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Tran TXM, Chang Y, Choi HR, Kwon R, Lim GY, Kim EY, Ryu S, Park B. Adiposity, Body Composition Measures, and Breast Cancer Risk in Korean Premenopausal Women. JAMA Netw Open 2024; 7:e245423. [PMID: 38578637 PMCID: PMC10998159 DOI: 10.1001/jamanetworkopen.2024.5423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 02/09/2024] [Indexed: 04/06/2024] Open
Abstract
Objective To investigate the association between body composition parameters and breast cancer (BC) risk in premenopausal women. Design, Setting, and Participants Prospective cohort study using data from the Kangbuk Samsung Cohort Study. Participants were women aged 20 to 54 years who were enrolled from 2011 to 2019 and followed up for BC development until December 31, 2020. Data were analyzed from June to August 2023. Exposures Trained nurses conducted anthropometric measurements and assessed body composition using segmental bioelectric impedance analysis. The analysis encompassed adiposity measures such as body mass index (BMI), waist circumference, and body composition parameters, including muscle mass, fat mass, ratio of muscle mass to weight, ratio of fat mass to weight, and fat mass index. Main outcomes and measures Adjusted hazard ratios (aHR) for BC during the follow-up period. Results Among 125 188 premenopausal women, the mean (SD) age was 34.9 (6.3) years. During a mean (range) follow-up of 6.7 (0.5-9.9) years, 1110 incident BC cases were identified. The mean (SD) BMI and waist circumference were 21.6 (3.1) and 75.3 (8.2) cm, respectively. Higher BMI and waist circumference were associated with decreased risk, with an aHR of 0.89 (95% CI, 0.84-0.95) per SD increase in BMI and 0.92 (95% CI, 0.86-0.98) per SD increase in waist circumference. A higher ratio of fat mass to weight was associated with decreased BC risk (aHR, 0.92; 95% CI, 0.86-0.99 per SD increase), whereas the opposite trend was observed for the ratio of muscle mass to weight, with an aHR of 1.08 (95% CI, 1.02-1.15) per SD increase. The results remained consistent even after additional adjustments for height in the model. The fat mass index was also inversely associated with BC risk, with an HR of 0.90 (95% CI, 0.85-0.97) per SD increase. Conclusions and Relevance In this cohort study of premenopausal women, a higher level of adiposity, represented by increased BMI, waist circumference, and fat mass, was consistently associated with decreased breast cancer risk. Conversely, muscle mass and its ratio to weight displayed opposite or inconsistent patterns. These findings suggest an inverse association between excess adiposity and the risk of BC in premenopausal women, confirming earlier findings that BMI is an indirect measure of adiposity.
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Affiliation(s)
- Thi Xuan Mai Tran
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
| | - Yoosoo Chang
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Hye Rin Choi
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Ria Kwon
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Ga-Young Lim
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Institute of Medical Research, Sungkyunkwan University, School of Medicine, Suwon, Republic of Korea
| | - Eun Young Kim
- Department of Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
| | - Seungho Ryu
- Center for Cohort Studies, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Occupational and Environmental Medicine, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea
- Department of Clinical Research Design and Evaluation, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Seoul, Republic of Korea
| | - Boyoung Park
- Department of Preventive Medicine, Hanyang University College of Medicine, Seoul, Republic of Korea
- Hanyang Institute of Bioscience and Biotechnology, Hanyang University, Seoul, Republic of Korea
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Mani C, Acharya G, Saamarthy K, Ochola D, Mereddy S, Pruitt K, Manne U, Palle K. Racial differences in RAD51 expression are regulated by miRNA-214-5P and its inhibition synergizes with olaparib in triple-negative breast cancer. Breast Cancer Res 2023; 25:44. [PMID: 37081516 PMCID: PMC10120249 DOI: 10.1186/s13058-023-01615-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/19/2022] [Accepted: 02/03/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Triple-negative breast cancer (TNBC) affects young women and is the most aggressive subtype of breast cancer (BC). TNBCs disproportionally affect women of African-American (AA) descent compared to other ethnicities. We have identified DNA repair gene RAD51 as a poor prognosis marker in TNBC and its posttranscriptional regulation through microRNAs (miRNAs). This study aims to delineate the mechanisms leading to RAD51 upregulation and develop novel therapeutic combinations to effectively treat TNBCs and reduce disparity in clinical outcomes. METHODS Analysis of TCGA data for BC cohorts using the UALCAN portal and PrognoScan identified the overexpression of RAD51 in TNBCs. miRNA sequencing identified significant downregulation of RAD51-targeting miRNAs miR-214-5P and miR-142-3P. RT-PCR assays were used to validate the levels of miRNAs and RAD51, and immunohistochemical and immunoblotting techniques were used similarly for RAD51 protein levels in TNBC tissues and cell lines. Luciferase assays were performed under the control of RAD51 3'-UTR to confirm that miR-214-5P regulates RAD51 expression. To examine the effect of miR-214-5P-mediated downregulation of RAD51 on homologous recombination (HR) in TNBC cells, Dr-GFP reporter assays were performed. To assess the levels of olaparib-induced DNA damage responses in miR-214-5P, transfected cells, immunoblots, and immunofluorescence assays were used. Furthermore, COMET assays were used to measure DNA lesions and colony assays were performed to assess the sensitivity of BRCA-proficient TNBC cells to olaparib. RESULTS In-silico analysis identified upregulation of RAD51 as a poor prognostic marker in TNBCs. miRNA-seq data showed significant downregulation of miR-214-5P and miR-142-3P in TNBC cell lines derived from AA women compared to Caucasian-American (CA) women. miR-214-5P mimics downregulated RAD51 expression and induces HR deficiency as measured by Dr-GFP assays in these cell lines. Based on these results, we designed a combination treatment of miR-214-5P and olaparib in HR-proficient AA TNBC cell lines using clonogenic survival assays. The combination of miR-214-5P and olaparib showed synergistic lethality compared to individual treatments in these cell lines. CONCLUSIONS Our studies identified a novel epigenetic regulation of RAD51 in TNBCs by miR-214-5P suggesting a novel combination therapies involving miR-214-5P and olaparib to treat HR-proficient TNBCs and to reduce racial disparity in therapeutic outcomes.
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Affiliation(s)
- Chinnadurai Mani
- Department of Cell Biology and Biochemistry, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Ganesh Acharya
- Department of Cell Biology and Biochemistry, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Karunakar Saamarthy
- Department of Cell Biology and Biochemistry, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Damieanus Ochola
- Department of Cell Biology and Biochemistry, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Srinidhi Mereddy
- Department of Cellular and Molecular Biology, University of Washington, 1400 NE Campus Parkway, Seattle, WA, 98195, USA
| | - Kevin Pruitt
- Department of Immunology and Infectious Diseases, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA
| | - Upender Manne
- Department of Pathology, University of Alabama at Birmingham, Birmingham, AL, 35294, USA
| | - Komaraiah Palle
- Department of Cell Biology and Biochemistry, Department of Surgery, Texas Tech University Health Sciences Center, 3601 4th Street, Lubbock, TX, 79430, USA.
- Department of Surgery, Texas Tech University Health Sciences Center, Lubbock, TX, 79430, USA.
