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Van Baelen K, Geukens T, Maetens M, Tjan-Heijnen V, Lord CJ, Linn S, Bidard FC, Richard F, Yang WW, Steele RE, Pettitt SJ, Van Ongeval C, De Schepper M, Isnaldi E, Nevelsteen I, Smeets A, Punie K, Voorwerk L, Wildiers H, Floris G, Vincent Salomon A, Derksen PWB, Neven P, Senkus E, Sawyer E, Kok M, Desmedt C. Corrigendum to "Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer": [Annals of Oncology 33 (2022) 769-785]. Ann Oncol 2023; 34:326. [PMID: 36529568 DOI: 10.1016/j.annonc.2022.11.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Affiliation(s)
- K Van Baelen
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven; Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - T Geukens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven; Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - M Maetens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven
| | - V Tjan-Heijnen
- Department of Medical Oncology Department, Maastricht University Medical Center (MUMC), School of GROW, Maastricht, The Netherlands
| | - C J Lord
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S Linn
- Department of Pathology, University Medical Center Utrecht, Utrecht; Department of Medical Oncology, Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F-C Bidard
- Department of Medical Oncology, Institut Curie, UVSQ/Paris-Saclav University, Paris, France
| | - F Richard
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven
| | - W W Yang
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - R E Steele
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S J Pettitt
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | | | - M De Schepper
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven; Department of Pathology, UZ Leuven, Leuven, Belgium
| | - E Isnaldi
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven
| | - I Nevelsteen
- Department of Surgical Oncology, UZ Leuven, Leuven, Belgium
| | - A Smeets
- Department of Surgical Oncology, UZ Leuven, Leuven, Belgium
| | - K Punie
- Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - L Voorwerk
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H Wildiers
- Department of General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - G Floris
- Department of Pathology, UZ Leuven, Leuven, Belgium
| | | | - P W B Derksen
- Department of Pathology, University Medical Center Utrecht, Utrecht
| | - P Neven
- Department of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - E Sawyer
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, Guy's Cancer Centre, King's College London, London, UK
| | - M Kok
- Department of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Department of Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Desmedt
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven.
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Van Baelen K, Geukens T, Maetens M, Tjan-Heijnen V, Lord CJ, Linn S, Bidard FC, Richard F, Yang WW, Steele RE, Pettitt SJ, Van Ongeval C, De Schepper M, Isnaldi E, Nevelsteen I, Smeets A, Punie K, Voorwerk L, Wildiers H, Floris G, Vincent-Salomon A, Derksen PWB, Neven P, Senkus E, Sawyer E, Kok M, Desmedt C. Current and future diagnostic and treatment strategies for patients with invasive lobular breast cancer. Ann Oncol 2022; 33:769-785. [PMID: 35605746 DOI: 10.1016/j.annonc.2022.05.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 12.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 05/06/2022] [Accepted: 05/17/2022] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Invasive lobular breast cancer (ILC) is the second most common type of breast cancer after invasive breast cancer of no special type (NST), representing up to 15% of all breast cancers. DESIGN Latest data on ILC are presented, focusing on diagnosis, molecular make-up according to the European Society for Medical Oncology Scale for Clinical Actionability of molecular Targets (ESCAT) guidelines, treatment in the early and metastatic setting and ILC-focused clinical trials. RESULTS At the imaging level, magnetic resonance imaging-based and novel positron emission tomography/computed tomography-based techniques can overcome the limitations of currently used imaging techniques for diagnosing ILC. At the pathology level, E-cadherin immunohistochemistry could help improving inter-pathologist agreement. The majority of patients with ILC do not seem to benefit as much from (neo-)adjuvant chemotherapy as patients with NST, although chemotherapy might be required in a subset of high-risk patients. No differences in treatment efficacy are seen for anti-human epidermal growth factor receptor 2 (HER2) therapies in the adjuvant setting and cyclin-dependent kinases 4 and 6 inhibitors in the metastatic setting. The clinical utility of the commercially available prognostic gene expression-based tests is unclear for patients with ILC. Several ESCAT alterations differ in frequency between ILC and NST. Germline BRCA1 and PALB2 alterations are less frequent in patients with ILC, while germline CDH1 (gene coding for E-cadherin) alterations are more frequent in patients with ILC. Somatic HER2 mutations are more frequent in ILC, especially in metastases (15% ILC versus 5% NST). A high tumour mutational burden, relevant for immune checkpoint inhibition, is more frequent in ILC metastases (16%) than in NST metastases (5%). Tumours with somatic inactivating CDH1 mutations may be vulnerable for treatment with ROS1 inhibitors, a concept currently investigated in early and metastatic ILC. CONCLUSION ILC is a unique malignancy based on its pathological and biological features leading to differences in diagnosis as well as in treatment response, resistance and targets as compared to NST.
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Affiliation(s)
- K Van Baelen
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; Departments of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - T Geukens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - M Maetens
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | - V Tjan-Heijnen
- Medical Oncology Department, Maastricht University Medical Center (MUMC), School of GROW, Maastricht, The Netherlands
| | - C J Lord
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S Linn
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands; Departments of Medical Oncology, Amsterdam, The Netherlands; Molecular Pathology, Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - F-C Bidard
- Department of Medical Oncology, Institut Curie, UVSQ/Paris-Saclav University, Paris, France
| | - F Richard
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | - W W Yang
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - R E Steele
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - S J Pettitt
- The CRUK Gene Function Laboratory and Breast Cancer Now Toby Robins Research Centre, The Institute of Cancer Research, London, UK
| | - C Van Ongeval
- Departments of Radiology, UZ Leuven, Leuven, Belgium
| | - M De Schepper
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium; Pathology, UZ Leuven, Leuven, Belgium
| | - E Isnaldi
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium
| | | | - A Smeets
- Surgical Oncology, UZ Leuven, Leuven, Belgium
| | - K Punie
- General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - L Voorwerk
- Departments of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - H Wildiers
- General Medical Oncology, UZ Leuven, Leuven, Belgium
| | - G Floris
- Pathology, UZ Leuven, Leuven, Belgium
| | | | - P W B Derksen
- Department of Pathology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - P Neven
- Departments of Gynaecology and Obstetrics, UZ Leuven, Leuven, Belgium
| | - E Senkus
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - E Sawyer
- School of Cancer and Pharmaceutical Sciences, Faculty of Life Sciences and Medicine, Guy's Cancer Centre, King's College London, London, UK
| | - M Kok
- Departments of Medical Oncology, The Netherlands Cancer Institute, Amsterdam, The Netherlands; Tumour Biology and Immunology, The Netherlands Cancer Institute, Amsterdam, The Netherlands
| | - C Desmedt
- Laboratory for Translational Breast Cancer Research (LTBCR), Department of Oncology, KU Leuven, Leuven, Belgium.
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Wheatley D, Haviland J, Patel J, Sydenham M, Alhasso A, Chan C, Cleator S, Coles C, Donovan E, Kirby A, Kirwan C, Nabi Z, Sawyer E, Somaiah N, Syndikus I, Venables K, Yarnold J, Brunt A, Bliss J. OC-0101 First results of FAST-Forward phase 3 RCT nodal substudy: 3-year normal tissue effects. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02477-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Dolly S, Russell B, Moss C, Tsotra E, Gousis C, Roca J, Sita-Lumsden A, Khan M, Josephs D, Zaki K, Smith D, Michalarea V, Kristeleit R, Enting D, Flanders L, Lei M, Sawyer E, Spicer J, Ross P, Montes A, Van Hemelrijick M. 1608P The impact of COVID-19 on the delivery of systemic anti-cancer treatment at Guy’s Cancer Centre. Ann Oncol 2021. [PMCID: PMC8454366 DOI: 10.1016/j.annonc.2021.08.1601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/01/2022] Open
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Coles C, Haviland J, Kirby A, Bhattacharya I, Brunt A, Chan C, Donovan E, Eaton D, Griffin C, Hopwood P, Jefford M, Lightowlers S, Rajapakse C, Sawyer E, Stones L, Syndikus I, Titley J, Tsang Y, Twyman N, Bliss J, Yarnold J. OC-0291 IMPORT HIGH trial: Dose escalated simultaneous integrated boost radiotherapy in early breast cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06840-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Hanumanthappa N, Goldsmith C, Sawyer E, Tutt A, Castell F, Azad G, Mullassery V, Ahmad S, Timbres J, Mera A, Swampillai A, Smith D. Adjuvant Breast Radiotherapy at an Academic Centre during the COVID-19 Pandemic: Reassuringly Safe. Clin Oncol (R Coll Radiol) 2021; 33:e221. [PMID: 33388225 PMCID: PMC7833576 DOI: 10.1016/j.clon.2020.12.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2020] [Revised: 12/12/2020] [Accepted: 12/17/2020] [Indexed: 11/27/2022]
Affiliation(s)
- N Hanumanthappa
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - C Goldsmith
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - E Sawyer
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - A Tutt
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - F Castell
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - G Azad
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - V Mullassery
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - S Ahmad
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - J Timbres
- Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - A Mera
- Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - A Swampillai
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
| | - D Smith
- Department of Clinical Oncology, Guy's Cancer Centre, Guy's & St Thomas' NHS Foundation Trust, London, UK
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Brunt A, Haviland J, Wheatley D, Sydenham M, Alhasso A, Bloomfield D, Chan C, Churn M, Cleator S, Coles C, Emson M, Goodman A, Harnett A, Hopwood P, Kirby A, Kirwan C, Morris C, Nabi Z, Sawyer E, Somaiah N, Stones L, Syndikus I, Wilcox M, Bliss J, Yarnold J. OC-0610: FAST-Forward phase 3 RCT of 1-week hypofractionated breast radiotherapy: 5-year results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00632-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Howlett S, Harvey-Jones E, Smith D, Ahmad S, Goldsmith C, Sawyer E, Castell F, Swampillai A, Mullassery V. Does Concurrent Use of CDK4/6 Inhibitors During Palliative Radiotherapy Increase Toxicity in Patients With Metastatic Breast Cancer? Clin Oncol (R Coll Radiol) 2020; 33:e99. [PMID: 33092944 DOI: 10.1016/j.clon.2020.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2020] [Accepted: 10/06/2020] [Indexed: 12/15/2022]
Affiliation(s)
- S Howlett
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - E Harvey-Jones
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - D Smith
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - S Ahmad
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - C Goldsmith
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - E Sawyer
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - F Castell
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - A Swampillai
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
| | - V Mullassery
- Department of Clinical Oncology, Guy's Cancer Centre, London, UK
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Moss C, Haire A, Cahill F, Enting D, Hughes S, Smith D, Sawyer E, Davies A, Zylstra J, Haire K, Rigg A, Van Hemelrijck M. Guy's cancer cohort - real world evidence for cancer pathways. BMC Cancer 2020; 20:187. [PMID: 32178645 PMCID: PMC7077127 DOI: 10.1186/s12885-020-6667-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2019] [Accepted: 02/21/2020] [Indexed: 12/15/2022] Open
Abstract
Background The burden of disease due to cancer remains substantial. Since the value of real-world evidence has also been recognised by regulatory agencies, we established a Research Ethics Committee (REC) approved research database for cancer patients (Reference: 18/NW/0297). Construction and content Guy’s Cancer Cohort introduces the concept of opt-out consent processes for research in a subset of oncology patients diagnosed and treated at a large NHS Trust in the UK. From April 2016 until March 2017, 1388 eligible patients visited Guy’s and St Thomas’ NHS Foundation Trust (GSTT) for breast cancer management. For urological cancers this number was 1757 and for lung cancer 677. The Cohort consists of a large repository of routinely collected clinical data recorded both retrospectively and prospectively. The database contains detailed clinical information collected at various timepoints across the treatment pathway inclusive of diagnostic data, and data on disease progression, recurrence and survival. Conclusions Guy’s Cancer Cohort provides a valuable infrastructure to answer a wide variety of research questions of a clinical, mechanistic, and supportive care nature. Clinical research using this database will result in improved patient safety and experience. Guy’s Cancer Cohort promotes collaborative research and will accept applications for the release of anonymised datasets for research purposes.
