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Odumegwu JN, Chavez-Yenter D, Goodman MS, Kaphingst KA. Associations between subjective social status and predictors of interest in genetic testing among women diagnosed with breast cancer at a young age. Cancer Causes Control 2024; 35:1201-1212. [PMID: 38700724 DOI: 10.1007/s10552-024-01878-0] [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] [Received: 02/26/2024] [Accepted: 04/02/2024] [Indexed: 07/24/2024]
Abstract
PURPOSE Genetic testing for gene mutations which elevate risk for breast cancer is particularly important for women diagnosed at a young age. Differences remain in access and utilization to testing across social groups, and research on the predictors of interest in genetic testing for women diagnosed at a young age is limited. METHODS We examined the relationships between subjective social status (SSS) and variables previously identified as possible predictors of genetic testing, including genome sequencing knowledge, genetic worry, cancer worry, health consciousness, decision-making preferences, genetic self-efficacy, genetic-related beliefs, and subjective numeracy, among a cohort of women who were diagnosed with breast cancer at a young age. RESULTS In this sample (n = 1,076), those who had higher SSS had significantly higher knowledge about the limitations of genome sequencing (Odds Ratio (OR) = 1.11; 95% CI = 1.01-1.21) and significantly higher informational norms (OR = 1.93; 95% CI = 1.19-3.14) than those with lower SSS. Similarly, education (OR = 2.75; 95% CI = 1.79-4.22), health status (OR = 2.18; 95% CI = 1.44-3.31) were significant predictors among higher SSS women compared to lower SSS women in our multivariate analysis. Lower SSS women with low self-reported income (OR = 0.13; 95% CI = 0.08-0.20) had lower odds of genetic testing interest. Our results are consistent with some prior research utilizing proxy indicators for socioeconomic status, but our research adds the importance of using a multidimensional indicator such as SSS to examine cancer and genetic testing predictor outcomes. CONCLUSION To develop interventions to improve genetic knowledge, researchers should consider the social status and contexts of women diagnosed with breast cancer at a young age (or before 40 years old) to ensure equity in the distribution of genetic testing benefits.
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Affiliation(s)
- Jonathan N Odumegwu
- Department of Biostatistics, NYU School of Global Public Health, New York, NY, USA
| | - Daniel Chavez-Yenter
- Department of Communication, University of Utah, Salt Lake City, UT, USA.
- Cancer Control & Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA.
| | - Melody S Goodman
- Department of Biostatistics, NYU School of Global Public Health, New York, NY, USA
| | - Kimberly A Kaphingst
- Department of Communication, University of Utah, Salt Lake City, UT, USA
- Cancer Control & Population Sciences, Huntsman Cancer Institute, Salt Lake City, UT, USA
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Wagener R, Walter C, Auer F, Alzoubi D, Hauer J, Fischer U, Varghese J, Dugas M, Borkhardt A, Brozou T. The CHK2 kinase is recurrently mutated and functionally impaired in the germline of pediatric cancer patients. Int J Cancer 2023; 152:1388-1398. [PMID: 36468172 DOI: 10.1002/ijc.34390] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2022] [Revised: 10/25/2022] [Accepted: 11/16/2022] [Indexed: 12/11/2022]
Abstract
Predisposing CHEK2 germline variants are associated with various adult-type malignancies, whereas their impact on cancer susceptibility in childhood cancer is unclear. To understand the frequency of germline variants in the CHEK2 gene and their impact on pediatric malignancies, we used whole-exome sequencing to search for CHEK2 variants in the germlines of 418 children diagnosed with cancer in our clinics. Moreover, we performed functional analysis of the pathogenic CHEK2 variants to analyze the effect of the alterations on CHK2 protein function. We detected a CHEK2 germline variant in 32/418 (7.7%) pediatric cancer patients and 46.8% of them had leukemia. Functional analysis of the pathogenic variants revealed that 5 pathogenic variants impaired CHK2 protein function. 6/32 patients carried one of these clearly damaging CHEK2 variants and two of them harbored a matching family history of cancer. In conclusion, we detected germline CHEK2 variants in 7.7% of all pediatric cancer patients, of which a minority but still relevant fraction of approximately 20% had a profound impact on protein expression or its phosphorylation after irradiation-induced DNA damage. Accordingly, we conclude that CHEK2 variants increase the risk for not only adult-onset but also pediatric cancer.