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Barańska A. Oral Contraceptive Use and Assessment of Breast Cancer Risk among Premenopausal Women via Molecular Characteristics: Systematic Review with Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:15363. [PMID: 36430082 PMCID: PMC9691184 DOI: 10.3390/ijerph192215363] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 09/27/2022] [Revised: 11/06/2022] [Accepted: 11/19/2022] [Indexed: 06/16/2023]
Abstract
Breast cancer is divided into four molecular subtypes. Each one has distinct clinical features. The aim of this study was to assess individual breast cancer subtype risk in premenopausal women taking oral contraceptives (OCs). Databases (MEDLINE; PubMed, EMBASE, and the Cochrane Library) were searched to January 2022 to identify case-control studies meeting the inclusion criteria. The influence of OCs intake on the risk of ER-positive breast cancer (ER+BC) was revealed to be non-significant with regard to reduction: OR = 0.9134, 95% CI: 0.8128 to 1.0265, p = 0.128. Assessment of ER-negative subtype breast cancer (ER-BC) risk indicated that OCs use significantly increased the risk: OR = 1.3079, 95% CI: 1.0003 to 1.7100, p = 0.050. Analysis for HER2-positive breast cancer (HER2+BC) risk showed that OCs use statistically non-significantly lowered the risk: OR = 0.8810, 95% CI: 0.5977 to 1.2984, p = 0.522. Meta-analysis with regard to Triplet-negative breast cancer (TNBC) risk showed non-statistically significant increased risk: OR = 1.553, 95% CI: 0.99 to 2.43, p = 0.055. The findings of the meta-analysis suggest that breast cancer risk in premenopausal women may vary with respect to molecular subtypes. Extensive scientific work is still necessary in order to understand the impact of OCs use on breast cancer risk in young women.
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Affiliation(s)
- Agnieszka Barańska
- Department of Medical Informatics and Statistics with e-Health Lab, Medical University of Lublin, 20-094 Lublin, Poland
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Zhang Z, Bassale S, Jindal S, Fraser A, Guinto E, Anderson W, Mori M, Smith KR, Schedin P. Young-Onset Breast Cancer Outcomes by Time Since Recent Childbirth in Utah. JAMA Netw Open 2022; 5:e2236763. [PMID: 36239933 PMCID: PMC9568799 DOI: 10.1001/jamanetworkopen.2022.36763] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
IMPORTANCE Breast cancer diagnosed within 5 to 10 years after childbirth, called postpartum breast cancer (PPBC), is associated with increased risk for metastasis and death. Whether a postpartum diagnosis is an independent risk factor or a surrogate marker of cancer features associated with poor outcomes remains understudied. OBJECTIVE To determine whether diagnostic temporal proximity to childbirth is associated with features of breast cancer associated with poor outcomes, including tumor stage, estrogen receptor (ER) status, and risk for distant metastasis and breast cancer-specific mortality, using a population database from the state of Utah. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study using the Utah Population Database (UPDB) included individuals with stage I to III breast cancer diagnosed at age 45 years or younger between 1996 and 2017, followed-up until February 2020. Participant data were analyzed from November 2019 to August 2022. EXPOSURE The primary exposures were no prior childbirth or time between most recent childbirth and breast cancer diagnosis. Patients were grouped by diagnoses within less than 5 years, 5 to less than 10 years, or 10 years or more since recent childbirth. MAIN OUTCOMES AND MEASURES The 2 primary outcomes were distant metastasis-free survival and breast cancer-specific death. Cox proportional hazard models were used to investigate associations between exposures and outcomes adjusting for diagnosis year, patient age, tumor stage, and estrogen receptor (ER) status. RESULTS Of 2970 individuals with breast cancer diagnosed at age 45 years or younger (mean [SD] age, 39.3 [5.0] years; 12 Black individuals [0.4%], 2679 White individuals [90.2%]), breast cancer diagnosis within 5 years of recent childbirth was independently associated with approximately 1.5-fold elevated risk for metastasis (hazard ratio [HR], 1.5; 95% CI, 1.2-2.0) and breast cancer-specific death (HR, 1.5; 95% CI, 1.1-2.1) compared with nulliparous individuals. For cancers classically considered to have tumor features associated with good outcomes (ie, stage I or II and ER-positive), a postpartum diagnosis was a dominant feature associated with increased risk for metastasis and death (eg, for individuals with ER-positive disease diagnosed within <5 years of childbirth: age-adjusted metastasis HR, 1.5; 95% CI, 1.1-2.1; P = .01; age-adjusted death HR, 1.5; 95% CI, 1.0-2.1; P = .04) compared with nulliparous individuals. Furthermore, liver metastases were specifically increased in the group with diagnosis within 5 years postpartum and with positive ER expression (38 of 83 patients [45.8%]) compared with the nulliparous (28 of 77 patients [36.4%]), although the difference was not statistically significant. Overall, these data implicate parity-associated breast and liver biology in the observed poor outcomes of PPBC. CONCLUSIONS AND RELEVANCE In this cohort study of individuals with breast cancer diagnosed at age 45 years or younger, a postpartum breast cancer diagnosis was a risk factor associated with poor outcomes. Irrespective of ER status, clinical consideration of time between most recent childbirth and breast cancer diagnosis could increase accuracy of prognosis in patients with young-onset breast cancer.
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Affiliation(s)
- Zhenzhen Zhang
- Division of Oncological Sciences, Oregon Health & Science University, Portland
- Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Solange Bassale
- Biostatistics Shared Resources, Knight Cancer Institute, Oregon Health & Science University, Portland
| | - Sonali Jindal
- Knight Cancer Institute, Oregon Health & Science University, Portland
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland
| | - Alison Fraser
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Emily Guinto
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Weston Anderson
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland
| | - Motomi Mori
- Department of Biostatistics, St Jude Children’s Research Hospital, Memphis, Tennessee
| | - Ken R. Smith
- Pedigree and Population Resource, Population Sciences, Huntsman Cancer Institute, Salt Lake City, Utah
| | - Pepper Schedin
- Knight Cancer Institute, Oregon Health & Science University, Portland
- Department of Cell, Developmental & Cancer Biology, Oregon Health & Science University, Portland
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Goel S, Tan AR, Rugo HS, Aftimos P, Andrić Z, Beelen A, Zhang J, Yi JS, Malik R, O'Shaughnessy J. Trilaciclib prior to gemcitabine plus carboplatin for metastatic triple-negative breast cancer: phase III PRESERVE 2. Future Oncol 2022; 18:3701-3711. [PMID: 36135712 DOI: 10.2217/fon-2022-0773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is an aggressive malignancy for which cytotoxic chemotherapy remains the backbone of treatment. Trilaciclib is an intravenous cyclin-dependent kinase 4/6 inhibitor that induces transient cell cycle arrest of hematopoietic stem and progenitor cells and immune cells during chemotherapy exposure, protecting them from chemotherapy-induced damage and enhancing immune activity. Administration of trilaciclib prior to gemcitabine plus carboplatin (GCb) significantly improved overall survival (OS) compared with GCb alone in an open-label phase II trial in patients with metastatic TNBC, potentially through protection and direct activation of immune function. The randomized, double-blind, placebo-controlled, phase III PRESERVE 2 trial will evaluate the efficacy and safety of trilaciclib administered prior to GCb in patients with locally advanced unresectable or metastatic TNBC. Clinical Trial Registration: NCT04799249 (ClinicalTrials.gov).