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Affiliation(s)
- C Moss
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.
| | - A Haire
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - F Cahill
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
| | - D Enting
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - S Hughes
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK.,Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - D Smith
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - E Sawyer
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Davies
- Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - J Zylstra
- Department of Upper Gastrointestinal Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - K Haire
- South East London (SEL) Accountable Cancer Network, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - A Rigg
- Comprehensive Cancer Centre, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - M Van Hemelrijck
- King's College London, School of Cancer and Pharmaceutical Sciences, Translational Oncology and Urology Research (TOUR), Guy's Hospital, 3rd Floor Bermondsey Wing, London, SE1 9RT, UK
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Tong D, Nintos G, Sarker D, Mansi J, Sawyer E. Experience of Next-generation Somatic Mutation Testing in Advanced Breast Cancer at Guy's Cancer Centre. Clin Oncol (R Coll Radiol) 2019. [DOI: 10.1016/j.clon.2019.03.038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Masannat Y, Husain E, Roylance R, Heys S, Carder P, Ali H, Maurice Y, Pinder S, Sawyer E, Shaaban A. Pleomorphic LCIS what do we know? A UK multicenter audit of pleomorphic lobular carcinoma in situ. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.071] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Copson E, Shaaban AM, Maishman T, Moseley PM, McKenzie H, Bradbury J, Borley A, Brzezinska M, Chan SYT, Ching J, Cutress RI, Danial I, Dall B, Kerin M, Lowery AJ, Macpherson IR, Romics L, Sawyer E, Sharmat N, Sircar T, Vidya R, Pan Y, Rea D, Jones L, Eccles DM, Berditchevski F. The presentation, management and outcome of inflammatory breast cancer cases in the UK: Data from a multi-centre retrospective review. Breast 2018; 42:133-141. [PMID: 30278369 DOI: 10.1016/j.breast.2018.09.003] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2018] [Revised: 08/22/2018] [Accepted: 09/10/2018] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVES Inflammatory Breast cancer (IBC) is a rare but aggressive form of breast cancer. Its incidence and behaviour in the UK is poorly characterised. We collected retrospective data from hospitals in the UK and Ireland to describe the presentation, pathology, treatment and clinical course of IBC in the UK. MATERIALS AND METHODS Patients with IBC diagnosed between 1997-2014 at fourteen UK and Irish hospitals were identified from local breast unit databases. Patient characteristics, tumour pathology and stage, and details of surgical, systemic and radiotherapy treatment and follow-up data were collected from electronic patient records and medical notes. RESULT This retrospective review identified 445 patients with IBC accounting for 0.4-1.8% of invasive breast cancer cases. Median follow-up was 4.2 years. 53.2% of tumours were grade 3, 56.2% were oestrogen receptor positive, 31.3% were HER2 positive and 25.1% were triple negative. 20.7% of patients had distant metastases at presentation. Despite trimodality treatment in 86.4%, 40.1% of stage III patients developed distant metastases. Five-year overall survival (OS) was 61.0% for stage III and 21.4% for stage IV patients. CONCLUSIONS This is the largest series of UK IBC patients reported to date. It indicates a lower incidence than in American series, but confirms that IBC has a high risk of recurrence with poor survival despite contemporary multi-modality therapy. A national strategy is required to facilitate translational research into this aggressive disease.
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Affiliation(s)
- E Copson
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK.
| | - A M Shaaban
- Department of Histopathology and University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW, UK
| | - T Maishman
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - P M Moseley
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - H McKenzie
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - J Bradbury
- Department of Oncology, Salisbury NHS Foundation Trust, Salisbury District Hospital, Odstock Road, Salisbury, Wiltshire, SP2 8BJ, UK
| | - A Borley
- Velindre Cancer Centre, Whitchurch, Cardiff, CF14 2TL, UK
| | - M Brzezinska
- Edinburgh Breast Unit, Western General Hospital, Edinburgh, Crewe Road South Edinburgh, EH4 2XU, UK
| | - S Y T Chan
- Clinical Oncology Department, Nottingham University Hospitals NHS Trust, Nottingham, NG5 1PB, UK
| | - J Ching
- Poole Hospital NHS Foundation Trust, Longfleet Road, Poole, BH15 2JB, UK
| | - R I Cutress
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - I Danial
- Department of Histopathology and University of Birmingham, University Hospitals Birmingham NHS Foundation Trust, Queen Elizabeth Hospital Birmingham, Mindelsohn Way, Edgbaston, Birmingham, B152GW, UK
| | - B Dall
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Leeds Teaching Hospitals NHS Trust, Becket Street, Leeds, LS9 7TF, UK
| | - M Kerin
- The Lambe Institute for Translational Research, National University of Ireland & University Hospital Galway, Galway, Ireland
| | - A J Lowery
- The Lambe Institute for Translational Research, National University of Ireland & University Hospital Galway, Galway, Ireland
| | - I R Macpherson
- Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, G61 1QH, UK
| | - L Romics
- Wolfson Wohl Cancer Research Centre, University of Glasgow, Glasgow, G61 1QH, UK
| | - E Sawyer
- Research Oncology, Division of Cancer Studies, Guy's Hospital, King's College London, London, SE1 9RT, UK
| | - N Sharmat
- Breast Unit, Level 1 Chancellor Wing, St James Hospital, Leeds Teaching Hospitals NHS Trust, Becket Street, Leeds, LS9 7TF, UK
| | - T Sircar
- Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
| | - R Vidya
- Royal Wolverhampton NHS Trust, New Cross Hospital, Wolverhampton Road, Wolverhampton, WV10 0QP, UK
| | - Y Pan
- Centre for Computational Biology, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK; Institute of Immunology and Immunotherapy, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - D Rea
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
| | - L Jones
- Barts NHS Trust and Barts Cancer Institute, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, Charterhouse Square, London, EC1M 6BQ, UK
| | - D M Eccles
- Cancer Sciences Academic Unit and Southampton Clinical Trials Unit, University of Southampton, Southampton General Hospital, Tremona Road, Southampton, UK
| | - F Berditchevski
- Institute of Cancer and Genomic Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK
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Sarkodie T, Sawyer E. Loco-regional Recurrence After 3-field Breast Radiotherapy. Clin Oncol (R Coll Radiol) 2018. [DOI: 10.1016/j.clon.2018.02.020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Nimalasena S, Gothard L, Kothari G, Allen S, Sinnett V, Musallam A, Kirby A, Ross G, Lucy C, Castell F, Cleator S, Locke I, Sawyer E, Tait D, Westbury C, Wolstenholme V, Box C, Robinson S, Yarnold J, Somaiah N. EP-1315: KORTUC phase I/II trial testing a novel radiation sensitiser in breast cancer: preliminary results. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)31625-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Brunt A, Haviland J, Sydenham M, Al-hasso A, Bloomfield D, Chan C, Churn M, Cleator S, Coles C, Emson M, Goodman A, Griffin C, Harnett A, Hopwood P, Kirby A, Kirwan C, Morris C, Sawyer E, Somaiah N, Syndikus I, Wilcox M, Zotova R, Wheatley D, Bliss J, Yarnold J. OC-0595: FAST-Forward phase 3 RCT of 1-week hypofractionated breast radiotherapy:3-year normal tissue effects. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30905-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Thompson AM, Clements K, Cheung S, Pinder SE, Lawrence G, Sawyer E, Kearins O, Ball GR, Tomlinson I, Hanby AM, Thomas J, Maxwell AJ, Wallis MG, Dodwell DJ. Abstract P4-15-02: Impact of radiotherapy and endocrine therapy on further events: Final multivariate analysis of a prospective, national cohort study of screen detected ductal carcinoma in situ (DCIS) of the breast. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p4-15-02] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Key words: DCIS, radiotherapy, endocrine therapy, survival, surgical margins
Background:
The benefits and risks of breast screening remain controversial, with particular concern that ductal carcinoma in situ (DCIS) may be over-diagnosed and over-treated. There is little prospective data on treatment or outcomes for screen detected DCIS.
Methods:
A prospective cohort of non-invasive lesions diagnosed through the United Kingdom National Health Service Breast Screening Programme (NHSBSP) (1 April 2003 to 31 March 2012) was linked to national databases and case note review to analyse patterns of care, recurrence and mortality.
Results:
Screen-detected DCIS in 9938 women was analysed, 33% (9938/30041) of women with a final diagnosis of non-invasive breast neoplasia diagnosed through the NHSBSP over the same time.
The patients (mean age was 60 years: range 46-87 years) were treated by breast conservation surgery (BCS; 7007; 70.5%) or mastectomy (2931). At 64 months median follow up, 697 (6.8%) had further DCIS or invasive breast cancer after BCS (7.8%) or mastectomy (4.5%) (p<0.001) and 228 women (2.3%) developed contralateral malignancy.
Breast radiotherapy (RT) after BCS (4363/7007; 62%) was associated with a 3.1% absolute reduction in any ipsilateral DCIS or invasive cancer (No RT: 7.2% vs RT: 4.1% (p<0.001) and a 1.9% absolute reduction for ipsilateral invasive breast recurrence (No RT: 3.8% vs RT: 1.9% (p<0.001), independent of excision margin width or size of DCIS. Women who did not receive RT after BCS had more ipsilateral events (p=0.008) when the radial excision margin was <2mm. RT was rarely used after mastectomy for DCIS (33 women). Adjuvant endocrine therapy (prescribed for 1208/9938; 12.2%) was associated with a reduction in any ipsilateral recurrence, independent of whether women did (HR 0.57: 95% CI 0.41 - 0.80) or did not (HR 0.68: 95% CI 0.51 - 0.91) receive RT after BCS.
Among 321 (3.2%) women who died, 46 deaths (0.5%; 14.3% of all deaths) were attributed to invasive breast cancer. Death from breast cancer was uncommon and outnumbered 5:1 by death due to other causes. RT after BCS was associated with a non-significant 0.2% absolute reduction in breast cancer mortality. However, women who developed invasive breast cancer had a worse survival than those with further DCIS (p<0.001).
Conclusions:
Recurrent DCIS or invasive cancer is uncommon following screen detected DCIS treated by surgery and adjuvant therapy. Both RT and endocrine therapy following surgery were associated with a significant reduction in further DCIS and invasive disease, but not breast cancer mortality, within 5 years of diagnosis. This study quantifies the benefits of radiotherapy and endocrine therapy to inform decision making in the management of screen detected DCIS.
Citation Format: Thompson AM, Clements K, Cheung S, Pinder SE, Lawrence G, Sawyer E, Kearins O, Ball GR, Tomlinson I, Hanby AM, Thomas J, Maxwell AJ, Wallis MG, Dodwell DJ. Impact of radiotherapy and endocrine therapy on further events: Final multivariate analysis of a prospective, national cohort study of screen detected ductal carcinoma in situ (DCIS) of the breast [abstract]. In: Proceedings of the 2017 San Antonio Breast Cancer Symposium; 2017 Dec 5-9; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2018;78(4 Suppl):Abstract nr P4-15-02.