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Affiliation(s)
- Rabea Wagener
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Carolin Walter
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Franziska Auer
- TUM School of Medicine, Department of Pediatrics, Technical University of Munich, Munchen, Germany
| | - Deya Alzoubi
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
| | - Julia Hauer
- TUM School of Medicine, Department of Pediatrics, Technical University of Munich, Munchen, Germany
| | - Ute Fischer
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Julian Varghese
- Institute of Medical Informatics, University of Münster, Münster, Germany
| | - Martin Dugas
- Institute of Medical Informatics, Heidelberg University Hospital, Heidelberg, Germany
| | - Arndt Borkhardt
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany.,German Cancer Consortium (DKTK), partner site Essen/Düsseldorf, Düsseldorf, Germany
| | - Triantafyllia Brozou
- Department of Pediatric Oncology, Hematology and Clinical Immunology, Medical Faculty, Heinrich Heine University Düsseldorf, Düsseldorf, Germany
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Akakpo PK, Imbeah EG, Edusei L, Naporo S, Ulzen-Appiah K, Clegg-Lamptey JN, Dedey F, Nsaful J, Affram N, Wiafe B, Mensah S, Nortey M, Sheriff M, Amponsah-Manu F, Agbedinu K, Jiagge EM. Clinicopathologic characteristics of early-onset breast cancer: a comparative analysis of cases from across Ghana. BMC Womens Health 2023; 23:5. [PMID: 36597014 PMCID: PMC9808934 DOI: 10.1186/s12905-022-02142-w] [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: 08/17/2022] [Accepted: 12/20/2022] [Indexed: 01/04/2023] Open
Abstract
BACKGROUND Breast cancer is the commonest cancer diagnosed globally and the second leading cause of cancer-related mortality among women younger than 40 years. This study comparatively reviewed the demographic, pathologic and molecular features of Early-Onset Breast Cancer (EOBC) reported in Ghana in relation to Late Onset Breast Cancer (LOBC). METHODS A descriptive, cross-sectional design was used, with purposive sampling of retrospective histopathology data from 2019 to 2021. Reports of core or incision biopsy, Wide Local Excision or Mastectomy with or without axillary lymph node dissection specimen and matched immunohistochemistry reports were merged into a single file and analysed with SPSS v. 20.0. Descriptive statistics of frequencies and percentages were used to describe categorical variables. Cross-tabulation and chi-square test was done at a 95% confidence interval with significance established at p < 0.05. RESULTS A total of 2418 cases were included in the study with 20.2% (488 cases) being EOBCs and 79.8% (1930 cases) being LOBCs. The median age at diagnosis was 34.66 (IQR: 5.55) in the EOBC group (< 40 years) and 54.29 (IQR: 16.86) in the LOBC group (≥ 40 years). Invasive carcinoma-No Special Type was the commonest tumour type with grade III tumours being the commonest in both categories of patients. Perineural invasion was the only statistically significant pathologic parameter with age. EOBC was associated with higher DCIS component (24.8% vs 21.6%), lower hormone-receptor-positive status (52.30% vs 55.70%), higher proliferation index (Ki-67 > 20: 82.40% vs 80.30%) and a higher number of involved lymph nodes (13.80% vs 9.00%). Triple-Negative Breast cancer (26.40% vs 24.30%) was the most predominant molecular subtype of EOBC. CONCLUSION EOBCs in our setting are generally more aggressive with poorer prognostic histopathological and molecular features when compared with LOBCs. A larger study is recommended to identify the association between relevant pathological features and early onset breast cancer in Ghana. Again, further molecular and genetic studies to understand the molecular genetic drivers of the general poorer pathological features of EOBCs and its relation to patient outcome in our setting is needed.
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Affiliation(s)
- Patrick Kafui Akakpo
- grid.413081.f0000 0001 2322 8567Department of Pathology, University of Cape Coast/Cape Coast Teaching Hospital, Cape Coast, Ghana ,ACT Pathology Consult, Pedu Estate, Cape Coast, Ghana ,Pathologists Without Borders Ltd, A585/4 Eduardo Mohdlana St. Laterbiokoshie, Accra, Ghana
| | - Emmanuel Gustav Imbeah
- ACT Pathology Consult, Pedu Estate, Cape Coast, Ghana ,Pathologists Without Borders Ltd, A585/4 Eduardo Mohdlana St. Laterbiokoshie, Accra, Ghana
| | - Lawrence Edusei
- Pathologists Without Borders Ltd, A585/4 Eduardo Mohdlana St. Laterbiokoshie, Accra, Ghana
| | - Simon Naporo
- Pathologists Without Borders Ltd, A585/4 Eduardo Mohdlana St. Laterbiokoshie, Accra, Ghana
| | - Kofi Ulzen-Appiah
- grid.413081.f0000 0001 2322 8567Department of Pathology, University of Cape Coast/Cape Coast Teaching Hospital, Cape Coast, Ghana ,ACT Pathology Consult, Pedu Estate, Cape Coast, Ghana
| | - Joe Nat Clegg-Lamptey
- grid.8652.90000 0004 1937 1485Department of Surgery, University of Ghana Medical School/Korle Bu Teaching Hospital Accra, Accra, Ghana
| | - Florence Dedey
