onset of natural menopause, hormone therapy, and previous false-positive mammography. A simpler model that includes only age, breast cancer in first-degree relatives, and previous breast biopsy performs well for estrogen receptor-positive breast cancer in postmenopausal women. As many as 10 million women in the United States are at increased risk, and clinicians are obligated to identify these women and manage their risk appropriately.
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Abstract
The clinical benefits associated with the use of ionizing radiation for diagnostic and therapeutic purposes are well established, particularly in cancer medicine. Unfortunately, it is now clear that prior exposure to radiation is associated with an excess risk of developing malignancy in the exposure field. Indeed, the development of a second primary malignancy is a devastating side effect that can often be attributed to radiotherapy for a first cancer. Research has focused on elucidating the relationship between therapeutic radiation dose and site-specific cancer risk, and how this relationship is affected by host factors such as age, sex, and exposure to other potential carcinogens. By contrast, there is a relative paucity of data on host genetic susceptibility to cancer following cytotoxic and mutagenic radiation exposure. Animal model systems suggest a strong genetic basis underlying susceptibility to radiogenic cancer. In humans, research has focused on investigating loci with relatively rare putative high penetrance risk alleles. However, genetic susceptibility to radiogenic cancer and other late effects of radiation exposure may be determined predominantly by co-inheritance of low penetrance risk alleles, and how these interact with each other (gene-gene interactions), with radiation dose (gene-exposure interactions) and other risk factors.
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Affiliation(s)
- James M Allan
- Northern Institute for Cancer Research, Newcastle University, Newcastle upon Tyne, United Kingdom.
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Russo A, Calò V, Bruno L, Rizzo S, Bazan V, Di Fede G. Hereditary ovarian cancer. Crit Rev Oncol Hematol 2008; 69:28-44. [PMID: 18656380 DOI: 10.1016/j.critrevonc.2008.06.003] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2008] [Revised: 05/31/2008] [Accepted: 06/11/2008] [Indexed: 01/12/2023] Open
Abstract
At least 10% of ovarian tumors are hereditary and associated with highly penetrant, autosomal, dominant genetic predisposition. Three clinical manifestations of hereditary ovarian cancer have been identified: site-specific ovarian cancer, hereditary breast and/or ovarian cancer (HBOC) and hereditary non-polyposis colorectal cancer (HNPCC) syndromes. BRCA germline mutations account for more than 90% of all hereditary epithelial ovarian tumors whereas most of the remaining 10% are caused by MLH1 and MSH2 mutations, which are susceptibility genes of HNPCC. Genetic testing is available for each of the three hereditary syndromes above mentioned. The recommendations for OC surveillance in high-risk women having a strong family history or BRCA mutation carriers include transvaginal pelvic ultrasound with color Doppler and serum CA125 every 6 months. Bilateral salpingo-oophorectomy appears to be effective to reduce the risk of ovarian cancer in BRCA mutation carriers. Hysterosalpingo-oophorectomy should be considered in HNPCC women who undergo surgery for colorectal carcinoma.
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Affiliation(s)
- Antonio Russo
- Department of Surgery and Oncology, Regional Reference Center for the Biomolecular Characterization and Genetic Screening of Hereditary Tumors, Università di Palermo, Palermo, Italy.
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Making sense of cancer risk calculators on the web. J Gen Intern Med 2008; 23:229-35. [PMID: 18188653 PMCID: PMC2359468 DOI: 10.1007/s11606-007-0484-x] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2006] [Revised: 06/08/2007] [Accepted: 10/29/2007] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Cancer risk calculators on the internet have the potential to provide users with valuable information about their individual cancer risk. However, the lack of oversight of these sites raises concerns about low quality and inconsistent information. These concerns led us to evaluate internet cancer risk calculators. DESIGN After a systematic search to find all cancer risk calculators on the internet, we reviewed the content of each site for information that users should seek to evaluate the quality of a website. We then examined the consistency of the breast cancer risk calculators by having 27 women complete 10 of the breast cancer risk calculators for themselves. We also completed the breast cancer risk calculators for a hypothetical high- and low-risk woman, and compared the output to Surveillance Epidemiology and End Results estimates for the average same-age and same-race woman. RESULTS Nineteen sites were found, 13 of which calculate breast cancer risk. Most sites do not provide the information users need to evaluate the legitimacy of a website. The breast cancer calculator sites vary in the risk factors they assess to calculate breast cancer risk, how they operationalize each risk factor and in the risk estimate they provide for the same individual. CONCLUSIONS Internet cancer risk calculators have the potential to provide a public health benefit by educating individuals about their risks and potentially encouraging preventive health behaviors. However, our evaluation of internet calculators revealed several problems that call into question the accuracy of the information that they provide. This may lead the users of these sites to make inappropriate medical decisions on the basis of misinformation.