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Affiliation(s)
- Shom Goel
- Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Antoinette R Tan
- Levine Cancer Institute, Atrium Health, Charlotte, NC 28204, USA
| | - Hope S Rugo
- University of California San Francisco Comprehensive Cancer Center, San Francisco, CA 94158-1710, USA
| | - Philippe Aftimos
- Institut Jules Bordet, Université Libre de Bruxelles, 1070, Brussels, Belgium
| | - Zoran Andrić
- Clinical Hospital Centre Bezanijska Kosa, 11080, Belgrade, Serbia
| | - Andrew Beelen
- G1 Therapeutics, Research Triangle Park, NC 27709, USA
| | | | - John S Yi
- G1 Therapeutics, Research Triangle Park, NC 27709, USA
| | - Rajesh Malik
- G1 Therapeutics, Research Triangle Park, NC 27709, USA
| | - Joyce O'Shaughnessy
- Baylor University Medical Center, Texas Oncology, US Oncology, Dallas, TX 75246, USA
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Barańska A, Dolar-Szczasny J, Kanadys W, Kinik W, Ceglarska D, Religioni U, Rejdak R. Oral Contraceptive Use and Breast Cancer Risk According to Molecular Subtypes Status: A Systematic Review and Meta-Analysis of Case-Control Studies. Cancers (Basel) 2022; 14:cancers14030574. [PMID: 35158842 PMCID: PMC8833678 DOI: 10.3390/cancers14030574] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 01/19/2022] [Accepted: 01/21/2022] [Indexed: 01/10/2023] Open
Abstract
We conducted a systematic review and meta-analysis to investigate the effect of oral contraceptives (OCs) on risk of breast cancer (BrCa) by status of estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor 2 (HER2). We searched the MEDLINE (PubMed), Embase and the Cochrane Library database and bibliographies of pertinent articles published up to 2020. Therein, we identified nineteen eligible case-control studies which provided data by breast cancer subtypes: ER-positive (ER+), ER-negative (ER−), HER2-positive (HER2+) and Triplet-negative (TN). Summary risk estimates (pooled OR [pOR]) and 95% confidence intervals (CIs) were calculated using fixed/random effects models. The summary meta-analysis showed that over-use of OCs led to significant increased risk of TNBrCa (OR = 1.37, 95% CI; 1.13 to 1.67, p = 0.002), as well as of ER−BrCa (OR = 1.20, 95% CI: 1.03 to 1.40, p = 0.019). There was also a significant reduction in the risk of ER+BrCa (OR = O.92, 95% CI: 0.86 to 0.99, p = 0.026,) and a slight reduction in the risk of HER2+BrCa (OR = 0.95, 95% CI; 0.79 to 1.14, p = 0.561) after taking OCs. Meta-analysis indicated that OC use has different impacts on risk of breast cancer subtypes defined by receptor status. The identified differences between individual subtypes of breast cancer may reflect different mechanisms of carcinogenesis.
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Affiliation(s)
- Agnieszka Barańska
- Department of Medical Informatics and Statistics with E-Learning Lab, Medical University of Lublin, 20-090 Lublin, Poland
- Correspondence:
| | - Joanna Dolar-Szczasny
- Department of General and Pediatric Ophtalmology, Medical University of Lublin, 20-070 Lublin, Poland; (J.D.-S.); (R.R.)
| | | | - Wiktoria Kinik
- Science Popularization Centre, Medical University of Lublin, 20-059 Lublin, Poland;
| | - Dorota Ceglarska
- Subunit, Primary Health Care Center Provita, 20-093 Lublin, Poland;
| | - Urszula Religioni
- School of Public Health, Centre of Postgraduate Medical Education of Warsaw, 01-813 Warsaw, Poland;
- National Institute of Public Health-National Institute of Hygiene, Warsaw School of Economics, 02-554 Warsaw, Poland
| | - Robert Rejdak
- Department of General and Pediatric Ophtalmology, Medical University of Lublin, 20-070 Lublin, Poland; (J.D.-S.); (R.R.)
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Barańska A, Błaszczuk A, Kanadys W, Malm M, Drop K, Polz-Dacewicz M. Oral Contraceptive Use and Breast Cancer Risk Assessment: A Systematic Review and Meta-Analysis of Case-Control Studies, 2009-2020. Cancers (Basel) 2021; 13:cancers13225654. [PMID: 34830807 PMCID: PMC8616467 DOI: 10.3390/cancers13225654] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 11/09/2021] [Indexed: 11/16/2022] Open
Abstract
To perform a meta-analysis of case-control studies that addressed the association between oral contraceptive pills (OC) use and breast cancer (BrCa), PubMED (MEDLINE), Embase, and the Cochrane Library were searched to identify case-control studies of OC and BrCa published between 2009 and 2020. We used the DerSimonian-Laird method to compute pooled odds ratios (ORs) and confidence intervals (CIs), and the Mantel-Haenszel test to assess the association between OC use and cancer. Forty-two studies were identified that met the inclusion criteria and we included a total of 110,580 women (30,778 into the BrCa group and 79,802 into the control group, of which 15,722 and 38,334 were using OC, respectively). The conducted meta-analysis showed that the use of OC was associated with a significantly increased risk of BrCa in general, OR = 1.15, 95% CI: 1.01 to 1.31, p = 0.0358. Regarding other risk factors for BrCa, we found that increased risk was associated significantly with early menarche, nulliparous, non-breastfeeding, older age at first parity, postmenopause, obesity, smoking, and family history of BrCa. Despite our conclusion that birth control pills increase the cancer risk being supported by extensive previous studies and meta-analyzes, further confirmation is required.
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Affiliation(s)
- Agnieszka Barańska
- Department of Medical Informatics and Statistics with E-Learning Lab, Medical University of Lublin, 20-090 Lublin, Poland;
- Correspondence:
| | - Agata Błaszczuk
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
| | - Wiesław Kanadys
- Specialistic Medical Center Czechow, Gynecology Unit, 20-848 Lublin, Poland;
| | - Maria Malm
- Department of Medical Informatics and Statistics with E-Learning Lab, Medical University of Lublin, 20-090 Lublin, Poland;
| | - Katarzyna Drop
- Department of Language, Rhetoric and Media Law, John Paul II Catholic University, 20-950 Lublin, Poland;
| | - Małgorzata Polz-Dacewicz
- Department of Virology with SARS Laboratory, Medical University of Lublin, 20-059 Lublin, Poland; (A.B.); (M.P.-D.)