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Affiliation(s)
- AM Thompson
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - K Clements
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - S Cheung
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - SE Pinder
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - G Lawrence
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - E Sawyer
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - O Kearins
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - GR Ball
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - I Tomlinson
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - AM Hanby
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - J Thomas
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - AJ Maxwell
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - MG Wallis
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
| | - DJ Dodwell
- The University of Texas MD Anderson Cancer Center, Houston, TX; Public Health England; Guy's Hospital; Nottingham Trent University, Nottingham, United Kingdom; Oxford NIHR Comprehensive Biomedical Research Centre, Oxford, United Kingdom; St James Hospital, Leeds, United Kingdom; Western General Hospital, Edinburgh, United Kingdom; University of Manchester, Manchester, United Kingdom; Cambridge University Hospitals, Cambridge, United Kingdom; University of Oxford, Oxford, United Kingdom
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Jurkovic D, Memtsa M, Sawyer E, Donaldson ANA, Jamil A, Schramm K, Sana Y, Otify M, Farahani L, Nunes N, Ambler G, Ross JA. Single-dose systemic methotrexate vs expectant management for treatment of tubal ectopic pregnancy: a placebo-controlled randomized trial. Ultrasound Obstet Gynecol 2017; 49:171-176. [PMID: 27731538 DOI: 10.1002/uog.17329] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/10/2016] [Revised: 10/04/2016] [Accepted: 10/05/2016] [Indexed: 06/06/2023]
Abstract
OBJECTIVE Methotrexate is used routinely worldwide for the medical treatment of clinically stable women with a tubal ectopic pregnancy. This is despite the lack of robust evidence to show its superior effectiveness over expectant management. The aim of our multicenter randomized controlled trial was to compare success rates of methotrexate against placebo for the conservative treatment of tubal ectopic pregnancy. METHODS This study took place in two early-pregnancy units in the UK between August 2005 and June 2014. Inclusion criteria were clinically stable women with a conclusive ultrasound diagnosis of a tubal ectopic pregnancy, presenting with a low serum beta human chorionic gonadotropin (β-hCG) level of < 1500 IU/L. Women were assigned randomly to a single systemic injection of either 50 mg/m2 methotrexate or placebo. The primary outcome was a binary indicator for success of conservative management, defined as resolution of clinical symptoms and decline of serum β-hCG to < 20 IU/L or a negative urine pregnancy test without the need for any additional medical intervention. An intention-to-treat analysis was followed. RESULTS We recruited a total of 80 women, 42 of whom were assigned to methotrexate and 38 to placebo. The arms of the study were matched in terms of age, ethnicity, obstetric history, pregnancy characteristics and serum levels of β-hCG and progesterone. The rates of success were similar for the two study arms: 83% with methotrexate and 76% with placebo. On univariate analysis, this difference was not statistically significant (χ2 (1 degree of freedom) = 0.53; P = 0.47). On multivariate logistic regression, the serum level of β-hCG was the only covariate found to be significantly associated with outcome. The odds of failure increased by 0.15% for each unit increase in β-hCG (odds ratio, 1.0015 (95% CI, 1.0002-1.003); P = 0.02). In 14 women presenting with serum β-hCG of 1000-1500 IU/L, the success rate was 33% in those managed expectantly compared with 62% in those receiving methotrexate. This difference was not statistically significant and a larger sample size would be needed to give sufficient power to detect a difference in the subgroup of women with higher β-hCG. In women with successful conservative treatment, there was no significant difference in median β-hCG resolution times between study arms (17.5 (interquartile range (IQR), 14-28.0) days (n = 30) in the methotrexate group vs 14 (IQR, 7-29.5) days (n = 25) in the placebo group; P = 0.73). CONCLUSIONS The results of our study do not support the routine use of methotrexate for the treatment of clinically stable women diagnosed with tubal ectopic pregnancy presenting with low serum β-hCG (< 1500 IU/L). Further work is required to identify a subgroup of women with tubal ectopic pregnancy and β-hCG ≥ 1500 IU/L in whom methotrexate may offer a safe and cost-effective alternative to surgery. Copyright © 2016 ISUOG. Published by John Wiley & Sons Ltd. Comparación entre una sola dosis de metotrexate sistémico y la conducta expectante en el tratamiento de casos de embarazo ectópico tubárico: un ensayo aleatorio controlado con placebo RESUMEN OBJETIVO: El metotrexate se utiliza de modo rutinario en todo el mundo para el tratamiento de las mujeres clínicamente estables con un embarazo ectópico tubárico. Esto sucede a pesar de la falta de evidencia rigurosa que demuestre que su eficacia es superior a la conducta expectante. El objetivo de este ensayo controlado aleatorio multicéntrico fue comparar las tasas de éxito del metotrexate con las de un placebo para el tratamiento cauteloso del embarazo ectópico tubárico. MÉTODOS: Este estudio se llevó a cabo en dos clínicas de control de gestación temprana en el Reino Unido entre agosto de 2005 y junio de 2014. Los criterios de inclusión fueron mujeres clínicamente estables con un diagnóstico ecográfico concluyente de embarazo ectópico tubárico, las cuáles presentaban una concentración sérica baja de la β hormona coriónica gonadotrópica (β-hCG) inferior a 1500 UI/L. Las mujeres fueron asignadas aleatoriamente a una sola inyección sistémica de 50 mg/m2 de metotrexate o a placebo. El resultado primario fue un indicador binario del éxito del tratamiento conservador, definido como la resolución de los síntomas clínicos y la disminución en el suero de la β-hCG a <20 UI/L o una prueba de embarazo negativa en orina sin la necesidad de ninguna intervención médica adicional. Se hizo un análisis por intención de tratar. RESULTADOS Se reclutó un total de 80 mujeres; a 42 de ellas se les asignó el metotrexate y a 38 el placebo. Los grupos del estudio se realizaron en función de la edad, el origen étnico, los antecedentes obstétricos, las características del embarazo y los niveles séricos de la β-hCG y la progesterona. Las tasas de éxito fueron similares para los dos grupos de estudio: 83% con metotrexate y 76% con placebo. En el análisis univariante, esta diferencia no fue estadísticamente significativa (χ2 (1 grado de libertad) = 0,53; P = 0,47). En la regresión logística multivariante, el nivel sérico de la β-hCG fue la única covariable que se encontró significativamente asociada con el resultado. Las probabilidades de fracaso aumentaron en un 0,15% por cada unidad de aumento de la β-hCG (cociente de probabilidad 1,0015 (IC 95%, 1,0002-1,003); P = 0,02). La tasa de éxito en las 14 mujeres con un nivel sérico de la β-hCG de 1000-1500 UI/L fue del 33% en las tratadas con conducta expectante frente al 62% en las que recibieron metotrexate. Esta diferencia no fue estadísticamente significativa, por lo que se necesitaría un tamaño de muestra mayor, lo suficiente como para poder detectar diferencias en el subgrupo de mujeres con una β-hCG más elevada. En las mujeres en las que el tratamiento conservador tuvo éxito, no hubo una diferencia significativa en la mediana de los tiempos de resolución de la ß-hCG entre los grupos del estudio (17,5 (amplitud intercuartílica (IQR), 14-28,0) días (n = 30) en el grupo de metotrexate frente a 14 (IQR, 7-29.5) días (n = 25) en el grupo de placebo; P = 0,73). CONCLUSIONES Los resultados de este estudio no apoyan el uso rutinario de metotrexate para el tratamiento de las mujeres clínicamente estables diagnosticadas con un embarazo ectópico tubárico que presenta un nivel sérico bajo la β-hCG (<1500 UI/L). Serán necesarios estudios adicionales para identificar un subgrupo de mujeres con embarazo ectópico tubárico y β-hCG ≥1500 UI/L para quienes el metotrexate puede ofrecer una alternativa segura y rentable en comparación con la cirugía. : : ,,。。 : 2005820146,2。,,β(beta human chorionic gonadotropin,β-hCG)<1500 IU/L。,(50 mg/m2 )。,β-hCG<20 IU/L,。。 : 80,42,38。2、、、β-hCG。2:83%,76%。,[χ2 (1)=0.53;P=0.47]。logistic,β-hCG。β-hCG,0.15%[,1.0015(95% CI,1.0002~1.003);P=0.02]。14β-hCG1000~1500 IU/L,33%,62%。,β-hCG。,2β-hCG(P=0.73),17.5[(interquartile range,IQR),14~28.0](n=30),14 (IQR,7~29.5)(n=25)。 : 、、β-hCG(<1500 IU/L)。,β-hCG>1500 IU/L、。.
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Affiliation(s)
- D Jurkovic
- Institute for Women's Health, University College Hospital, London, UK
| | - M Memtsa
- Institute for Women's Health, University College Hospital, London, UK
| | - E Sawyer
- Early Pregnancy Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
| | - A N A Donaldson
- Applied Mathematics & Statistics Department, State University of New York, Stony Brook, NY, USA
| | - A Jamil
- Institute for Women's Health, University College Hospital, London, UK
| | - K Schramm
- Early Pregnancy Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
| | - Y Sana
- Early Pregnancy Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
| | - M Otify
- Early Pregnancy Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
| | - L Farahani
- Institute for Women's Health, University College Hospital, London, UK
| | - N Nunes
- Institute for Women's Health, University College Hospital, London, UK
| | - G Ambler
- Department of Statistical Science, University College London, London, UK
| | - J A Ross
- Early Pregnancy Unit, Department of Obstetrics and Gynaecology, King's College Hospital, London, UK
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Ep Chaabouni NK, Ruggles N, Petridis C, Pinder S, Roylance R, Sawyer E. Recurrence Data on 373 Cases of Lobular Carcinoma in Situ (LCIS) from the GLACIER Study. Clin Oncol (R Coll Radiol) 2015. [DOI: 10.1016/j.clon.2015.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Leongamornlert D, Saunders E, Dadaev T, Tymrakiewicz M, Goh C, Jugurnauth-Little S, Kozarewa I, Fenwick K, Assiotis I, Barrowdale D, Govindasami K, Guy M, Sawyer E, Wilkinson R, Antoniou AC, Eeles R, Kote-Jarai Z. Frequent germline deleterious mutations in DNA repair genes in familial prostate cancer cases are associated with advanced disease. Br J Cancer 2014; 110:1663-72. [PMID: 24556621 PMCID: PMC3960610 DOI: 10.1038/bjc.2014.30] [Citation(s) in RCA: 114] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/19/2013] [Revised: 12/19/2013] [Accepted: 01/08/2014] [Indexed: 12/30/2022] Open
Abstract
BACKGROUND Prostate cancer (PrCa) is one of the most common diseases to affect men worldwide and among the leading causes of cancer-related death. The purpose of this study was to use second-generation sequencing technology to assess the frequency of deleterious mutations in 22 tumour suppressor genes in familial PrCa and estimate the relative risk of PrCa if these genes are mutated. METHODS Germline DNA samples from 191 men with 3 or more cases of PrCa in their family were sequenced for 22 tumour suppressor genes using Agilent target enrichment and Illumina technology. Analysis for genetic variation was carried out by using a pipeline consisting of BWA, Genome Analysis Toolkit (GATK) and ANNOVAR. Clinical features were correlated with mutation status using standard statistical tests. Modified segregation analysis was used to determine the relative risk of PrCa conferred by the putative loss-of-function (LoF) mutations identified. RESULTS We discovered 14 putative LoF mutations in 191 samples (7.3%) and these mutations were more frequently associated with nodal involvement, metastasis or T4 tumour stage (P=0.00164). Segregation analysis of probands with European ancestry estimated that LoF mutations in any of the studied genes confer a relative risk of PrCa of 1.94 (95% CI: 1.56-2.42). CONCLUSIONS These findings show that LoF mutations in DNA repair pathway genes predispose to familial PrCa and advanced disease and therefore warrants further investigation. The clinical utility of these findings will become increasingly important as targeted screening and therapies become more widespread.
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Affiliation(s)
- D Leongamornlert
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - E Saunders
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - T Dadaev
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - M Tymrakiewicz
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - C Goh
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - S Jugurnauth-Little
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - I Kozarewa
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
| | - K Fenwick
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
| | - I Assiotis
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
| | - D Barrowdale
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - K Govindasami
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - M Guy
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - E Sawyer
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - R Wilkinson
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
| | - The UKGPCS Collaborators
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW7 3RP, UK
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
- The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - A C Antoniou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge CB1 8RN, UK
| | - R Eeles
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
- The Royal Marsden NHS Foundation Trust, London SM2 5PT, UK
| | - Z Kote-Jarai
- Division of Genetics and Epidemiology, The Institute of Cancer Research, London SW7 3RP, UK
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Agarwal D, Pineda S, Michailidou K, Herranz J, Pita G, Moreno LT, Alonso MR, Dennis J, Wang Q, Bolla MK, Meyer KB, Menéndez-Rodríguez P, Hardisson D, Mendiola M, González-Neira A, Lindblom A, Margolin S, Swerdlow A, Ashworth A, Orr N, Jones M, Matsuo K, Ito H, Iwata H, Kondo N, Hartman M, Hui M, Lim WY, T-C Iau P, Sawyer E, Tomlinson I, Kerin M, Miller N, Kang D, Choi JY, Park SK, Noh DY, Hopper JL, Schmidt DF, Makalic E, Southey MC, Teo SH, Yip CH, Sivanandan K, Tay WT, Brauch H, Brüning T, Hamann U, Dunning AM, Shah M, Andrulis IL, Knight JA, Glendon G, Tchatchou S, Schmidt MK, Broeks A, Rosenberg EH, van't Veer LJ, Fasching PA, Renner SP, Ekici AB, Beckmann MW, Shen CY, Hsiung CN, Yu JC, Hou MF, Blot W, Cai Q, Wu AH, Tseng CC, Van Den Berg D, Stram DO, Cox A, Brock IW, Reed MWR, Muir K, Lophatananon A, Stewart-Brown S, Siriwanarangsan P, Zheng W, Deming-Halverson S, Shrubsole MJ, Long J, Shu XO, Lu W, Gao YT, Zhang B, Radice P, Peterlongo P, Manoukian S, Mariette F, Sangrajrang S, McKay J, Couch FJ, Toland AE, Yannoukakos D, Fletcher O, Johnson N, Silva IDS, Peto J, Marme F, Burwinkel B, Guénel P, Truong T, Sanchez M, Mulot C, Bojesen SE, Nordestgaard BG, Flyer H, Brenner H, Dieffenbach AK, Arndt V, Stegmaier C, Mannermaa A, Kataja V, Kosma VM, Hartikainen JM, Lambrechts D, Yesilyurt BT, Floris G, Leunen K, Chang-Claude J, Rudolph A, Seibold P, Flesch-Janys D, Wang X, Olson JE, Vachon C, Purrington K, Giles GG, Severi G, Baglietto L, Haiman CA, Henderson BE, Schumacher F, Le Marchand L, Simard J, Dumont M, Goldberg MS, Labrèche F, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Grip M, Devilee P, Tollenaar RAEM, Seynaeve C, García-Closas M, Chanock SJ, Lissowska J, Figueroa JD, Czene K, Eriksson M, Humphreys K, Darabi H, Hooning MJ, Kriege M, Collée JM, Tilanus-Linthorst M, Li J, Jakubowska A, Lubinski J, Jaworska-Bieniek K, Durda K, Nevanlinna H, Muranen TA, Aittomäki K, Blomqvist C, Bogdanova N, Dörk T, Hall P, Chenevix-Trench G, Easton DF, Pharoah PDP, Arias-Perez JI, Zamora P, Benítez J, Milne RL. FGF receptor genes and breast cancer susceptibility: results from the Breast Cancer Association Consortium. Br J Cancer 2014; 110:1088-100. [PMID: 24548884 PMCID: PMC3929867 DOI: 10.1038/bjc.2013.769] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2013] [Revised: 11/08/2013] [Accepted: 11/15/2013] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Breast cancer is one of the most common malignancies in women. Genome-wide association studies have identified FGFR2 as a breast cancer susceptibility gene. Common variation in other fibroblast growth factor (FGF) receptors might also modify risk. We tested this hypothesis by studying genotyped single-nucleotide polymorphisms (SNPs) and imputed SNPs in FGFR1, FGFR3, FGFR4 and FGFRL1 in the Breast Cancer Association Consortium. METHODS Data were combined from 49 studies, including 53 835 cases and 50 156 controls, of which 89 050 (46 450 cases and 42 600 controls) were of European ancestry, 12 893 (6269 cases and 6624 controls) of Asian and 2048 (1116 cases and 932 controls) of African ancestry. Associations with risk of breast cancer, overall and by disease sub-type, were assessed using unconditional logistic regression. RESULTS Little evidence of association with breast cancer risk was observed for SNPs in the FGF receptor genes. The strongest evidence in European women was for rs743682 in FGFR3; the estimated per-allele odds ratio was 1.05 (95% confidence interval=1.02-1.09, P=0.0020), which is substantially lower than that observed for SNPs in FGFR2. CONCLUSION Our results suggest that common variants in the other FGF receptors are not associated with risk of breast cancer to the degree observed for FGFR2.