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Berstein LM. Endocrinology of the wild and mutant BRCA1 gene and types of hormonal carcinogenesis. Future Oncol 2008; 4:23-39. [PMID: 18240998 DOI: 10.2217/14796694.4.1.23] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
Information related to the BRCA1 gene has increasingly become a subject for analysis by endocrinologists. For example, it is hard to dismiss the fact that, in BRCA1 mutation carriers, tumors develop predominantly in such estrogen-dependent organs as the mammary glands and ovaries but not in the endometrium. Another characteristic feature is that although BRCA1 mutants and knock-downs are unable to inhibit the transcriptional activity of estrogen receptor-alpha, in BRCA1 mutation carriers breast cancers are often estrogen receptor-negative and originate from the basal rather than the luminal epithelium. The latter, together with other data, suggests that BRCA1-positive breast neoplasms could be considered to be a consequence of the genotoxic variant of hormonal carcinogenesis (that is, associated with DNA damaging rather then with pure hormonal/physiological properties of hormones or their derivatives). Of indisputable significance are the data demonstrating that knocking down of the BRCA1 gene is accompanied by aromatase overexpression and the abolishment of IGF-1 receptor expression suppression, thus increasing both steroid and insulin signaling. Importantly, the endocrine-genotoxic 'liberation' found upon transfer from the wild-type to the mutant BRCA1 provides grounds to regard BRCA1 as a modulator of endocrine-genotoxic switching (predominantly into a direction of DNA-damaging hormone effects) and also to ask whether this is a property of only this or some other tumor suppressor's.
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Affiliation(s)
- Lev M Berstein
- N.N.Petrov Research Institute of Oncology, Pesochny-2, Leningradskaja 68, St Petersburg 197758, Russia.
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Prucka SK, McIlvried DE, Korf BR. Cancer risk assessment and the genetic counseling process: using hereditary breast and ovarian cancer as an example. Med Princ Pract 2008; 17:173-89. [PMID: 18408385 DOI: 10.1159/000117790] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2007] [Accepted: 12/25/2007] [Indexed: 01/07/2023] Open
Abstract
While only a small proportion of cancers can be attributed to a hereditary susceptibility, identifying high-risk individuals plays an essential role in medical management and has a significant impact on the patient as well as their immediate and extended family members. This paper aims at increasing the medical professionals' knowledge of the components of a genetic counseling session, with particular attention toward identifying at-risk individuals and understanding the complexities of the testing process. In addition, tools are provided to assist in identifying these individuals in clinical practice and streamlining the referral process to a cancer genetics center.
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Affiliation(s)
- Sandra K Prucka
- Department of Genetics, University of Alabama at Birmingham, Birmingham, Ala., USA
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Ferla R, Calò V, Cascio S, Rinaldi G, Badalamenti G, Carreca I, Surmacz E, Colucci G, Bazan V, Russo A. Founder mutations in BRCA1 and BRCA2 genes. Ann Oncol 2007; 18 Suppl 6:vi93-8. [PMID: 17591843 DOI: 10.1093/annonc/mdm234] [Citation(s) in RCA: 169] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
BRCA1 and BRCA2 germline mutations contribute to a significant number of familial and hereditary breast and/or ovarian cancers. The proportion of high-risk families with breast and/or ovarian cancer cases due to mutations in these tumor suppressor genes varies widely among populations. In some population, a wide spectrum of different mutations in both genes are present, whereas in other groups specific mutations in BRCA1 and BRCA2 have been reported with high frequency. Most of these mutations are prevalent in restricted populations as consequence of a founder effect. The comparison of haplotypes between families with the same mutation can distinguish whether high-frequency alleles derive from an older or more recent single mutational event or whether they have arisen independently more than once. Here, we review some of the most well-known and significant examples of founder mutations in BRCA genes found in European and non-European populations. In conclusion, the identification of the ethnic group of families undergoing genetic counseling enables the geneticist and oncologist to make more specific choices, leading to simplify the clinical approach to genetic testing carried out on members of high-risk families. Futhermore, the high frequency of founder mutations, allowing to analyze a large number of cases, might provide accurate information regarding their penetrance.