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Risk factors for breast cancer subtypes among Black women undergoing screening mammography. Breast Cancer Res Treat 2021; 189:827-835. [PMID: 34342765 DOI: 10.1007/s10549-021-06340-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Accepted: 07/24/2021] [Indexed: 01/16/2023]
Abstract
PURPOSE Black women are more likely than non-Hispanic White women to be diagnosed with triple negative breast cancer (TNBC), an aggressive subtype with limited treatment options. The study objective was to evaluate the associations of known breast cancer risk factors, including breast density, with TNBC among Black women. METHODS This study included Black women who underwent screening mammography between the ages of 40-84 years at a University of Pennsylvania Health System between 2010 and 2015. Cox proportional hazard models using multiple imputation with chained equations were used to estimate hazard ratios and 95% confidence intervals for risk factors for ER/PR+/HER2- and TNBC. RESULTS Among 25,013 Black women, there were 330 incident breast cancers (1.3%) during a mean follow-up of 5.8 years; 218 (66.1%) ER/PR+ HER- and 61 (18.1%) TNBC. Having dense breasts (heterogeneously dense or extremely dense) vs. non-dense breasts (almost entirely fatty or scattered areas of fibroglandular density) increased risk of ER/PR+/HER2- breast cancer almost 80% (HR 1.79, 95% CI 1.32-2.43) and TNBC more than twofold (HR 2.53, 1.45-4.44). Older age was associated with an increased risk for ER/PR+/HER2- (HR 1.04, 1.03-1.06) and TNBC (HR 1.03, 1.00-1.05). Having a BMI of > 30 kg/m2 was associated with an increased risk (HR 2.77, 1.05-7.30) for TNBC and an increased risk of ERPR+/HER2- breast cancer in postmenopausal but not pre-menopausal women (p-interaction = 0.016). CONCLUSION Our results suggest that breast density and obesity are strong risk factors for TNBC among Black women. Understanding breast cancer subtype specific risk factors among Black women can help improve risk assessment.
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Subramanian S, Jones M, Tangka FKL, Edwards P, Flanigan T, Kaganova J, Smith K, Fairley T, Hawkins NA, Rodriguez JL, Guy GP, Thomas CC. Utility of linking survey and registry data to evaluate interventions and policies to address disparities in breast cancer survivorship among young women. EVALUATION AND PROGRAM PLANNING 2021; 88:101967. [PMID: 34091395 PMCID: PMC8533048 DOI: 10.1016/j.evalprogplan.2021.101967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Revised: 04/27/2021] [Accepted: 05/18/2021] [Indexed: 06/12/2023]
Abstract
PURPOSE There is limited research linking data sources to evaluate the multifactorial impacts on the quality of treatment received and financial burden among young women with breast cancer. To address this gap and support future evaluation efforts, we examined the utility of combining patient survey and cancer registry data. PATIENT AND METHODS We administered a survey to women, aged 18-39 years, with breast cancer from four U.S. states. We conducted a systematic response-rate analysis and evaluated differences between racial groups. Survey responses were linked with cancer registry data to assess whether surveys could reliably supplement registry data. RESULTS A total of 830 women completed the survey for a response rate of 28.4 %. Blacks and Asian/Pacific Islanders were half as likely to respond as white women. Concordance between survey and registry data was high for demographic variables (Cohen's kappa [k]: 0.879 to 0.949), moderate to high for treatments received (k: 0.467 to 0.854), and low for hormone receptor status (k: 0.167 to 0.553). Survey items related to insurance status, employment, and symptoms revealed racial differences. CONCLUSION Cancer registry data, supplemented by patient surveys, can provide a broader understanding of the quality of care and financial impacts of breast cancer among young women.
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Affiliation(s)
| | - Madeleine Jones
- RTI International, 307 Waverly Oaks Road, Waltham, MA, 0245, USA
| | - Florence K L Tangka
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Patrick Edwards
- RTI International, 307 Waverly Oaks Road, Waltham, MA, 0245, USA
| | - Tim Flanigan
- RTI International, 307 Waverly Oaks Road, Waltham, MA, 0245, USA
| | - Jenya Kaganova
- RTI International, 307 Waverly Oaks Road, Waltham, MA, 0245, USA
| | - Kevin Smith
- RTI International, 307 Waverly Oaks Road, Waltham, MA, 0245, USA
| | - Temeika Fairley
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Nikki A Hawkins
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Juan L Rodriguez
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Gery P Guy
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
| | - Cheryll C Thomas
- Centers for Disease Control and Prevention, 1600 Clifton Rd., Atlanta, GA, USA
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Alhallak I, Wolter KG, Munoz AC, Simmen FA, Ward RJ, Petty SA, Li LX, Simmen RC. Breast adipose regulation of premenopausal breast epithelial phenotype involves interleukin 10. J Mol Endocrinol 2021; 67:173-188. [PMID: 34382943 PMCID: PMC8489570 DOI: 10.1530/jme-21-0100] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 08/12/2021] [Indexed: 11/08/2022]
Abstract
Epidemiological studies inversely associate BMI with breast cancer risk in premenopausal women, but the pathophysiological linkage remains ill-defined. Despite the documented relevance of the 'local' environment to breast cancer progression and the well-accepted differences in transcriptome and metabolic properties of anatomically distinct fat depots, specific breast adipose contributions to the proliferative potential of non-diseased breast glandular compartment are not fully understood. To address early breast cancer causation in the context of obesity status, we compared the cellular and molecular phenotypes of breast adipose and matched breast glandular tissue from premenopausal non-obese (mean BMI = 27 kg/m2) and obese (mean BMI = 44 kg/m2) women. Breast adipose from obese women showed higher expression levels of adipogenic, pro-inflammatory, and estrogen synthetic genes than from non-obese women. Obese breast glandular tissue displayed lower proliferation and inflammatory status and higher expression of anti-proliferative/pro-senescence biomarkers TP53 and p21 than from non-obese women. Transcript levels for T-cell receptor and co-receptors CD3 and CD4 were higher in breast adipose of obese cohorts, coincident with elevated adipose interleukin 10 (IL10) and FOXP3 gene expression. In human breast epithelial cell lines MCF10A and HMEC, recombinant human IL10 reduced cell viability and CCND1 transcript levels, increased those of TP53 and p21, and promoted (MCF10A) apoptosis. Our findings suggest that breast adipose-associated IL10 may mediate paracrine interactions between non-diseased breast adipose and breast glandular compartments and highlight how breast adipose may program the local inflammatory milieu, partly by recruiting FOXP3+ T regulatory cells, to influence premenopausal breast cancer risk.
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Affiliation(s)
- Iad Alhallak
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Keith G. Wolter
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Ana Castro Munoz
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Frank A. Simmen
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
- Department of The Winthrop P Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | | | - Stacy A. Petty
- Department of Surgery, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Lin-Xi Li
- Department of Microbiology & Immunology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
| | - Rosalia C.M. Simmen
- Department of Physiology & Cell Biology, University of Arkansas for Medical Sciences, Little Rock, AR 72205
- Department of The Winthrop P Rockefeller Cancer Institute, University of Arkansas for Medical Sciences, Little Rock, AR 72205
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11
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Semprini J, Olopade O. Evaluating the Effect of Medicaid Expansion on Black/White Breast Cancer Mortality Disparities: A Difference-in-Difference Analysis. JCO Glob Oncol 2021; 6:1178-1183. [PMID: 32721196 PMCID: PMC7392753 DOI: 10.1200/go.20.00068] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/17/2023] Open
Abstract
PURPOSE Medicaid expansion was designed to increase access to health care. Evidence is mixed, but theory and empirical data suggest that lower cost of care through greater access to insurance increases health care utilization and possibly improves the health of poor and sick populations. However, this major health policy has yet to be thoroughly investigated for its effect on health disparities. The current study is motivated by one of today’s most stark inequalities: the disparity in breast cancer mortality rates between Black and White women. METHODS This analysis used a difference-in-difference fixed effects regression model to evaluate the impact of Medicaid expansion on the disparity between Black and White breast cancer mortality rates. State-level breast cancer mortality data were obtained from the Centers for Disease Control and Prevention. Each state’s Medicaid expansion status was provided by a Kaiser Family Foundation white paper. Two tests were conducted, one compared all expanding states with all nonexpanding states, and the second compared all expanding states with nonexpanding states that voted to expand—but did not by 2014. The difference-in-difference regression models considered the year 2014 a washout period and compared 2012 and 2013 (pretreatment) with 2015 and 2016 (posttreatment). RESULTS Medicaid expansion did not lower the disparity in breast cancer mortality. In contrast to expectations, the Black/White mortality ratio increased in states expanding Medicaid for all Medicaid-eligible age groups, with significant effects in younger age groups (P = .01 to .15). CONCLUSION These results suggest that states cannot solely rely on access to insurance to alleviate disparities in cancer or other chronic conditions. More exploration of the impacts of low-quality health systems is warranted.