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MESH Headings
- Breast Neoplasms/genetics
- Case-Control Studies
- Female
- Genetic Predisposition to Disease
- Genetic Variation
- Genome-Wide Association Study
- Genotype
- Humans
- Polymorphism, Single Nucleotide/genetics
- Receptor, Fibroblast Growth Factor, Type 1/genetics
- Receptor, Fibroblast Growth Factor, Type 2/genetics
- Receptor, Fibroblast Growth Factor, Type 3/genetics
- Receptor, Fibroblast Growth Factor, Type 4/genetics
- Receptor, Fibroblast Growth Factor, Type 5/genetics
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Affiliation(s)
- D Agarwal
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
| | - S Pineda
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - K Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - J Herranz
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Biostatistics Unit, IMDEA Food Institute, Madrid, Spain
| | - G Pita
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - L T Moreno
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - M R Alonso
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - J Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - Q Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - M K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
| | - K B Meyer
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
| | | | - D Hardisson
- Department of Pathology, Hospital Universitario La Paz, IdiPAZ (Hospital La Paz Institute for Health Research) Universidad Autonoma de Madrid, Madrid, Spain
| | - M Mendiola
- Laboratory of Pathology and Oncology, Research Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
| | - A González-Neira
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - A Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - S Margolin
- Department of Oncology—Pathology, Karolinska Institutet, Stockholm, Sweden
| | - A Swerdlow
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - A Ashworth
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - N Orr
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
| | - M Jones
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
| | - K Matsuo
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
| | - H Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
| | - H Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - N Kondo
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
| | - kConFab Investigators18
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, IMDEA Food Institute, Madrid, Spain
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
- Hospital Monte Naranco, Oviedo, Spain
- Department of Pathology, Hospital Universitario La Paz, IdiPAZ (Hospital La Paz Institute for Health Research) Universidad Autonoma de Madrid, Madrid, Spain
- Laboratory of Pathology and Oncology, Research Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology—Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- QIMR Berghofer Institute of Medical Research, Brisbane, Queensland, Australia
- Saw Swee Hock School of Public Health, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Research Oncology, Division of Cancer Studies, Kings College London Guy's Hospital, London, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
- Singapore Eye Research Institute, National University of Singapore, Singapore
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Germany
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Institute for Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn GmbH, Johanniter Krankenhaus, Bonn, Germany
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- College of Public Health, China Medical University, Taichong, Taiwan
- Tri-Service General Hospital, Taipei, Taiwan
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
- Institute of Population Health, University of Manchester, Manchester, UK
- Division of Health Sciences, Warwick Medical School, Coventry, UK
- Ministry of Public Health, Bangkok, Thailand
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Shanghai Center for Disease Control and Prevention, Shanghai, China
- Shanghai Cancer Institute, Shanghai, China
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy
- National Cancer Institute, Bangkok, Thailand
- Genetic Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Mayo Clinic, Rochester, MN, USA
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
- Inserm (National Institute of Health and Medical Research), U775 Paris, France
- Centre de Ressources Biologiques EPIGENETEC, Paris, France
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Breast Surgery, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Saarland Cancer Registry, Saarbrücken, Germany
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Kuopio University Hospital, Kuopio, Finland
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UK
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Oviedo, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - Australian Ovarian Cancer Study Group1819
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, IMDEA Food Institute, Madrid, Spain
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
- Hospital Monte Naranco, Oviedo, Spain
- Department of Pathology, Hospital Universitario La Paz, IdiPAZ (Hospital La Paz Institute for Health Research) Universidad Autonoma de Madrid, Madrid, Spain
- Laboratory of Pathology and Oncology, Research Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology—Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- QIMR Berghofer Institute of Medical Research, Brisbane, Queensland, Australia
- Saw Swee Hock School of Public Health, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Research Oncology, Division of Cancer Studies, Kings College London Guy's Hospital, London, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
- Singapore Eye Research Institute, National University of Singapore, Singapore
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Germany
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Institute for Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn GmbH, Johanniter Krankenhaus, Bonn, Germany
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- College of Public Health, China Medical University, Taichong, Taiwan
- Tri-Service General Hospital, Taipei, Taiwan
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
- Institute of Population Health, University of Manchester, Manchester, UK
- Division of Health Sciences, Warwick Medical School, Coventry, UK
- Ministry of Public Health, Bangkok, Thailand
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Shanghai Center for Disease Control and Prevention, Shanghai, China
- Shanghai Cancer Institute, Shanghai, China
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy
- National Cancer Institute, Bangkok, Thailand
- Genetic Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Mayo Clinic, Rochester, MN, USA
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
- Inserm (National Institute of Health and Medical Research), U775 Paris, France
- Centre de Ressources Biologiques EPIGENETEC, Paris, France
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Breast Surgery, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Saarland Cancer Registry, Saarbrücken, Germany
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Kuopio University Hospital, Kuopio, Finland
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UK
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Oviedo, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - M Hartman
- Saw Swee Hock School of Public Health, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - M Hui
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - W Y Lim
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
| | - P T-C Iau
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
| | - E Sawyer
- Research Oncology, Division of Cancer Studies, Kings College London Guy's Hospital, London, UK
| | - I Tomlinson
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - M Kerin
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
| | - N Miller
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
| | - D Kang
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - J-Y Choi
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - S K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
| | - D-Y Noh
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - J L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - D F Schmidt
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - E Makalic
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
| | - M C Southey
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
| | - S H Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - C H Yip
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - K Sivanandan
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
| | - W-T Tay
- Singapore Eye Research Institute, National University of Singapore, Singapore
| | - H Brauch
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Germany
| | - T Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Germany
| | - U Hamann
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
| | - The GENICA Network35363738394041
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, IMDEA Food Institute, Madrid, Spain
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
- Hospital Monte Naranco, Oviedo, Spain
- Department of Pathology, Hospital Universitario La Paz, IdiPAZ (Hospital La Paz Institute for Health Research) Universidad Autonoma de Madrid, Madrid, Spain
- Laboratory of Pathology and Oncology, Research Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology—Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- QIMR Berghofer Institute of Medical Research, Brisbane, Queensland, Australia
- Saw Swee Hock School of Public Health, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Research Oncology, Division of Cancer Studies, Kings College London Guy's Hospital, London, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
- Singapore Eye Research Institute, National University of Singapore, Singapore
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Germany
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Institute for Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn GmbH, Johanniter Krankenhaus, Bonn, Germany
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- College of Public Health, China Medical University, Taichong, Taiwan
- Tri-Service General Hospital, Taipei, Taiwan
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
- Institute of Population Health, University of Manchester, Manchester, UK
- Division of Health Sciences, Warwick Medical School, Coventry, UK
- Ministry of Public Health, Bangkok, Thailand
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Shanghai Center for Disease Control and Prevention, Shanghai, China
- Shanghai Cancer Institute, Shanghai, China
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy
- National Cancer Institute, Bangkok, Thailand
- Genetic Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Mayo Clinic, Rochester, MN, USA
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
- Inserm (National Institute of Health and Medical Research), U775 Paris, France
- Centre de Ressources Biologiques EPIGENETEC, Paris, France
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Breast Surgery, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Saarland Cancer Registry, Saarbrücken, Germany
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Kuopio University Hospital, Kuopio, Finland
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UK
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Oviedo, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - A M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - M Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - I L Andrulis
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
| | - J A Knight
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - G Glendon
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
| | - S Tchatchou
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
| | - M K Schmidt
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - A Broeks
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - E H Rosenberg
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - L J van't Veer
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - P A Fasching
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
| | - S P Renner
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - A B Ekici
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - M W Beckmann
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | - C-Y Shen
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- College of Public Health, China Medical University, Taichong, Taiwan
| | - C-N Hsiung
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - J-C Yu
- Tri-Service General Hospital, Taipei, Taiwan
| | - M-F Hou
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
| | - W Blot
- Department of Medicine, Vanderbilt University, Nashville, TN USA
| | - Q Cai
- Department of Medicine, Vanderbilt University, Nashville, TN USA
| | - A H Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - C-C Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - D Van Den Berg
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - D O Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - A Cox
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
| | - I W Brock
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
| | - M W R Reed
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
| | - K Muir
- Institute of Population Health, University of Manchester, Manchester, UK
- Division of Health Sciences, Warwick Medical School, Coventry, UK
| | - A Lophatananon
- Division of Health Sciences, Warwick Medical School, Coventry, UK
| | - S Stewart-Brown
- Division of Health Sciences, Warwick Medical School, Coventry, UK
| | | | - W Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - S Deming-Halverson
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - M J Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J Long
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - X-O Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - W Lu
- Shanghai Center for Disease Control and Prevention, Shanghai, China
| | - Y-T Gao
- Shanghai Cancer Institute, Shanghai, China
| | - B Zhang
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
| | - P Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - P Peterlongo
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - S Manoukian
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
| | - F Mariette
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy
| | | | - J McKay
- Genetic Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - F J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - A E Toland
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - TNBCC73
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Department of Molecular, Cellular and Developmental Biology, Yale University, New Haven, CT, USA
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Biostatistics Unit, IMDEA Food Institute, Madrid, Spain
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- CRUK Cambridge Institute, University of Cambridge, Cambridge, UK
- Hospital Monte Naranco, Oviedo, Spain
- Department of Pathology, Hospital Universitario La Paz, IdiPAZ (Hospital La Paz Institute for Health Research) Universidad Autonoma de Madrid, Madrid, Spain
- Laboratory of Pathology and Oncology, Research Unit, Hospital Universitario La Paz, IdiPAZ, Madrid, Spain
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Department of Oncology—Pathology, Karolinska Institutet, Stockholm, Sweden
- Division of Genetics and Epidemiology, The Institute of Cancer Research, Sutton, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Breakthrough Breast Cancer Research Centre, Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Department of Preventive Medicine, Kyushu University Faculty of Medical Sciences, Fukuoka, Japan
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya, Japan
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya, Japan
- Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia
- QIMR Berghofer Institute of Medical Research, Brisbane, Queensland, Australia
- Saw Swee Hock School of Public Health, Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore and National University Health System, Singapore, Singapore
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore and National University Health System, Singapore, Singapore
- Research Oncology, Division of Cancer Studies, Kings College London Guy's Hospital, London, UK
- Wellcome Trust Centre for Human Genetics, University of Oxford, Oxford, UK
- Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
- School of Medicine, Clinical Science Institute, National University of Ireland, Galway, UK
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
- Department of Biomedical Sciences, Seoul National University Graduate School, Seoul, Korea
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Department of Pathology, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, University Malaya Medical Centre, Kuala Lumpur, Malaysia
- Singapore Eye Research Institute, National University of Singapore, Singapore
- Dr Margarete Fischer-Bosch Institute of Clinical Pharmacology, Stuttgart, Germany
- University of Tübingen, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr-University Bochum (IPA), Germany
- Molecular Genetics of Breast Cancer, Deutsches Krebsforschungszentrum (DKFZ), Heidelberg, Germany
- Institute for Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn GmbH, Johanniter Krankenhaus, Bonn, Germany
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
- Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Ontario, Canada
- Department of Molecular Genetics, University of Toronto, Toronto, Ontario, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Ontario Cancer Genetics Network, Lunenfeld-Tanenbaum Research Institute, Toronto, Ontario, Canada
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