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Affiliation(s)
- R Ferla
- Department of Surgery and Oncology, Regional Reference Center for the Biomolecular Characterization and Genetic Screening of Hereditary Tumors, Università di Palermo, Palermo
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Triple negative breast carcinoma and the basal phenotype: from expression profiling to clinical practice. Adv Anat Pathol 2007; 14:419-30. [PMID: 18049131 DOI: 10.1097/pap.0b013e3181594733] [Citation(s) in RCA: 91] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Triple negative breast carcinomas (TNBCs) are a group of primary breast tumors with aggressive clinical behavior. Most TNBCs possess a basal phenotype (BP) and show varying degrees of basal cytokeratin and myoepithelial marker expression. The importance of recognizing these tumors came to light largely as the result of gene expression profiling studies that categorized breast cancer into 3 major groups. Two of these groups are defined by their respective expression of estrogen receptor and HER2. TNBCs represent a third group and are defined by negativity for hormone receptors and HER2. TNBCs currently lack effective targeted therapies and are frequently resistant to standard chemotherapeutic regimens. These tumors tend to occur in premenopausal women and members of specific ethnic groups and a subset are associated with heritable BRCA1 mutations. For patients with sporadic TNBCs and BP tumors, BRCA1 dysfunction seems to play a major role in the development and progression of disease. The pathologist's role in the diagnosis and characterization of TNBCs and BP tumors is currently being defined as we are acquiring knowledge of the biologic and genetic underpinnings that drive this heterogeneous group of diseases. This review will provide a historical prospective on TNBCs and tumors that express basal cytokeratins and myoepithelial makers. Additionally, we will discuss the molecular biologic, genetic and pathologic aspects of these tumors. Guidelines will be provided on how to best approach the diagnosis of these cases and on what input pathologists should provide clinicians to help develop optimal therapeutic and preventative strategies against this aggressive group of breast cancers.
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Israeli ‘cancer shift’ over heart disease mortality may be led by greater risk in women with high intake of n-6 fatty acids. Eur J Cancer Prev 2007; 16:486-94. [DOI: 10.1097/cej.0b013e3280145b6d] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Berliner JL, Fay AM. Risk assessment and genetic counseling for hereditary breast and ovarian cancer: recommendations of the National Society of Genetic Counselors. J Genet Couns 2007; 16:241-60. [PMID: 17508274 DOI: 10.1007/s10897-007-9090-7] [Citation(s) in RCA: 143] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2007] [Accepted: 01/25/2007] [Indexed: 12/14/2022]
Abstract
These cancer genetic counseling recommendations describe the medical, psychosocial and ethical implications of identifying at-risk individuals for hereditary breast and ovarian cancer (HBOC) through cancer risk assessment, with or without genetic susceptibility testing. They were developed by members of the Practice Issues Subcommittee of the National Society of Genetic Counselors' Familial Cancer Risk Counseling Special Interest Group. The information contained in this document is derived from extensive review of the current literature on cancer genetic risk assessment as well as the professional expertise of genetic counselors with significant experience in education and counseling regarding hereditary breast and ovarian cancer. Critical components of the process include the ascertainment of medical and family histories, determination and communication of cancer risk, assessment of risk perception, education regarding the genetics of HBOC, discussion of molecular testing for HBOC if appropriate (including benefits, risks and limitations) and any necessary follow-up. These recommendations do not dictate an exclusive course of management or guarantee a specific outcome. Moreover, they do not replace the professional judgment of a health care provider based on the clinical situation of a client.
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Affiliation(s)
- Janice L Berliner
- Saint Barnabas Medical Center, 94 Old Short Hills Rd, Livingston, NJ 07039, USA.
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Brandt-Rauf SI, Raveis VH, Drummond NF, Conte JA, Rothman SM. Ashkenazi Jews and breast cancer: the consequences of linking ethnic identity to genetic disease. Am J Public Health 2006; 96:1979-88. [PMID: 17018815 PMCID: PMC1751808 DOI: 10.2105/ajph.2005.083014] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
We explored the advantages and disadvantages of using ethnic categories in genetic research. With the discovery that certain breast cancer gene mutations appeared to be more prevalent in Ashkenazi Jews, breast cancer researchers moved their focus from high-risk families to ethnicity. The concept of Ashkenazi Jews as genetically unique, a legacy of Tay-Sachs disease research and a particular reading of history, shaped this new approach even as methodological imprecision and new genetic and historical research challenged it. Our findings cast doubt on the accuracy and desirability of linking ethnic groups to genetic disease. Such linkages exaggerate genetic differences among ethnic groups and lead to unequal access to testing and therapy.