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Affiliation(s)
- Jason Semprini
- University of Chicago Center for Clinical Cancer Genetics and Global Health, Chicago, IL
| | - Olufunmilayo Olopade
- University of Chicago Center for Clinical Cancer Genetics and Global Health, Chicago, IL
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12
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Velie EM, Marcus LR, Pathak DR, Hamilton AS, DiGaetano R, Klinger R, Gollapudi B, Houang R, Carnegie N, Olson LK, Allen A, Zhang Z, Modjesk D, Norman G, Lucas DR, Gupta S, Rui H, Schwartz K. Theory, methods, and operational results of the Young Women's Health History Study: a study of young-onset breast cancer incidence in Black and White women. Cancer Causes Control 2021; 32:1129-1148. [PMID: 34292440 PMCID: PMC8416838 DOI: 10.1007/s10552-021-01461-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Accepted: 06/11/2021] [Indexed: 11/29/2022]
Abstract
Purpose The etiology of young-onset breast cancer (BC) is poorly understood, despite its greater likelihood of being hormone receptor-negative with a worse prognosis and persistent racial and socioeconomic inequities. We conducted a population-based case–control study of BC among young Black and White women and here discuss the theory that informed our study, exposures collected, study methods, and operational results. Methods Cases were non-Hispanic Black (NHB) and White (NHW) women age 20–49 years with invasive BC in metropolitan Detroit and Los Angeles County SEER registries 2010–2015. Controls were identified through area-based sampling from the U.S. census and frequency matched to cases on study site, race, and age. An eco-social theory of health informed life-course exposures collected from in-person interviews, including socioeconomic, reproductive, and energy balance factors. Measured anthropometry, blood (or saliva), and among cases SEER tumor characteristics and tumor tissue (from a subset of cases) were also collected. Results Of 5,309 identified potentially eligible cases, 2,720 sampled participants were screened and 1,812 completed interviews (682 NHB, 1140 NHW; response rate (RR): 60%). Of 24,612 sampled control households 18,612 were rostered, 2,716 participants were sampled and screened, and 1,381 completed interviews (665 NHB, 716 NHW; RR: 53%). Ninety-nine% of participants completed the main interview, 82% provided blood or saliva (75% blood only), and SEER tumor characteristics (including ER, PR and HER2 status) were obtained from 96% of cases. Conclusions Results from the successfully established YWHHS should expand our understanding of young-onset BC etiology overall and by tumor type and identify sources of racial and socioeconomic inequities in BC. Supplementary Information The online version of this article contains supplementary material available (10.1007/s10552-021-01461-x).
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Affiliation(s)
- Ellen M Velie
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA. .,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA.
| | - Lydia R Marcus
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Dorothy R Pathak
- Department of Epidemiology and Biostatistics, College of Human Medicine, Michigan State University, 909 Wilson Road Room B601, East Lansing, MI, 48824, USA
| | - Ann S Hamilton
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | | | - Ron Klinger
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Bibi Gollapudi
- Westat Inc., 1650 Research Blvd, Rockville, MD, 20850, USA
| | - Richard Houang
- Department of Education, Michigan State University, 620 Farm Ln, East Lancing, MI, 48824, USA
| | - Nicole Carnegie
- Department of Mathematics, Montana State University, 732 Grant St, Bozeman, MT, 59717, USA
| | - L Karl Olson
- Department of Physiology, Michigan State University, 567 Wilson Rd, East Lansing, MI, 48824, USA
| | - Amani Allen
- Departments of Community Health Sciences and Epidemiology, School of Public Health, University of California Berkeley, 2121 Berkeley Way, Berkeley, CA, 94720, USA
| | - Zhenzhen Zhang
- Division of Oncological Sciences, Knight Cancer Institute, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Mail Code: KCRB-PROS, Portland, OR, 97239, USA
| | - Denise Modjesk
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, 2001 N. Soto St, Los Angeles, CA, 90089-9239, USA
| | - Gwendolyn Norman
- College of Liberal Arts and Sciences, Wayne State University, 4841 Cass Avenue, Detroit, MI, 48201, USA
| | - Darek R Lucas
- Zilber School of Public Health, University of WI - Milwaukee, 1240 N. 10th Street, Milwaukee, WI, 53201, USA.,Departments of Medicine and Pathology, Medical College of Wisconsin, 9200 W. Wisconsin Ave, Milwaukee, WI, 53226, USA
| | - Sapna Gupta
- Cancer Research Informatics Core, University of Southern California Norris Cancer Center, NRT LG507, 1450 Biggy St, Los Angeles, CA, 90033, USA
| | - Hallgeir Rui
- Department of Pathology, Medical College of Wisconsin, 8701 Watertown Plank RD., Milwaukee, WI, 53226, USA
| | - Kendra Schwartz
- Department of Family Medicine and Public Health Sciences, Wayne State University, 3939 Woodward Ave, Detroit, MI, 48201, USA
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13
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Corey B, Smania MA, Spotts H, Andersen M. Young Women With Breast Cancer: Treatment, Care, and Nursing Implications. Clin J Oncol Nurs 2021; 24:139-147. [PMID: 32196004 DOI: 10.1188/20.cjon.139-147] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Young women with breast cancer (YWBC) are more likely to have aggressive disease, carry mutations for hereditary cancer genes, and experience higher mortality. They also may face reduced fertility because of the toxicity of chemotherapy. OBJECTIVES This article aims to present a review of YWBC treatments, sequelae of treatment, and psychosocial challenges. METHODS The authors performed a review of guideline-supported treatment options, patient resources, and nursing implications. FINDINGS Because of high-risk cancers and a lack of specific treatment guidelines, healthcare providers may consider aggressive treatments for younger patients. However, studies indicate that the foundation for treatment decisions for YWBC are best based on disease stage and National Comprehensive Cancer Network guidelines.