- Department of Gynecology and Obstetrics, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
- David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, CA, USA
- Institute of Human Genetics, University Hospital Erlangen, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
- College of Public Health, China Medical University, Taichong, Taiwan
- Tri-Service General Hospital, Taipei, Taiwan
- Cancer Center, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Surgery, Kaohsiung Medical University Chung-Ho Memorial Hospital, Kaohsiung, Taiwan
- Department of Medicine, Vanderbilt University, Nashville, TN USA
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield, UK
- Institute of Population Health, University of Manchester, Manchester, UK
- Division of Health Sciences, Warwick Medical School, Coventry, UK
- Ministry of Public Health, Bangkok, Thailand
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, USA
- Shanghai Center for Disease Control and Prevention, Shanghai, China
- Shanghai Cancer Institute, Shanghai, China
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
- Unit of Medical Genetics, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale dei Tumori (INT), Milan, Italy
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy
- National Cancer Institute, Bangkok, Thailand
- Genetic Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
- Mayo Clinic, Rochester, MN, USA
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
- London School of Hygiene and Tropical Medicine, London, UK
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
- Inserm (National Institute of Health and Medical Research), U775 Paris, France
- Centre de Ressources Biologiques EPIGENETEC, Paris, France
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Breast Surgery, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
- Saarland Cancer Registry, Saarbrücken, Germany
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Kuopio University Hospital, Kuopio, Finland
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
- University of Hawaii Cancer Center, Honolulu, HI, USA
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
- Department of Medicine, McGill University, Montreal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
- Department of Oncology, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UK
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Oviedo, Spain
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - D Yannoukakos
- Molecular Diagnostics Laboratory, INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - O Fletcher
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | - N Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | | | - J Peto
- London School of Hygiene and Tropical Medicine, London, UK
| | - F Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - B Burwinkel
- Department of Obstetrics and Gynecology, University of Heidelberg, Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Guénel
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
| | - T Truong
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
| | - M Sanchez
- Inserm (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer, Villejuif, France
- University Paris-Sud, UMRS 1018, Villejuif, France
| | - C Mulot
- Inserm (National Institute of Health and Medical Research), U775 Paris, France
- Centre de Ressources Biologiques EPIGENETEC, Paris, France
| | - S E Bojesen
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - B G Nordestgaard
- Copenhagen General Population Study, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Biochemistry, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H Flyer
- Department of Breast Surgery, Herlev University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - H Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - A K Dieffenbach
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
- German Cancer Consortium (DKTK), Heidelberg, Germany
| | - V Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - C Stegmaier
- Saarland Cancer Registry, Saarbrücken, Germany
| | - A Mannermaa
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - V Kataja
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Oncology, University of Eastern Finland, Kuopio, Finland
- Cancer Center, Kuopio University Hospital, Kuopio, Finland
| | - V-M Kosma
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - J M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland
- Biocenter Kuopio, University of Eastern Finland, Kuopio, Finland
- Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland
| | - D Lambrechts
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | - B T Yesilyurt
- Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | - G Floris
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
| | - K Leunen
- Multidisciplinary Breast Center, University Hospital Gasthuisberg, Leuven, Belgium
| | - J Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - A Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - P Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - D Flesch-Janys
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | - X Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - J E Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - C Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - K Purrington
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - G G Giles
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - G Severi
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - L Baglietto
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
| | - C A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - B E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - F Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - L Le Marchand
- University of Hawaii Cancer Center, Honolulu, HI, USA
| | - J Simard
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
| | - M Dumont
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Quebec Research Center and Laval University, Quebec, Canada
| | - M S Goldberg
- Department of Medicine, McGill University, Montreal, Montreal, Quebec, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Quebec, Canada
| | - F Labrèche
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, Quebec, Canada
| | - R Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - K Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital, Oulu, Finland
| | - A Jukkola-Vuorinen
- Department of Oncology, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - M Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - P Devilee
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
| | - R A E M Tollenaar
- Department of Surgical Oncology, Leiden University Medical Center, Leiden, The Netherlands
| | - C Seynaeve
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M García-Closas
- Division of Breast Cancer Research, The Institute of Cancer Research, London, UK
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London, UK
| | - S J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - J Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
| | - J D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD, USA
| | - K Czene
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M Eriksson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - K Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - H Darabi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - M J Hooning
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - M Kriege
- Department of Medical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J M Collée
- Department of Clinical Genetics, Family Cancer Clinic, Erasmus University Medical Center, Rotterdam, The Netherlands
| | - M Tilanus-Linthorst
- Department of Surgical Oncology, Family Cancer Clinic, Erasmus University Medical Centre, Rotterdam, The Netherlands
| | - J Li
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
| | - A Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - J Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - K Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - K Durda
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - H Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - T A Muranen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - K Aittomäki
- Department of Clinical Genetics, Helsinki University Central Hospital, Helsinki, Finland
| | - C Blomqvist
- Department of Oncology, Helsinki University Central Hospital, Helsinki, Finland
| | - N Bogdanova
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, Hannover, Germany
| | - T Dörk
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - P Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - G Chenevix-Trench
- QIMR Berghofer Institute of Medical Research, Brisbane, Queensland, Australia
| | - D F Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - P D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, University of Cambridge, Cambridge, UK
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - J I Arias-Perez
- Servicio de Cirugía General y Especialidades, Hospital Monte Naranco, Oviedo, Spain
| | - P Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | - J Benítez
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Human Genotyping-CEGEN Unit, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
| | - R L Milne
- Human Cancer Genetics Programme, Spanish National Cancer Research Centre (CNIO), Madrid, Spain
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Australia
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21
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French J, Ghoussaini M, Edwards S, Meyer K, Michailidou K, Ahmed S, Khan S, Maranian M, O’Reilly M, Hillman K, Betts J, Carroll T, Bailey P, Dicks E, Beesley J, Tyrer J, Maia AT, Beck A, Knoblauch N, Chen C, Kraft P, Barnes D, González-Neira A, Alonso M, Herrero D, Tessier D, Vincent D, Bacot F, Luccarini C, Baynes C, Conroy D, Dennis J, Bolla M, Wang Q, Hopper J, Southey M, Schmidt M, Broeks A, Verhoef S, Cornelissen S, Muir K, Lophatananon A, Stewart-Brown S, Siriwanarangsan P, Fasching P, Loehberg C, Ekici A, Beckmann M, Peto J, dos Santos Silva I, Johnson N, Aitken Z, Sawyer E, Tomlinson I, Kerin M, Miller N, Marme F, Schneeweiss A, Sohn C, Burwinkel B, Guénel P, Truong T, Laurent-Puig P, Menegaux F, Bojesen S, Nordestgaard B, Nielsen S, Flyger H, Milne R, Zamora M, Arias Perez J, Benitez J, Anton-Culver H, Brenner H, Müller H, Arndt V, Stegmaier C, Meindl A, Lichtner P, Schmutzler R, Engel C, Brauch H, Hamann U, Justenhoven C, Aaltonen K, Heikkilä P, Aittomäki K, Blomqvist C, Matsuo K, Ito H, Iwata H, Sueta A, Bogdanova N, Antonenkova N, Dörk T, Lindblom A, Margolin S, Mannermaa A, Kataja V, Kosma VM, Hartikainen J, Wu A, Tseng CC, Van Den Berg D, Stram D, Lambrechts D, Peeters S, Smeets A, Floris G, Chang-Claude J, Rudolph A, Nickels S, Flesch-Janys D, Radice P, Peterlongo P, Bonanni B, Sardella D, Couch F, Wang X, Pankratz V, Lee A, Giles G, Severi G, Baglietto L, Haiman C, Henderson B, Schumacher F, Le Marchand L, Simard J, Goldberg M, Labrèche F, Dumont M, Teo S, Yip C, Ng CH, Vithana E, Kristensen V, Zheng W, Deming-Halverson S, Shrubsole M, Long J, Winqvist R, Pylkäs K, Jukkola-Vuorinen A, Grip M, Andrulis I, Knight J, Glendon G, Mulligan A, Devilee P, Seynaeve C, García-Closas M, Figueroa J, Chanock S, Lissowska J, Czene K, Klevebring D, Schoof N, Hooning M, Martens J, Collée J, Tilanus-Linthorst M, Hall P, Li J, Liu J, Humphreys K, Shu XO, Lu W, Gao YT, Cai H, Cox A, Balasubramanian S, Blot W, Signorello L, Cai Q, Pharoah P, Healey C, Shah M, Pooley K, Kang D, Yoo KY, Noh DY, Hartman M, Miao H, Sng JH, Sim X, Jakubowska A, Lubinski J, Jaworska-Bieniek K, Durda K, Sangrajrang S, Gaborieau V, McKay J, Toland A, Ambrosone C, Yannoukakos D, Godwin A, Shen CY, Hsiung CN, Wu PE, Chen ST, Swerdlow A, Ashworth A, Orr N, Schoemaker M, Ponder B, Nevanlinna H, Brown M, Chenevix-Trench G, Easton D, Dunning A. Functional variants at the 11q13 risk locus for breast cancer regulate cyclin D1 expression through long-range enhancers. Am J Hum Genet 2013; 92:489-503. [PMID: 23540573 PMCID: PMC3617380 DOI: 10.1016/j.ajhg.2013.01.002] [Citation(s) in RCA: 154] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2012] [Revised: 12/21/2012] [Accepted: 01/03/2013] [Indexed: 10/27/2022] Open
Abstract
Analysis of 4,405 variants in 89,050 European subjects from 41 case-control studies identified three independent association signals for estrogen-receptor-positive tumors at 11q13. The strongest signal maps to a transcriptional enhancer element in which the G allele of the best candidate causative variant rs554219 increases risk of breast cancer, reduces both binding of ELK4 transcription factor and luciferase activity in reporter assays, and may be associated with low cyclin D1 protein levels in tumors. Another candidate variant, rs78540526, lies in the same enhancer element. Risk association signal 2, rs75915166, creates a GATA3 binding site within a silencer element. Chromatin conformation studies demonstrate that these enhancer and silencer elements interact with each other and with their likely target gene, CCND1.
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MESH Headings
- Binding Sites
- Breast Neoplasms/genetics
- Case-Control Studies
- Cell Line, Tumor
- Chromatin/chemistry
- Chromatin/genetics
- Chromatin Immunoprecipitation
- Chromosomes, Human, Pair 11/genetics
- Cyclin D1/genetics
- Cyclin D1/metabolism
- Electrophoretic Mobility Shift Assay
- Enhancer Elements, Genetic/genetics
- Female
- GATA3 Transcription Factor/antagonists & inhibitors
- GATA3 Transcription Factor/genetics
- GATA3 Transcription Factor/metabolism
- Gene Expression Regulation, Neoplastic
- Humans
- Luciferases/metabolism
- Polymorphism, Single Nucleotide/genetics
- Promoter Regions, Genetic/genetics
- RNA, Messenger/genetics
- RNA, Small Interfering/genetics
- Real-Time Polymerase Chain Reaction
- Reverse Transcriptase Polymerase Chain Reaction
- Silencer Elements, Transcriptional/genetics
- ets-Domain Protein Elk-4/antagonists & inhibitors
- ets-Domain Protein Elk-4/genetics
- ets-Domain Protein Elk-4/metabolism
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Affiliation(s)
- Juliet D. French
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Maya Ghoussaini
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Stacey L. Edwards
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Kerstin B. Meyer
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Shahana Ahmed
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Sofia Khan
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
| | - Mel J. Maranian
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Martin O’Reilly
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Kristine M. Hillman
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Joshua A. Betts
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Thomas Carroll
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Peter J. Bailey
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Ed Dicks
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Jonathan Beesley
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland 4029, Australia
| | - Jonathan Tyrer
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Ana-Teresa Maia
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Andrew Beck
- Harvard Medical School and Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Nicholas W. Knoblauch
- Harvard Medical School and Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA 02215, USA
| | - Constance Chen
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA
| | - Peter Kraft
- Department of Epidemiology, Harvard School of Public Health, Boston, MA 02215, USA
- Department of Biostatistics, Harvard School of Public Health, Boston, MA 02215, USA
| | - Daniel Barnes
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Anna González-Neira
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - M. Rosario Alonso
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Daniel Herrero
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - Daniel C. Tessier
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Daniel Vincent
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Francois Bacot
- Centre d’innovation Génome Québec et Université McGill, Montréal, QC H3A 0G1, Canada
| | - Craig Luccarini
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Caroline Baynes
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Don Conroy
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Joe Dennis
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Manjeet K. Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - John L. Hopper
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Melissa C. Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Victoria 3010, Australia
| | - Marjanka K. Schmidt
- Division of Psychosocial Research and Epidemiology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Annegien Broeks
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Senno Verhoef
- Family Cancer Clinic, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Sten Cornelissen
- Division of Molecular Pathology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, 1066 CX Amsterdam, the Netherlands
| | - Kenneth Muir
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
| | | | | | | | - Peter A. Fasching
- Department of Medicine, Division of Hematology and Oncology, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095, USA
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Christian R. Loehberg
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Arif B. Ekici
- Institute of Human Genetics, Friedrich Alexander University Erlangen-Nuremberg, 91054 Erlangen, Germany
| | - Matthias W. Beckmann
- University Breast Center Franconia, Department of Gynecology and Obstetrics, University Hospital Erlangen, 91054 Erlangen, Germany
| | - Julian Peto
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Isabel dos Santos Silva
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Nichola Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Zoe Aitken
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London WC1E 7HT, UK
| | - Elinor J. Sawyer