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Affiliation(s)
- Sherry I Brandt-Rauf
- Center for the Study of Society and Medicine, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA
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Hoppe E, Frankel R. Optometrists as key providers in the prevention and early detection of malignancies. ACTA ACUST UNITED AC 2006; 77:397-404. [PMID: 16877205 DOI: 10.1016/j.optm.2006.03.016] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Accepted: 03/29/2006] [Indexed: 11/17/2022]
Abstract
Optometrists have become active in many aspects of primary health care. Opportunities exist for optometrists to join other health care providers in the fight against cancer. The purpose of this article is to review information about cancer epidemiology, describe cancer screening guidelines, and to provide examples of ways for optometrists to become involved in promoting goals for reducing cancer risk and increasing the early detection of cancer. In addition to diagnosing ocular cancers and metastases to the eye and orbital region, optometrists may provide cancer information as part of their case history, provide positive health messages to reduce cancer risk factors, and directly observe signs of skin cancer.
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Affiliation(s)
- Elizabeth Hoppe
- New England College of Optometry, Boston, Massachusetts 02115, USA.
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45
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Abstract
The impact of predictive genetic testing on cancer care can be measured by the increased demand for and utilization of genetic services as well as in the progress made in reducing cancer risks in known mutation carriers. Nonetheless, differential access to and utilization of genetic counseling and cancer predisposition testing among underserved racial and ethnic minorities compared with the white population has led to growing health care disparities in clinical cancer genetics that are only beginning to be addressed. Furthermore, deficiencies in the utility of genetic testing in underserved populations as a result of limited testing experience and in the effectiveness of risk-reducing interventions compound access and knowledge-base disparities. The recent literature on racial/ethnic health care disparities is briefly reviewed, and is followed by a discussion of the current limitations of risk assessment and genetic testing outside of white populations. The importance of expanded testing in underserved populations is emphasized.
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Affiliation(s)
- Michael J Hall
- Department of Medicine, Mailman School of Public Health, Columbia University, New York, NY, USA
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46
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Piscopo P, Manfredi A, Malvezzi-Campeggi L, Crestini A, Spadoni O, Cherchi R, Deiana E, Piras MR, Confaloni A. Genetic study of Sardinian patients with Alzheimer's disease. Neurosci Lett 2006; 398:124-8. [PMID: 16423463 DOI: 10.1016/j.neulet.2005.12.063] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/12/2005] [Revised: 12/02/2005] [Accepted: 12/23/2005] [Indexed: 10/25/2022]
Abstract
We describe the genetic analysis of an Alzheimer's disease (AD) sample derived from a genetically isolated population. Genetic assessment included the analysis of genes involved in AD, such as the genes for amyloid precursor protein (APP), presenilin 1 (PSEN1) and presenilin 2 (PSEN2). We also assessed genes for some proteins that constitute the gamma-secretase complex: nicastrin (NCSTN), presenilin enhancer-2 (PEN2), in addition to the AD risk factor apolipoprotein E (APOE). Using polymerase chain reaction and single strand conformational polymorphism method, screens for APP, PSEN1 and PSEN2 genes revealed one mutation in PSEN1. Furthermore, we found an intronic +17G>C polymorphism in PEN2 which, in homozygous form, was greater in early onset Alzheimer's disease (EOAD) compared to controls, and one haplotype in the NCSTN gene which was linked to EOAD and familial AD (FAD). Finally, the genotyping of APOE confirmed that the varepsilon4 allele could be a risk factor for the onset of AD, in particular for FAD subjects. In conclusion, these results show the existence of Sardinian genetic peculiarities, essential in studies regarding genetically inherited and multifactorial disorders, as AD.
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Affiliation(s)
- Paola Piscopo
- Department of Cell Biology and Neurosciences, Istituto Superiore di Sanità, 00161 Rome, Italy
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47
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Siegel CA. As if mothers don't have enough to worry about.. Inflamm Bowel Dis 2006; 12:146-7. [PMID: 16432379 DOI: 10.1097/01.mib.0000201819.41877.20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022]
Affiliation(s)
- Corey A Siegel
- Dartmouth-Hitchcock Medical Center, Lebanon, New Hampshire, USA
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