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14
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Cui X, Song D, Li X. Construction and Validation of Nomograms Predicting Survival in Triple-Negative Breast Cancer Patients of Childbearing Age. Front Oncol 2021; 10:636549. [PMID: 33628740 PMCID: PMC7898905 DOI: 10.3389/fonc.2020.636549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2020] [Accepted: 12/21/2020] [Indexed: 11/17/2022] Open
Abstract
Background Triple-negative breast cancer (TNBC) is one of the most aggressive subtypes of breast cancer with poorest clinical outcomes. Patients of childbearing age have a higher probability of TNBC diagnosis, with more demands on maintenance and restoration of physical and psychosocial function. This study aimed to design effective and comprehensive nomograms to predict survival in these patients. Methods We used the SEER database to identify patients with TNBC aged between 18 and 45 and randomly classified these patients into a training (n=2,296) and a validation (n=2,297) cohort. Nomograms for estimating overall survival (OS) and breast cancer-specific survival (BCSS) were generated based on multivariate Cox proportional hazards models and competing-risk models in the training cohort. The performances of the nomograms were quantified in the validation cohort using calibration curves, time-dependent receiver operating characteristic (ROC) curves and Harrell’s concordance index (C-index). Results A total of 4,593 TNBC patients of childbearing age were enrolled. Four prognostic factors for OS and six for BCSS were identified and incorporated to construct nomograms. In the validation cohort, calibration curves showed excellent agreement between nomogram-predicted and actual survival data. The nomograms also achieved relatively high Harrell’s C-indexes and areas under the time-dependent ROC curves for estimating OS and BCSS in both training and validation cohorts. Conclusions Independent prognostic factors were identified, and used to develop nomograms to predict OS and BCSS in childbearing-age patients with TNBC. These models could enable individualized risk estimation and risk-adapted treatment for these patients.
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Affiliation(s)
- Xiang Cui
- Department of Thyroid and Breast Surgery, The First People's Hospital of Shangqiu, Shangqiu, China
| | - Deba Song
- Department of Thyroid and Breast Surgery, The First People's Hospital of Shangqiu, Shangqiu, China
| | - Xiaoxu Li
- Department of Thyroid and Breast Surgery, The First People's Hospital of Shangqiu, Shangqiu, China
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15
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Benefield HC, Zirpoli GR, Allott EH, Shan Y, Hurson AN, Omilian AR, Khoury T, Hong CC, Olshan AF, Bethea TN, Bandera EV, Palmer JR, Ambrosone CB, Troester MA. Epidemiology of Basal-like and Luminal Breast Cancers among Black Women in the AMBER Consortium. Cancer Epidemiol Biomarkers Prev 2021; 30:71-79. [PMID: 33097496 PMCID: PMC8935955 DOI: 10.1158/1055-9965.epi-20-0556] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 06/07/2020] [Accepted: 10/16/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Evidence suggests etiologic heterogeneity among breast cancer subtypes. Previous studies with six-marker IHC classification of intrinsic subtypes included small numbers of black women. METHODS Using centralized laboratory results for estrogen receptor (ER), progesterone receptor, HER2, proliferation marker, Ki-67, EGFR, and cytokeratin (CK)5/6, we estimated case-only and case-control ORs for established breast cancer risk factors among cases (n = 2,354) and controls (n = 2,932) in the African American Breast Cancer Epidemiology and Risk (AMBER) consortium. ORs were estimated by ER status and intrinsic subtype using adjusted logistic regression. RESULTS Case-only analyses by ER status showed etiologic heterogeneity by age at menarche, parity (vs. nulliparity), and age at first birth. In case-control analyses for intrinsic subtype, increased body mass index and waist-to-hip ratio (WHR) were associated with increased risk of luminal A subtype, whereas older age at menarche and parity, regardless of breastfeeding, were associated with reduced risk. For basal-like cancers, parity without breastfeeding and increasing WHR were associated with increased risk, whereas breastfeeding and age ≥25 years at first birth were associated with reduced risk among parous women. Basal-like and ER-/HER2+ subtypes had earlier age-at-incidence distribution relative to luminal subtypes. CONCLUSIONS Breast cancer subtypes showed distinct etiologic profiles in the AMBER consortium, a study of more than 5,000 black women with centrally assessed tumor biospecimens. IMPACT Among black women, high WHR and parity without breastfeeding are emerging as important intervention points to reduce the incidence of basal-like breast cancer.
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Affiliation(s)
- Halei C. Benefield
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gary R. Zirpoli
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Emma H. Allott
- Patrick G Johnston Centre for Cancer Research, Queen’s University Belfast, Belfast, United Kingdom
| | - Yue Shan
- Department of Biostatistics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Amber N. Hurson
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Angela R. Omilian
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Thaer Khoury
- Department of Pathology, Roswell Park Cancer Institute, Buffalo, NY, USA
| | - Chi-Chen Hong
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Andrew F. Olshan
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Traci N. Bethea
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Elisa V. Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, NJ, USA
| | - Julie R. Palmer
- Slone Epidemiology Center at Boston University, Boston, MA, USA
| | - Christine B. Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Melissa A. Troester
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
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16
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Prakash O, Hossain F, Danos D, Lassak A, Scribner R, Miele L. Racial Disparities in Triple Negative Breast Cancer: A Review of the Role of Biologic and Non-biologic Factors. Front Public Health 2020; 8:576964. [PMID: 33415093 PMCID: PMC7783321 DOI: 10.3389/fpubh.2020.576964] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/20/2020] [Indexed: 11/22/2022] Open
Abstract
Triple-negative breast cancer (TNBC) is an aggressive subtype of breast cancer that lacks expression of the estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor receptor (HER2). TNBC constitutes about 15–30 percent of all diagnosed invasive breast cancer cases in the United States. African-American (AA) women have high prevalence of TNBC with worse clinical outcomes than European-American (EA) women. The contributing factors underlying racial disparities have been divided into two major categories based on whether they are related to lifestyle (non-biologic) or unrelated to lifestyle (biologic). Our objective in the present review article was to understand the potential interactions by which these risk factors intersect to drive the initiation and development of the disparities resulting in the aggressive TNBC subtypes in AA women more likely than in EA women. To reach our goal, we conducted literature searches using MEDLINE/PubMed to identify relevant articles published from 2005 to 2019 addressing breast cancer disparities primarily among AA and EA women in the United States. We found that disparities in TNBC may be attributed to racial differences in biological factors, such as tumor heterogeneity, population genetics, somatic genomic mutations, and increased expression of genes in AA breast tumors which have direct link to breast cancer. In addition, a large number of non-biologic factors, including socioeconomic deprivation adversities associated with poverty, social stress, unsafe neighborhoods, lack of healthcare access and pattern of reproductive factors, can promote comorbid diseases such as obesity and diabetes which may adversely contribute to the aggression of TNBC biology in AA women. Further, the biological risk factors directly linked to TNBC in AA women may potentially interact with non-biologic factors to promote a higher prevalence of TNBC, more aggressive biology, and poor survival. The relative contributions of the biologic and non-biologic factors and their potential interactions is essential to our understanding of disproportionately high burden and poor survival rates of AA women with TNBC.