- Division of Cancer Studies, NIHR Comprehensive Biomedical Research Centre, Guy’s & St. Thomas’ NHS Foundation Trust in partnership with King’s College London, London SE1 9RT, UK
| | - Ian Tomlinson
- Welcome Trust Centre for Human Genetics and Oxford Biomedical Research Centre, University of Oxford, Oxford OX3 7BN, UK
| | - Michael J. Kerin
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, Galway, Ireland
| | - Nicola Miller
- Surgery, Clinical Science Institute, Galway University Hospital and National University of Ireland, Galway, Ireland
| | - Frederik Marme
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, 69120 Heidelberg, Germany
| | - Andreas Schneeweiss
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- National Center for Tumor Diseases, University of Heidelberg, 69120 Heidelberg, Germany
| | - Christof Sohn
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
| | - Barbara Burwinkel
- Department of Obstetrics and Gynecology, University of Heidelberg, 69115 Heidelberg, Germany
- Molecular Epidemiology Group, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Pascal Guénel
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Thérèse Truong
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Pierre Laurent-Puig
- Université Paris Sorbonne Cité, UMR-S775 INSERM, 75270 Paris Cedex 06, France
| | - Florence Menegaux
- INSERM (National Institute of Health and Medical Research), CESP (Center for Research in Epidemiology and Population Health), U1018, Environmental Epidemiology of Cancer Team, 94807 Villejuif, France
- University Paris-Sud, UMRS 1018, 94807 Villejuif, France
| | - Stig E. Bojesen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Børge G. Nordestgaard
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Sune F. Nielsen
- Copenhagen General Population Study, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, 2730 Herlev, Denmark
| | - Henrik Flyger
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Copenhagen, 2730 Herlev, Denmark
| | - Roger L. Milne
- Genetic & Molecular Epidemiology Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
| | - M. Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid 28046, Spain
| | | | - Javier Benitez
- Human Genotyping-CEGEN Unit, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid 28029, Spain
- Centro de Investigación en Red de Enfermedades Raras (CIBERER), Madrid 28029, Spain
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California, Irvine, Irvine, CA 92697, USA
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Heiko Müller
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | | | - Alfons Meindl
- Division of Gynaecology and Obstetrics, Technische Universität München, 81675 Munich, Germany
| | - Peter Lichtner
- Institute of Human Genetics, Helmholtz Zentrum München - German Research Center for Environmental Health, 85764 Neuherberg, Germany
| | - Rita K. Schmutzler
- Division of Molecular Gyneco-Oncology, Department of Gynaecology and Obstetrics, University Cologne, 50931 Cologne, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, 04107 Leipzig, Germany
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Christina Justenhoven
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
| | - The GENICA Network
- Dr. Margarete Fischer-Bosch Institute of Clinical Pharmacology, 70376 Stuttgart, Germany
- University of Tübingen, 72074 Tübingen, Germany
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, 53113 Bonn, Germany
- Institute and Outpatient Clinic of Occupational Medicine, Saarland University Medical Center and Saarland University Faculty of Medicine, 66421 Homburg, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), 44789 Bochum, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, 53123 Bonn, Germany
| | - Kirsimari Aaltonen
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Päivi Heikkilä
- Department of Pathology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Kristiina Aittomäki
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Helsinki, 00029, Finland
| | - Keitaro Matsuo
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Hidemi Ito
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Hiroji Iwata
- Department of Breast Oncology, Aichi Cancer Center Hospital, Nagoya 464-8681, Japan
| | - Aiko Sueta
- Division of Epidemiology and Prevention, Aichi Cancer Center Research Institute, Nagoya 464-8681, Japan
| | - Natalia V. Bogdanova
- Department of Obstetrics and Gynaecology, Hannover Medical School, 30625 Hannover, Germany
- Department of Radiation Oncology, Hannover Medical School, 30625 Hannover, Germany
| | - Natalia N. Antonenkova
- N.N. Alexandrov Research Institute of Oncology and Medical Radiology, 223040 Minsk, Belarus
| | - Thilo Dörk
- Department of Obstetrics and Gynaecology, Hannover Medical School, 30625 Hannover, Germany
| | - Annika Lindblom
- Department of Molecular Medicine and Surgery, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Sara Margolin
- Department of Oncology-Pathology, Karolinska Institutet, 171 77 Stockholm, Sweden
| | - Arto Mannermaa
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
- Cancer Center, Kuopio University Hospital, 70211 Kuopio, Finland
| | - Veli-Matti Kosma
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | - Jaana M. Hartikainen
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, 70211 Kuopio, Finland
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, 70211 Kuopio, Finland
| | | | - Anna H. Wu
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Chiu-chen Tseng
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - David Van Den Berg
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Daniel O. Stram
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, 3000 Leuven, Belgium
- Vesalius Research Center (VRC), VIB, 3000 Leuven, Belgium
| | - Stephanie Peeters
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Ann Smeets
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Giuseppe Floris
- Multidisciplinary Breast Center, University Hospital Leuven and KU Leuven, 3000 Leuven, Belgium
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Anja Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Stefan Nickels
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
| | - Dieter Flesch-Janys
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), 69120 Heidelberg, Germany
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, 20246 Hamburg, Germany
| | - Paolo Radice
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori (INT), 20133 Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Paolo Peterlongo
- Unit of Molecular Bases of Genetic Risk and Genetic Testing, Department of Preventive and Predictive Medicine, Fondazione IRCCS Istituto Nazionale Tumori (INT), 20133 Milan, Italy
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Bernardo Bonanni
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia, 20141 Milan, Italy
| | - Domenico Sardella
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, 20139 Milan, Italy
| | - Fergus J. Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Vernon S. Pankratz
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Adam Lee
- Department of Molecular Pharmacology and Experimental Therapeutics, Mayo Clinic, Rochester, MN 55905, USA
| | - Graham G. Giles
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Gianluca Severi
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Laura Baglietto
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Victoria 3010, Australia
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria 3053, Australia
| | - Christopher A. Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Brian E. Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Fredrick Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center, University of Hawaii, Honolulu, HI 96813, USA
| | - Jacques Simard
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec and Laval University, Québec City, QC G1V 4G2, Canada
| | - Mark S. Goldberg
- Department of Medicine, McGill University, Montreal, QC H3A 1A1, Canada
- Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, QC H3A 1A1, Canada
| | - France Labrèche
- Département de médecine sociale et préventive, Département de santé environnementale et santé au travail, Université de Montréal, Montreal, QC H3A 3C2, Canada
| | - Martine Dumont
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec and Laval University, Québec City, QC G1V 4G2, Canada
| | - Soo Hwang Teo
- Cancer Research Initiatives Foundation, Sime Darby Medical Centre, Subang Jaya, 47500 Selangor, Malaysia
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Cheng Har Yip
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | - Char-Hong Ng
- Breast Cancer Research Unit, University Malaya Cancer Research Institute, Faculty of Medicine, University Malaya, 50603 Kuala Lumpur, Malaysia
| | | | - Vessela Kristensen
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, 0310 Oslo, Norway
- Faculty of Medicine (Faculty Division Ahus), University of Oslo, 0318 Oslo, Norway
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Sandra Deming-Halverson
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Martha Shrubsole
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Genetics and Biocenter Oulu, University of Oulu, Oulu University Hospital, 90014 Oulu, Finland
| | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Genetics and Biocenter Oulu, University of Oulu, Oulu University Hospital, 90014 Oulu, Finland
| | - Arja Jukkola-Vuorinen
- Department of Oncology, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Mervi Grip
- Department of Surgery, Oulu University Hospital, University of Oulu, 90014 Oulu, Finland
| | - Irene L. Andrulis
- Department of Molecular Genetics, University of Toronto, Toronto, ON M5S 1A8, Canada
- Ontario Cancer Genetics Network, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Julia A. Knight
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, ON M5T 3M7, Canada
- Prosserman Centre for Health Research, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5T 3L9, Canada
| | - Gord Glendon
- Ontario Cancer Genetics Network, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON M5G 1X5, Canada
| | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON M5S 1A8, Canada
- Laboratory Medicine Program, University Health Network, 200 Elizabeth Street, Toronto, ON M5G 2C4, Canada
| | - Peter Devilee
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, 2300 RC Leiden, the Netherlands
| | - Caroline Seynaeve
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Center, 3075 EA Rotterdam, the Netherlands
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - Montserrat García-Closas
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Jonine Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | - Stephen J. Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, MD 20892, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, 02-781 Warsaw, Poland
| | - Kamila Czene
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Daniel Klevebring
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Nils Schoof
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Maartje J. Hooning
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - John W.M. Martens
- Department of Medical Oncology, Erasmus University Medical Center, 3075 EA Rotterdam, the Netherlands
| | - J. Margriet Collée
- Department of Clinical Genetics, Erasmus University Medical Center, 3008 AE Rotterdam, the Netherlands
| | | | - Per Hall
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672, Singapore
| | - Keith Humphreys
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 17 177, Sweden
| | - Xiao-Ou Shu
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Wei Lu
- Shanghai Center for Disease Control and Prevention, Shanghai 200336, China
| | - Yu-Tang Gao
- Department of Epidemiology, Shanghai Cancer Institute, Shanghai 200032, China
| | - Hui Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Angela Cox
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield S10 2RX, UK
| | - Sabapathy P. Balasubramanian
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology, University of Sheffield, Sheffield S10 2RX, UK
| | - William Blot
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
- International Epidemiology Institute, Rockville, MD 20850, USA
| | - Lisa B. Signorello
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
- International Epidemiology Institute, Rockville, MD 20850, USA
| | - Qiuyin Cai
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN 37203, USA
| | - Paul D.P. Pharoah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Catherine S. Healey
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Mitul Shah
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Karen A. Pooley
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Daehee Kang
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Keun-Young Yoo
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Dong-Young Noh
- Seoul National University College of Medicine, Seoul 110-799, Korea
| | - Mikael Hartman
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117597, Singapore
| | - Hui Miao
- Saw Swee Hock School of Public Health, National University of Singapore, Singapore 117597, Singapore
| | - Jen-Hwei Sng
- Department of Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore 119228, Singapore
| | - Xueling Sim
- Centre for Molecular Epidemiology, National University of Singapore, Singapore 117597, Singapore
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | - Katarzyna Jaworska-Bieniek
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
- Postgraduate School of Molecular Medicine, Warsaw Medical University, ul. Żwirki i Wigury 61, 02-091 Warsaw, Poland
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, u. Polabska 4, 70-115 Szczecin, Poland
| | | | - Valerie Gaborieau
- International Agency for Research on Cancer, 69372 Lyon Cedex 08, France
| | - James McKay
- International Agency for Research on Cancer, 69372 Lyon Cedex 08, France
| | - Amanda E. Toland
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | - Christine B. Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory, IRRP, National Centre for Scientific Research “Demokritos,” Athens 15310, Greece
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Chen-Yang Shen
- Colleague of Public Health, China Medical University, Taichong 40402, Taiwan, ROC
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Chia-Ni Hsiung
- Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Pei-Ei Wu
- Taiwan Biobank, Institute of Biomedical Sciences, Academia Sinica, Taipei 115, Taiwan, ROC
| | - Shou-Tung Chen
- Department of Surgery, Changhua Christian Hospital, Changhua City, Changhua county 500, Taiwan, ROC
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Alan Ashworth
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
| | - Nick Orr
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London SW3 6JB, UK
- Division of Breast Cancer Research, The Institute of Cancer Research, London SW3 6JB, UK
| | - Minouk J. Schoemaker
- Division of Genetics and Epidemiology, Institute of Cancer Research and Breakthrough Breast Cancer Research Centre, London SM2 5NG, UK
| | - Bruce A.J. Ponder
- Cancer Research UK Cambridge Research Institute, Li Ka Shing Centre, Cambridge CB2 0RE, UK
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki 00029, Finland
| | - Melissa A. Brown
- School of Chemistry and Molecular Biosciences, The University of Queensland, Brisbane, Queensland 4072, Australia
| | - Georgia Chenevix-Trench
- Department of Genetics, Queensland Institute of Medical Research, Brisbane, Queensland 4029, Australia
| | - Douglas F. Easton
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
| | - Alison M. Dunning
- Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB1 8RN, UK
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Ross GM, Johnson N, Orr N, Walker K, Gibson L, Folkerd E, Haynes B, Palles C, Coupland B, Shoemaker M, Jones M, Broderick P, Sawyer E, Kerin M, Tomlinson I, Zvelebil M, Chilcott-Burns S, Tomczyk K, Simpson G, Willianson J, Hillier S, Houlston R, Swerdlow A, Ashworth A, Dowsett M, Peto J, dos Santos I, Fletcher O. Abstract P3-08-04: Impact of CYP3A variation on estrone levels and breast cancer risk. Cancer Res 2012. [DOI: 10.1158/0008-5472.sabcs12-p3-08-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Epidemiological studies provide strong evidence for a role of endogenous sex steroids in the etiology of breast cancer. Our aim was to identify common variants in genes involved in sex steroid synthesis or metabolism that were associated with premenopausal hormone levels and breast cancer risk.
Methods: We measured urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PG) using a protocol specifically developed to account for cyclic variation in hormone levels during the menstrual cycle, plasma sex hormone-binding globulin (SHBG) and androgenic precursors in up to 763 healthy premenopausal women. We genotyped 642 single nucleotide polymorphisms (SNPs) in these women; a single SNP was further tested for association with breast cancer risk in data from 10,551 breast cancer case patients and 17,535 control subjects. All statistical tests were two-sided.
Results: rs10273424 mapping approximately 50kb centromeric to the cytochrome P450 3A (CYP3A) cluster (7q22.1) was associated with a 21.8% reduction in E1G levels (P = 2.7 × 10−9) and a modest reduction in breast cancer risk in cases diagnosed at or before age 50 (OR = 0.91; P = 0.03) but not older cases (odds ratio (OR) = 1.01; P = 0.82). A rare non-synonymous SHBG SNP was associated with reduced plasma SHBG levels.
Conclusions: Genetic variation in non-coding sequences flanking the CYP3A locus contributes to variance in premenopausal E1G levels and breast cancer risk in younger cases. Since CYP3A4, the most predominantly expressed CYP3A gene, is responsible for metabolism of endogenous and exogenous hormones and hormonal agents such as tamoxifen, used in the treatment of breast cancer this association may have wider implications.
Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-08-04.