- grid.8652.90000 0004 1937 1485Department of Surgery, University of Ghana Medical School/Korle Bu Teaching Hospital Accra, Accra, Ghana
| | - Josephine Nsaful
- grid.8652.90000 0004 1937 1485Department of Surgery, University of Ghana Medical School/Korle Bu Teaching Hospital Accra, Accra, Ghana
| | - Nelson Affram
- Department of Surgery, Ho Teaching Hospital, Ho, Ghana
| | | | - Samuel Mensah
- grid.9829.a0000000109466120Department of Surgery, School of Medicine and Dentistry, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - Michael Nortey
- grid.413081.f0000 0001 2322 8567Department of Surgery, University of Cape Coast / Cape Coast Teaching Hospital, Cape Coast, Ghana
| | - Mohammed Sheriff
- grid.460777.50000 0004 0374 4427Department of Surgery, Tamale Teaching Hospital, Tamale, Ghana
| | | | - Kwabena Agbedinu
- grid.415450.10000 0004 0466 0719Department of Surgery, Komfo-Anokye Teaching Hospital, Kumasi, Ghana
| | - Evelyn Mawunyo Jiagge
- grid.446722.10000 0004 0635 5208Henry Ford Cancer Institute/Henry Ford Health System, 2799W Grand Blvd, Detroit, MI USA
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Zhang X. Molecular Classification of Breast Cancer: Relevance and Challenges. Arch Pathol Lab Med 2023; 147:46-51. [PMID: 36136295 DOI: 10.5858/arpa.2022-0070-ra] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/04/2022] [Indexed: 12/31/2022]
Abstract
CONTEXT.— Appropriate patient management requires precise and meaningful tumor classification. Breast cancer classification continues to evolve from traditional morphologic evaluation to more sophisticated systems with the integration of new knowledge from research being translated into practice. Breast cancer is heterogeneous at the molecular level, with diversified patterns of gene expression, which is presumably responsible for the difference in tumor behavior and prognosis. Since the beginning of this century, new molecular technology has been gradually applied to breast cancer research on issues pertinent to prognosis (prognostic signature) and therapeutic prediction (predictive signature), and much progress has been made. OBJECTIVE.— To summarize the current state and the prospective future of molecular classification of breast cancer. DATA SOURCES.— Sources include recent medical literature on molecular classification of breast cancer. CONCLUSIONS.— Identification of intrinsic tumor subtypes has set a foundation for refining the breast cancer molecular classification. Studies have explored the genetic features within the intrinsic cancer subtypes and have identified novel molecular targets that led to the innovation of clinical assays to predict a patient's prognosis and to provide specific guidelines for therapeutic decisions. With the development and implication of these molecular tools, we have remarkably advanced our knowledge and enhanced our power to provide optimal management to patients. However, challenges still exist. Besides accurate prediction of prognosis, we are still in urgent need of more molecular predictors for tumor response to therapeutic regimes. Further exploration along this path will be critical for improving a patient's prognosis.
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Affiliation(s)
- Xinmin Zhang
- From the Department of Pathology, Cooper University Hospital, Cooper Medical School of Rowan University, Camden, New Jersey
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Next-Generation Sequencing in Lung Cancer Patients: A Comparative Approach in NSCLC and SCLC Mutational Landscapes. J Pers Med 2022; 12:jpm12030453. [PMID: 35330454 PMCID: PMC8955273 DOI: 10.3390/jpm12030453] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2022] [Revised: 03/09/2022] [Accepted: 03/11/2022] [Indexed: 02/04/2023] Open
Abstract
Background: Lung cancer remains one of the most diagnosed malignancies, being the second most diagnosed cancer, while still being the leading cause of cancer-related deaths. Late diagnosis remains a problem, alongside the high mutational burden encountered in lung cancer. Methods: We assessed the genetic profile of cancer genes in lung cancer using The Cancer Genome Atlas (TCGA) datasets for mutations and validated the results in a separate cohort of 32 lung cancer patients using tumor tissue and whole blood samples for next-generation sequencing (NGS) experiments. Another separate cohort of 32 patients was analyzed to validate some of the molecular alterations depicted in the NGS experiment. Results: In the TCGA analysis, we identified the most commonly mutated genes in each lung cancer dataset, with differences among the three histotypes analyzed. NGS analysis revealed TP53, CSF1R, PIK3CA, FLT3, ERBB4, and KDR as being the genes most frequently mutated. We validated the c.1621A>C mutation in KIT. The correlation analysis indicated negative correlation between adenocarcinoma and altered PIK3CA (r = −0.50918; p = 0.0029). TCGA survival analysis indicated that NRAS and IDH2 (LUAD), STK11 and TP53 (LUSC), and T53 (SCLC) alterations are correlated with the survival of patients. Conclusions: The study revealed differences in the mutational landscape of lung cancer histotypes.
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