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Affiliation(s)
- Om Prakash
- Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United States
| | - Fokhrul Hossain
- Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United States
| | - Denise Danos
- Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United States
| | - Adam Lassak
- Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United States
| | - Richard Scribner
- Department of Public Health and Preventive Medicine, St. George's University, True Blue, Grenada
| | - Lucio Miele
- Louisiana Health Sciences Center, School of Medicine, New Orleans, LA, United States
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17
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Brenner DR, Ruan Y, Shaw E, O'Sullivan D, Poirier AE, Heer E, Villeneuve PJ, Walter SD, Friedenreich CM, Smith L, De P. Age-standardized cancer-incidence trends in Canada, 1971-2015. CMAJ 2020; 191:E1262-E1273. [PMID: 31740536 DOI: 10.1503/cmaj.190355] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/23/2019] [Indexed: 11/01/2022] Open
Abstract
BACKGROUND Although cancer incidence over time is well documented in Canada, trends by birth cohort and age group are less well known. We analyzed age- and sex-standardized incidence trends in Canada for 16 major cancer sites and all cancers combined. METHODS We obtained nationally representative population-based cancer incidence data in Canada between 1971 and 2015 from the National Cancer Incidence Reporting System (1969-1992) and the Canadian Cancer Registry (1992-2015). We analyzed cancer-incidence trends, reported as annual percent change (APC) for each 10-year group from age 20 to 89 years. We also estimated age-adjusted incidence rate ratios from fitted birth cohort models. RESULTS Across most age categories, the most recent trends show significant decreases in the incidence of cervical (APC -8.8% to -0.33%), lung (men: -7.42% to -0.36%; women: -6.27% to 1.07%), bladder (women: -4.12% to -0.07%; men: -5.13% to -0.38%) and prostate cancer (-11.11% to -1.11%). Significant increasing trends were observed for kidney, thyroid and uterine cancers. Overall incidence has increased among both sexes younger than 50 years of age, with recent increases in pancreatic cancer among men, breast cancer among women and colorectal cancer among both sexes. From the birth cohort analysis, we observed increasing trends in colorectal, liver and prostate cancers among men; kidney cancer and melanoma among women; and thyroid cancer among both sexes. We observed decreasing trends in cervical and ovarian cancers, and in bladder and lung cancers among men. INTERPRETATION Cancer incidence is decreasing at many sites targeted by primary-prevention efforts, such as smoking cessation and screening programs. Substantial increases in incidence among younger populations are driven by cancers possibly associated with obesity.
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Affiliation(s)
- Darren R Brenner
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont.
| | - Yibing Ruan
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Eileen Shaw
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Dylan O'Sullivan
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Abbey E Poirier
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Emily Heer
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Paul J Villeneuve
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Stephen D Walter
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Christine M Friedenreich
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Leah Smith
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
| | - Prithwish De
- Departments of Oncology and Community Health Sciences (Brenner, Friedenreich), Cumming School of Medicine, University of Calgary; Department of Cancer Epidemiology and Prevention Research (Brenner, Ruan, Shaw, Poirier, Heer, Friedenreich), CancerControl Alberta, Alberta Health Services, Calgary, Alta.; Department of Public Health Sciences (O'Sullivan), Queen's University, Kingston, Ont.; Department of Health Sciences (Villeneuve), Carleton University, Ottawa, Ont.; Department of Clinical Epidemiology and Biostatistics (Walter), McMaster University, Hamilton, Ont.; Canadian Cancer Society (Smith); Surveillance and Cancer Registry (De), Cancer Care Ontario, Toronto, Ont
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Jenkins BD, Martini RN, Hire R, Brown A, Bennett B, Brown I, Howerth EW, Egan M, Hodgson J, Yates C, Kittles R, Chitale D, Ali H, Nathanson D, Nikolinakos P, Newman L, Monteil M, Davis MB. Atypical Chemokine Receptor 1 ( DARC/ACKR1) in Breast Tumors Is Associated with Survival, Circulating Chemokines, Tumor-Infiltrating Immune Cells, and African Ancestry. Cancer Epidemiol Biomarkers Prev 2020; 28:690-700. [PMID: 30944146 DOI: 10.1158/1055-9965.epi-18-0955] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2018] [Revised: 11/11/2018] [Accepted: 01/04/2019] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Tumor-specific immune response is an important aspect of disease prognosis and ultimately impacts treatment decisions for innovative immunotherapies. The atypical chemokine receptor 1 (ACKR1 or DARC) gene plays a pivotal role in immune regulation and harbors several single-nucleotide variants (SNV) that are specific to sub-Saharan African ancestry. METHODS Using computational The Cancer Genome Atlas (TCGA) analysis, case-control clinical cohort Luminex assays, and CIBERSORT deconvolution, we identified distinct immune cell profile-associated DARC/ACKR1 tumor expression and race with increased macrophage subtypes and regulatory T cells in DARC/ACKR1-high tumors. RESULTS In this study, we report the clinical relevance of DARC/ACKR1 tumor expression in breast cancer, in the context of a tumor immune response that may be associated with sub-Saharan African ancestry. Briefly, we found that for infiltrating carcinomas, African Americans have a higher proportion of DARC/ACKR1-negative tumors compared with white Americans, and DARC/ACKR1 tumor expression is correlated with proinflammatory chemokines, CCL2/MCP-1 (P <0.0001) and anticorrelated with CXCL8/IL8 (P <0.0001). Sub-Saharan African-specific DARC/ACKR1 alleles likely drive these correlations. Relapse-free survival (RFS) and overall survival (OS) were significantly longer in individuals with DARC/ACKR1-high tumors (P <1.0 × 10-16 and P <2.2 × 10-6, respectively) across all molecular tumor subtypes. CONCLUSIONS DARC/AKCR1 regulates immune responses in tumors, and its expression is associated with sub-Saharan African-specific alleles. DARC/ACKR1-positive tumors will have a distinct immune response compared with DARC/AKCR1-negative tumors. IMPACT This study has high relevance in cancer management, as we introduce a functional regulator of inflammatory chemokines that can determine an infiltrating tumor immune cell landscape that is distinct among patients of African ancestry.
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Affiliation(s)
- Brittany D Jenkins
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Rachel N Martini
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Rupali Hire
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Andrea Brown
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Briana Bennett
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - I'nasia Brown
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia
| | - Elizabeth W Howerth
- Department of Pathology, College of Veterinary Medicine, University of Georgia, Athens, Georgia
| | - Mary Egan
- University Cancer and Blood Center, Athens, Georgia
| | | | - Clayton Yates
- Department of Biology and Center for Cancer Research, Tuskegee University, Tuskegee, Alabama
| | - Rick Kittles
- Department of Population Sciences, City of Hope Comprehensive Cancer Center, Duarte, California
| | - Dhananjay Chitale
- Department of Pathology, Henry Ford Health System, Detroit, Michigan
| | - Haythem Ali
- Department of Hematology and Oncology, Henry Ford Health System, Detroit, Michigan
| | - David Nathanson
- Department of Surgery, Henry Ford Health System, Detroit, Michigan
| | | | - Lisa Newman
- Department of Surgery, Henry Ford Health System, Detroit, Michigan
| | - Michele Monteil
- Department of Molecular Biology and Biochemistry, Augusta University/University of Georgia Medical Partnership, Athens, Georgia
| | - Melissa B Davis
- Department of Genetics, Franklin College of Arts and Sciences, University of Georgia, Athens, Georgia. .,Department of Molecular Biology and Biochemistry, Augusta University/University of Georgia Medical Partnership, Athens, Georgia.,Department of Public Health Sciences, Henry Ford Health System, Detroit, Michigan
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Breast Cancer in Young Women: Status Quo and Advanced Disease Management by a Predictive, Preventive, and Personalized Approach. Cancers (Basel) 2019; 11:cancers11111791. [PMID: 31739537 PMCID: PMC6896106 DOI: 10.3390/cancers11111791] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2019] [Revised: 11/08/2019] [Accepted: 11/12/2019] [Indexed: 12/24/2022] Open
Abstract
Why does healthcare of breast cancer (BC) patients, especially in a young population, matter and why are innovative strategies by predictive, preventive, and personalized medicine (PPPM) strongly recommended to replace current reactive medical approach in BC management? Permanent increase in annual numbers of new BC cases with particularly quick growth of premenopausal BC patients, an absence of clearly described risk factors for those patients, as well as established screening tools and programs represent important reasons to focus on BC in young women. Moreover, "young" BC cases are frequently "asymptomatic", difficult to diagnose, and to treat effectively on time. The objective of this article is to update the knowledge on BC in young females, its unique molecular signature, newest concepts in diagnostics and therapy, and to highlight the concepts of predictive, preventive, and personalized medicine with a well-acknowledged potential to advance the overall disease management.