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Affiliation(s)
- GM Ross
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - N Johnson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - N Orr
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - K Walker
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - L Gibson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - E Folkerd
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - B Haynes
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - C Palles
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - B Coupland
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Shoemaker
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Jones
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - P Broderick
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - E Sawyer
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Kerin
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - I Tomlinson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Zvelebil
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - S Chilcott-Burns
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - K Tomczyk
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - G Simpson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - J Willianson
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - S Hillier
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - R Houlston
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - A Swerdlow
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - A Ashworth
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - M Dowsett
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - J Peto
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - I dos Santos
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
| | - O Fletcher
- Royal Marsden Hospital, London, United Kingdom; Breakthrough Breast Cancer, Instiute of Cancer Research, London, United Kingdom; London School of Hygiene and Tropical Medicine, United Kingdom; Wellcome Trust Centre for Human Genetics, Oxford, United Kingdom; Biomedical Research Centre, Guys, United Kingdom; Edinburgh University, United Kingdom; University Hospital, Galway, Ireland
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23
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Leongamornlert D, Mahmud N, Tymrakiewicz M, Saunders E, Dadaev T, Castro E, Goh C, Govindasami K, Guy M, O'Brien L, Sawyer E, Hall A, Wilkinson R, Easton D, Goldgar D, Eeles R, Kote-Jarai Z. Germline BRCA1 mutations increase prostate cancer risk. Br J Cancer 2012; 106:1697-701. [PMID: 22516946 PMCID: PMC3349179 DOI: 10.1038/bjc.2012.146] [Citation(s) in RCA: 209] [Impact Index Per Article: 17.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 02/24/2012] [Accepted: 03/25/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Prostate cancer (PrCa) is one of the most common cancers affecting men but its aetiology is poorly understood. Family history of PrCa, particularly at a young age, is a strong risk factor. There have been previous reports of increased PrCa risk in male BRCA1 mutation carriers in female breast cancer families, but there is a controversy as to whether this risk is substantiated. We sought to evaluate the role of germline BRCA1 mutations in PrCa predisposition by performing a candidate gene study in a large UK population sample set. METHODS We screened 913 cases aged 36–86 years for germline BRCA1 mutation, with the study enriched for cases with an early age of onset. We analysed the entire coding region of the BRCA1 gene using Sanger sequencing. Multiplex ligation-dependent probe amplification was also used to assess the frequency of large rearrangements in 460 cases. RESULTS We identified 4 deleterious mutations and 45 unclassified variants (UV). The frequency of deleterious BRCA1 mutation in this study is 0.45%; three of the mutation carriers were affected at age 65 years and one developed PrCa at 69 years. Using previously estimated population carrier frequencies, deleterious BRCA1 mutations confer a relative risk of PrCa of ~3.75-fold, (95% confidence interval 1.02–9.6) translating to a 8.6% cumulative risk by age 65. CONCLUSION This study shows evidence for an increased risk of PrCa in men who harbour germline mutations in BRCA1. This could have a significant impact on possible screening strategies and targeted treatments.
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Affiliation(s)
- D Leongamornlert
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - N Mahmud
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - M Tymrakiewicz
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - E Saunders
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - T Dadaev
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - E Castro
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - C Goh
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - K Govindasami
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - M Guy
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - L O'Brien
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - E Sawyer
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - A Hall
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - R Wilkinson
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
| | - D Easton
- Centre for Cancer Genetic
Epidemiology, Department of Public Health and Primary Care, Strangeways
Laboratory, Cambridge
CB1 8RN, UK
| | - The UKGPCS Collaborators5
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
- Centre for Cancer Genetic
Epidemiology, Department of Public Health and Primary Care, Strangeways
Laboratory, Cambridge
CB1 8RN, UK
- Department of Dermatology, University
of Utah, Salt Lake City, UT
84132, USA
- The Royal Marsden NHS Foundation
Trust, Sutton
SM2 5NG, UK
| | - D Goldgar
- Department of Dermatology, University
of Utah, Salt Lake City, UT
84132, USA
| | - R Eeles
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
- The Royal Marsden NHS Foundation
Trust, Sutton
SM2 5NG, UK
| | - Z Kote-Jarai
- Oncogenetics Team, The Institute of
Cancer Research, Sutton
SM2 5NG, UK
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24
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McInerney NM, Miller N, Rowan A, Colleran G, Barclay E, Curran C, Kerin MJ, Tomlinson IP, Sawyer E. Erratum to: Evaluation of variants in the CHEK2, BRIP1 and PALB2 genes in an Irish breast cancer cohort. Breast Cancer Res Treat 2012. [DOI: 10.1007/s10549-011-1464-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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25
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Ur Rahman AA, Lophatananon A, Lobaz J, Robinson F, Brown SS, Parker T, Easton D, Kote-Jarai Z, Pocock R, Dearnaley D, Guy M, Wilkinson RA, Hall AL, Sawyer E, Page E, Liu JF, Eeles RA, Muir KR. P2-250 Omega 3 polyunsaturated fatty acids (PUFAs) and risk of early onset prostate cancer. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.83] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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26
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Rahman AA, Lophatananon A, Stewart-Brown S, Harriss D, Anderson J, Parker T, Easton D, Kote-Jarai Z, Pocock R, Dearnaley D, Guy M, O'Brien L, Wilkinson RA, Hall AL, Sawyer E, Page E, Liu JF, Eeles RA, Muir KR. Reply: ‘Hand pattern indicates risk of prostate cancer’. Br J Cancer 2011. [PMCID: PMC3172897 DOI: 10.1038/bjc.2011.233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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27
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Castro E, Goh CL, Olmos D, Leongamornlert D, Saunders E, Tymrakiewicz M, Mahmud N, Dadaev T, Govindasami K, Guy M, OBrien L, Sawyer E, Hall A, Wilkinson R, Kote-Jarai Z, Eeles RA. Correlation of germ-line BRCA2 mutations with aggressive prostate cancer and outcome. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.15_suppl.1517] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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28
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Kote-Jarai Z, Amin Al Olama A, Leongamornlert D, Tymrakiewicz M, Saunders E, Guy M, Giles GG, Severi G, Southey M, Hopper JL, Sit KC, Harris JM, Batra J, Spurdle AB, Clements JA, Hamdy F, Neal D, Donovan J, Muir K, Pharoah PDP, Chanock SJ, Brown N, Benlloch S, Castro E, Mahmud N, O'Brien L, Hall A, Sawyer E, Wilkinson R, Easton DF, Eeles RA. Identification of a novel prostate cancer susceptibility variant in the KLK3 gene transcript. Hum Genet 2011; 129:687-94. [PMID: 21465221 PMCID: PMC3092928 DOI: 10.1007/s00439-011-0981-1] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2011] [Accepted: 03/14/2011] [Indexed: 11/29/2022]
Abstract
Genome-wide association studies (GWAS) have identified more than 30 prostate cancer (PrCa) susceptibility loci. One of these (rs2735839) is located close to a plausible candidate susceptibility gene, KLK3, which encodes prostate-specific antigen (PSA). PSA is widely used as a biomarker for PrCa detection and disease monitoring. To refine the association between PrCa and variants in this region, we used genotyping data from a two-stage GWAS using samples from the UK and Australia, and the Cancer Genetic Markers of Susceptibility (CGEMS) study. Genotypes were imputed for 197 and 312 single nucleotide polymorphisms (SNPs) from HapMap2 and the 1000 Genome Project, respectively. The most significant association with PrCa was with a previously unidentified SNP, rs17632542 (combined P = 3.9 × 10−22). This association was confirmed by direct genotyping in three stages of the UK/Australian GWAS, involving 10,405 cases and 10,681 controls (combined P = 1.9 × 10−34). rs17632542 is also shown to be associated with PSA levels and it is a non-synonymous coding SNP (Ile179Thr) in KLK3. Using molecular dynamic simulation, we showed evidence that this variant has the potential to introduce alterations in the protein or affect RNA splicing. We propose that rs17632542 may directly influence PrCa risk.
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Affiliation(s)
- Z Kote-Jarai
- The Institute of Cancer Research, Sutton, Surrey SM2 5NG, UK.
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29
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Chetty M, Sawyer E, Dew T, Chapman AJ, Elson J. The use of novel biochemical markers in predicting spontaneously resolving 'pregnancies of unknown location'. Hum Reprod 2011; 26:1318-23. [DOI: 10.1093/humrep/der064] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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30
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Rahman AA, Lophatananon A, Stewart-Brown S, Harriss D, Anderson J, Parker T, Easton D, Kote-Jarai Z, Pocock R, Dearnaley D, Guy M, O'Brien L, Wilkinson RA, Hall AL, Sawyer E, Page E, Liu JF, Eeles RA, Muir K. Hand pattern indicates prostate cancer risk. Br J Cancer 2010; 104:175-7. [PMID: 21119657 PMCID: PMC3039824 DOI: 10.1038/sj.bjc.6605986] [Citation(s) in RCA: 61] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
BACKGROUND The ratio of digit lengths is fixed in utero, and may be a proxy indicator for prenatal testosterone levels. METHODS We analysed the right-hand pattern and prostate cancer risk in 1524 prostate cancer cases and 3044 population-based controls. RESULTS Compared with index finger shorter than ring finger (low 2D : 4D), men with index finger longer than ring finger (high 2D : 4D) showed a negative association, suggesting a protective effect with a 33% risk reduction (odds ratio (OR) 0.67, 95% confidence interval (CI) 0.57-0.80). Risk reduction was even greater (87%) in age group <60 (OR 0.13, 95% CI 0.09-0.21). CONCLUSION Pattern of finger lengths may be a simple marker of prostate cancer risk, with length of 2D greater than 4D suggestive of lower risk.
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Affiliation(s)
- A A Rahman
- Division of Epidemiology and Public Health, University of Nottingham, Queens Medical Centre, Nottingham NG7 2UH, UK
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Gati S, Papadakis M, Basavarajaiah S, Rawlins J, Chandra N, Sawyer E, Carby L, Sharma S. 059 Relationship between exercise related blood pressure response and differences in magnitude of left ventricular hypertrophy between African/Afro-Caribbean (black) athletes and Caucasian athletes: Abstract 59 Table 1. Heart 2010. [DOI: 10.1136/hrt.2010.195966.7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Papadakis M, Baines G, Kouloubinis A, O'Sullivan A, van Niekerk N, Sawyer E, White T, Chandra N, Rawlins J, Sharma S. 140 The diagnostic yield of brugada syndrome in families affected by sudden arrhythmic death syndrome; the impact of higher intercostal V1 and V2 leads. Heart 2010. [DOI: 10.1136/hrt.2010.196113.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Yates L, Kohut K, Jones A, Patel H, Gillet C, Tomlinson I, Pinder S, Roylance R, Sawyer E. SNP-LOH Analysis of Lobular Carcinoma In Situ and Associated Invasive Lobular Cancer. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-09-5169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Lobular carcinoma in situ (LCIS) is a risk factor for the development of subsequent invasive breast carcinoma in either breast. Approximately 50-70% of these subsequent cancers are invasive lobular carcinoma (ILC). Recent molecular evidence suggests that LCIS may be a precursor of ILC. However, not all LCIS progresses to invasive disease and at present there are no biomarkers that predict which cases are going to develop invasive disease. SNP-LOH analysis may be a useful method to analyse genome wide loss of heterozygosity (LOH) and copy number variation in LCIS and associated invasive disease in order to identify such biomarkers. The study of LCIS poses specific technical challenges as available samples are almost exclusively formalin fixed paraffin embedded (FFPE) tissue and LCIS tends to occur in small scattered foci which require micro-dissection.Aims: To assess the feasibility of performing SNP-LOH on micro-dissected FFPE tissue To compare patterns of LOH in pure LCIS and LCIS associated with ILCTo examine the genetic relationship between LCIS and associated ILCMethods: Tumour blocks were collected as part of the GLACIER Study (a study to investigate the Genetics of LobulAr Carcinoma In situ in EuRope). Tissue was micro-dissected from FFPE specimens. DNA was extracted with the DNEasy kit (Qiagen) if it was possible to micro-dissect by hand under a light microscope. For cases extracted using the laser capture microscope (LCM) the Picopure Kit (MDS Analytical Tech)) was used to extract DNA. SNP-LOH was performed using the GoldenGate Assay(Illumina) on 28 samples (20 LCIS, 8 ILC). A minimum of 250ng of DNA was required. For samples with low DNA yields, DNA was amplified using the Genomeplex Amplification Kit(Sigma).Results: Results were obtained on 24 samples that were micro-dissected under the light microscope and extracted using the DNEasy kit(Qiagen). Amplification of DNA was also possible from these samples and the SNP-LOH results for amplified DNA correlated with those for unamplified DNA(1 case).SNP-LOH was performed on 13 cases of classical LCIS: 6 pure LCIS, 7 with associated ILC. LOH events were more common in LCIS associated with invasive disease (range 2-5, median 3) than pure LCIS (range 0-5, median 2). The commonest change in both groups was 16q LOH (6/6 LCIS with invasive disease, 4/7 pure LCIS, p=0.12, Fishers Exact Test). 1q LOH was also present in all samples associated with invasive disease, but only identified in 3/7 samples of pure LCIS (p=0.049, Fishers Exact Test). There were also other regions of LOH that were more common in LCIS associated with ILC, but did not reach significance.Comparing LOH patterns in LCIS and associated ILC revealed that in 3/6 cases of ILC genetic changes were identical to those in the LCIS. In 2/6 cases the ILC had the same genetic changes but had also acquired new genetic changes. Interestingly in 1 case the LCIS had more genetic changes than the ILC.Conclusions: This pilot study has shown that it is possible to perform SNP-LOH on small amounts of micro-dissected FFPE tissue. The results confirm the findings of others that LCIS is a likely precursor lesion of ILC and suggest that even with this limited number of samples pure LCIS and LCIS associated with ILC may have different genetic profiles.