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Grassi TF, Bidinotto LT, Lopes GAD, Zapaterini JR, Rodrigues MAM, Barbisan LF. Maternal western-style diet enhances the effects of chemically-induced mammary tumors in female rat offspring through transcriptome changes. Nutr Res 2018; 61:41-52. [PMID: 30683438 DOI: 10.1016/j.nutres.2018.09.009] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2018] [Revised: 09/06/2018] [Accepted: 09/27/2018] [Indexed: 01/09/2023]
Abstract
Previous studies have shown that early life intake of high-fat diet or western-style diet (WD) enhances the development of mammary tumors in adult female rats. Thus, we hypothesized that maternal WD throughout pregnancy and the lactation period could speed up the development of MNU-induced mammary tumors and alter their gene expression. For this, the present study investigated the gene expression profile of chemically-induced mammary tumors in female rat offspring from dams fed a WD or a control diet. Pregnant female Sprague-Dawley rats received a WD (high-fat, low-fiber and oligoelements) or a control diet from gestational day 12 until post-natal day (PND) 21. At PND 21, female offspring received a single dose of N-Methyl-N-Nitrosourea (MNU, 50 mg/kg body weight) and were fed a control diet for 13 weeks. Tumor incidence, multiplicity, and latency were recorded and mammary gland samples were collected for histopathology and gene expression analysis. Tumor multiplicity and histological grade were significantly higher and tumor latency was lower in WD offspring compared to control offspring. Transcriptome profiling identified 57 differentially expressed genes in tumors from WD offspring as compared to control offspring. There was also an increase in mRNA expression of genes such as Emp3, Ccl7, Ets1, Abcc5, and Cyr61, indicative of more aggressive disease detected in tumors from WD offspring. Thus, maternal WD diet increased MNU-induced mammary carcinogenesis in adult female offspring through transcriptome changes that resulted in a more aggressive disease.
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Affiliation(s)
- Tony F Grassi
- UNESP - Univ. Estadual Paulista, Botucatu Medical School, Department of Pathology, Botucatu, 18610-307, SP, Brazil; UNESP - Univ. Estadual Paulista, Institute of Biosciences of Botucatu, Department of Morphology, Botucatu 18618-689, SP, Brazil
| | - Lucas T Bidinotto
- Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos 14784-400, SP, Brazil; Barretos School of Health Sciences, Dr. Paulo Prata -FACISB, Barretos 14785-002, SP, Brazil
| | - Gisele A D Lopes
- UNESP - Univ. Estadual Paulista, Botucatu Medical School, Department of Pathology, Botucatu, 18610-307, SP, Brazil
| | - Joyce R Zapaterini
- UNESP - Univ. Estadual Paulista, Botucatu Medical School, Department of Pathology, Botucatu, 18610-307, SP, Brazil; UNESP - Univ. Estadual Paulista, Institute of Biosciences of Botucatu, Department of Morphology, Botucatu 18618-689, SP, Brazil
| | - Maria A M Rodrigues
- UNESP - Univ. Estadual Paulista, Botucatu Medical School, Department of Pathology, Botucatu, 18610-307, SP, Brazil
| | - Luís F Barbisan
- UNESP - Univ. Estadual Paulista, Institute of Biosciences of Botucatu, Department of Morphology, Botucatu 18618-689, SP, Brazil.
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21
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Rida P, Ogden A, Ellis IO, Varga Z, Wolff AC, Traina TA, Hatzis C, Palmer JR, Ambrosone CB, Lehmann BD, Nanda R, Montgomery Rice V, Brawley OW, Torres MA, Rakha E, Aneja R. First international TNBC conference meeting report. Breast Cancer Res Treat 2018; 169:407-412. [PMID: 29417299 PMCID: PMC5955852 DOI: 10.1007/s10549-018-4692-3] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2018] [Accepted: 01/23/2018] [Indexed: 12/30/2022]
Abstract
Recently, Georgia State University's Centennial Hall was the premier location for the 2017 International Conference on Triple Negative Breast Cancer (TNBC): Illuminating Actionable Biology, which was held from Sept. 18 to 20, 2017, in Atlanta, USA. The conference featured a stellar line-up of domestic and international speakers and diverse participants including TNBC survivors, luminaries in breast cancer research, medical students and fellows, clinicians, translational researchers, epidemiologists, biostatisticians, bioinformaticians, and representatives from the industry. This report distills the burning questions that spiked the event and summarizes key themes, findings, unique opportunities and future directions that emerged from this confluence of thought leaders.
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Affiliation(s)
- Padmashree Rida
- Department of Biology, Georgia State University, Atlanta, GA, USA
- Novazoi Theranostics, Rolling Hills Estates, CA, USA
| | - Angela Ogden
- Department of Biology, Georgia State University, Atlanta, GA, USA
| | - Ian O Ellis
- Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University Hospital Zurich, Zurich, Switzerland
| | - Antonio C Wolff
- The Johns Hopkins Kimmel Comprehensive Cancer Center, Baltimore, MD, USA
| | - Tiffany A Traina
- Breast Medicine Service, Memorial Sloan Kettering Cancer Center, New York, NY, USA
- Weill Cornell Medicine, New York, NY, USA
| | - Christos Hatzis
- Department of Medicine, Breast Medical Oncology, Yale School of Medicine, Yale University, New Haven, CT, USA
| | - Julie R Palmer
- Slone Epidemiology Center, Boston University, Boston, MA, USA
| | - Christine B Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY, USA
| | - Brian D Lehmann
- Department of Biochemistry, Vanderbilt University, Nashville, TN, USA
| | - Rita Nanda
- Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Chicago, IL, USA
| | | | | | - Mylin A Torres
- Department of Radiation Oncology, Emory University, Atlanta, GA, USA
- Glenn Family Breast Center, Winship Cancer Institute, Emory University, Atlanta, GA, USA
| | - Emad Rakha
- Department of Histopathology, Nottingham City Hospital NHS Trust, Nottingham University, Nottingham, UK
| | - Ritu Aneja
- Department of Biology, Georgia State University, Atlanta, GA, USA.
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