Citation Information: Cancer Res 2009;69(24 Suppl):Abstract nr 5169.
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Affiliation(s)
- L. Yates
- 1Guy's and St Thomas' Hospitals, United Kingdom
| | - K. Kohut
- 2Barts and the London School of Medicine, United Kingdom
| | - A. Jones
- 3Wellcome Trust Centre for Human Genetics, United Kingdom
| | - H. Patel
- 2Barts and the London School of Medicine, United Kingdom
| | - C. Gillet
- 4King's College London, United Kingdom
| | - I. Tomlinson
- 3Wellcome Trust Centre for Human Genetics, United Kingdom
| | - S. Pinder
- 4King's College London, United Kingdom
| | - R. Roylance
- 2Barts and the London School of Medicine, United Kingdom
| | - E. Sawyer
- 1Guy's and St Thomas' Hospitals, United Kingdom
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Day A, Sawyer E, Mavrelos D, Tailor A, Helmy S, Jurkovic D. Use of serum progesterone measurements to reduce need for follow-up in women with pregnancies of unknown location. Ultrasound Obstet Gynecol 2009; 33:704-710. [PMID: 19444818 DOI: 10.1002/uog.6380] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
OBJECTIVE To assess the efficacy of a progesterone-based algorithm for the management of women with pregnancies of unknown location (PULs) and explore the feasibility of developing a single-visit strategy in those with a low risk of requiring medical intervention. METHODS All clinically stable women in whom pregnancy could not be identified on ultrasound scan were managed by a pre-defined protocol based on measurement of serum progesterone and beta-human chorionic gonadotropin (beta-hCG). Intervention in the form of surgery or medical treatment with methotrexate was offered to all women with persistent or worsening symptoms and non-declining serum beta-hCG. Decision-tree analysis was used to develop a protocol for the management of women with resolving pregnancies who are at low risk of requiring medical intervention. RESULTS 1110 women were included in the data analysis: normal intrauterine pregnancy was diagnosed in 248 (22.3%; 95% CI, 19.9-24.8) women. 761 (68.6%; 95% CI, 65.8-71.3) abnormal pregnancies resolved spontaneously on expectant management, while the remaining 101 (9.1%; 95% CI, 7.4-10.8) women with abnormal pregnancies required some form of medical intervention. Intervention rates in patients presenting with initial serum progesterone levels of <or= 20 nmol/L and <or= 10 nmol/L, were 3.9% (95% CI, 2.4-5.4) and 2.1% (95% CI, 0.9-3.3), respectively. In women presenting with progesterone <or= 10 nmol/L and beta-hCG < 450 IU/L, the intervention rate was 1.3% (95% CI, 0.2-2.5). CONCLUSION Women with PULs with progesterone <or= 10 nmol/L at presentation are at low risk of requiring medical intervention and may not benefit from attending routine follow-up visits.
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Affiliation(s)
- A Day
- Early Pregnancy and Acute Gynaecology Assessment Unit, King's College Hospital, London, UK
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35
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Beresford MJ, Whipp E, Sawyer E, Halliwell M. Local recurrence rates in the conserved breast after MRI targeted radiotherapy. Cancer Res 2009. [DOI: 10.1158/0008-5472.sabcs-5143] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Abstract #5143
Background: To optimise the effects of whole breast irradiation after breast conservation surgery, precise identification and delineation of clinical target volumes is essential. If the site of the “post-operative cavity” (POCx) is inaccurately located, any target miss of residual cancer cells may lead to underdosing and thus impact on local recurrence rates and survival. Studies with surgical clips have shown rates of geographical miss of the POCx to be worryingly high for radiotherapy boost doses (up to 87%). Of even more concern is that the whole breast tangential fields frequently miss the tumour bed even though the fields appear adequate based on external landmarks (in approximately a quarter of cases). MRI has subtle breast tissue characterisation that may demonstrate post-operative detail more clearly than CT and more accurately than surgical clips.
 Methods and Materials: Simple opposed tangential fields were defined by surface anatomy in the conventional manner in 221 consecutive patients. Following MR imaging, fields were modified by a single radiation oncologist (EW) to encompass the POCx with a 10mm margin. Patients were treated to a dose of 45Gy in 20 fractions or 50Gy in 25 fractions, with or without an electron boost to the tumour bed (usually 12.5Gy in 5 fractions). Genetic analysis, using genome wide single nucleotide polymorphism (SNP) arrays and loss of heterozygosity (LOH), was performed on all local relapses to distinguish true recurrences (TRs) from new primaries (NPs)
 Results: This cohort was at relatively high risk, with only 9.8% classified as low risk by St Gallen criteria. 43.4% were grade 3 and 19.9% had surgical margins <1mm. 62.4% of patients received boosts to the tumour bed. After a median follow-up of 5 years there were 3 local recurrences. This is an actuarial 5-year local relapse rate of 1.3%. Genetic analysis showed that 2 local relapses had identical genetic profiles to the initial primaries; they were TRs. The other was genetically distinct; it was an NP.
 Conclusions: In this cohort of relatively high risk patients, the TR rate was 0.9% at 5 years. These figures compare favourably with the EORTC boost trial and the START results, although both of these studies had different inclusion criteria, particularly with regard to surgical margins. Theoretically, TRs should be the type of relapse most likely to be avoided by accurate coverage of the post-operative complex. Radiotherapy planned with guidance from MR images may cover the clinical target volume more accurately than treatment guided by anatomical landmarks alone.
Citation Information: Cancer Res 2009;69(2 Suppl):Abstract nr 5143.
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Affiliation(s)
- MJ Beresford
- 1 Bristol Breast Research Group, Bristol Oncology Centre, Bristol, United Kingdom
| | - E Whipp
- 1 Bristol Breast Research Group, Bristol Oncology Centre, Bristol, United Kingdom
| | - E Sawyer
- 2 Guys, Kings, St Thomas' Cancer Centre/Molecular and Population Genetics Laboratory, Cancer Research UK, 44 Lincoln's Inn Fields, London, United Kingdom
| | - M Halliwell
- 1 Bristol Breast Research Group, Bristol Oncology Centre, Bristol, United Kingdom
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Ofili-Yebovi D, Ben-Nagi J, Sawyer E, Yazbek J, Lee C, Gonzalez J, Jurkovic D. Deficient lower-segment Cesarean section scars: prevalence and risk factors. Ultrasound Obstet Gynecol 2008; 31:72-77. [PMID: 18061960 DOI: 10.1002/uog.5200] [Citation(s) in RCA: 148] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVE To examine the sonographic features of transverse lower-segment uterine Cesarean section scars in non-pregnant, premenopausal women and to identify factors associated with scar deficiency. METHODS Non-pregnant, premenopausal women with histories of previous transverse lower-segment Cesarean sections, who were referred for an ultrasound scan for a variety of gynecological indications, were included in this study. An attempt was made to identify the uterine scars on transvaginal ultrasound scan and to describe their locations and morphological features. Various demographic, clinical and ultrasound data were examined in order to identify factors associated with deficient scars. Deficient scars were defined as detectable myometrial thinning at the site of the Cesarean section scar. RESULTS Lower-segment uterine scars were detected in 321/324 (99.1%; 95% CI, 98.0-100) women with a history of previous Cesarean section. Sixty-three (19.4%; 95% CI, 15.1-23.8) women had evidence of deficient Cesarean scars. Using multivariate analysis, a history of multiple Cesarean sections, uterine retroflexion and the inability to visualize all Cesarean scars in women with previous multiple Cesarean sections were all shown to be significantly associated with deficient scars. CONCLUSION Deficient uterine scars are a frequent finding in women with a history of previous Cesarean section. The risk of scar deficiency is increased in women with a retroflexed uterus and in those who have undergone multiple Cesarean sections.
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Affiliation(s)
- D Ofili-Yebovi
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK
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Helmy S, Sawyer E, Ofili-Yebovi D, Yazbek J, Ben Nagi J, Jurkovic D. Fertility outcomes following expectant management of tubal ectopic pregnancy. Ultrasound Obstet Gynecol 2007; 30:988-993. [PMID: 18044813 DOI: 10.1002/uog.5186] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To evaluate fertility outcome after the expectant management of tubal ectopic pregnancy. METHODS Our dedicated early pregnancy database was searched for all women diagnosed with a tubal ectopic pregnancy between January 1999 and June 2003 who were either managed expectantly or underwent a salpingectomy. They were contacted to enquire about their ability to conceive following the ectopic pregnancy and about the outcomes of any subsequent pregnancies. RESULTS Four hundred and forty-four women had a diagnosis of tubal ectopic pregnancy, and 173 (39%) were successfully contacted. A total of 146/173 (84.4%; 95% CI, 79-89.8%) tried for another pregnancy: 49/59 (83.1%; 95% CI, 73.4-92.6%) in the expectant management and 97/114 (85.1%; 95% CI, 78.4-91.6%) in the salpingectomy group (P > 0.05). Spontaneous intrauterine pregnancy occurred in 41/49 (83.7%; 95% CI, 73.3-94.2%) women managed expectantly and in 62/97 (63.9%; 95% CI, 54.4-73.5%) women managed surgically (odds ratio 2.89; 95% CI, 1.22-6.86%). The risk of recurrent ectopic pregnancy was not significantly different between the two management groups. CONCLUSIONS Fertility outcomes following the expectant management of tubal ectopic pregnancy are comparable to those following salpingectomy.
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Affiliation(s)
- S Helmy
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK
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Yazbek J, Helmy S, Ben-Nagi J, Holland T, Sawyer E, Jurkovic D. Value of preoperative ultrasound examination in the selection of women with adnexal masses for laparoscopic surgery. Ultrasound Obstet Gynecol 2007; 30:883-888. [PMID: 17932999 DOI: 10.1002/uog.5169] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES To assess the value of preoperative ultrasound examination in predicting the feasibility of intermediate-level laparoscopic surgery for benign adnexal masses. METHODS Symptomatic women with a clinical or ultrasound diagnosis of adnexal mass were offered a detailed transvaginal ultrasound scan in order to assess the feasibility of laparoscopic cystectomy/oophorectomy. In all cases an attempt was made to establish a likely histological diagnosis using the pattern recognition method. The selection criteria for laparoscopic surgery were: no ultrasound features suggestive of ovarian cancer, predominantly cystic lesion with no solid foci > 5 cm in mean diameter, no evidence of severe pelvic endometriosis or severe pelvic adhesions and dermoid cyst < 10 cm in mean diameter. Laparoscopic surgery was classified as successful if the mass was removed completely without resorting to a laparotomy. RESULTS One hundred and forty-three women were diagnosed with a total of 162 adnexal cysts. The final dataset consisted of 137 women (with 153 lesions), 113 (82.5%) of whom were selected for laparoscopy and 24 (17.5%) for laparotomy. On histological examination 152 (99.3%) cysts were benign and the remaining one (0.7%) was borderline. The operation was successfully completed laparoscopically in 107/113 (94.7%) cases. The preoperative ultrasound assessment predicted the successful outcome of laparoscopic surgery with a sensitivity of 98% (95% CI, 94-99%), specificity of 79% (95% CI, 60-90%), positive predictive value of 95% (95% CI, 89-98%), positive likelihood ratio of 4.58 (95% CI, 2.25-9.32) and negative likelihood ratio of 0.02 (95% CI, 0.01-0.09). CONCLUSIONS A detailed preoperative transvaginal ultrasound examination is a helpful tool for assessing the feasibility of intermediate-level laparoscopic surgery in women with benign adnexal lesions.
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Affiliation(s)
- J Yazbek
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK.
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Mavrelos D, Sawyer E, Helmy S, Holland TK, Ben-Nagi J, Jurkovic D. Ultrasound diagnosis of ectopic pregnancy in the non-communicating horn of a unicornuate uterus (cornual pregnancy). Ultrasound Obstet Gynecol 2007; 30:765-70. [PMID: 17763478 DOI: 10.1002/uog.5131] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/17/2023]
Abstract
OBJECTIVE To prospectively evaluate ultrasound criteria for the diagnosis of pregnancy in the rudimentary horn of a unicornuate uterus (cornual pregnancy). METHODS This was a prospective observational study over a period of 90 months in a tertiary referral center in a London teaching hospital. A diagnosis of cornual pregnancy was made when all the following ultrasound criteria were met: (1) a single interstitial portion of Fallopian tube in the main uterine body; (2) a gestational sac, mobile and separate from the uterus, surrounded by myometrium; and (3) a vascular pedicle joining the gestational sac to the unicornuate uterus. In cases where the ultrasound criteria were met the pregnancy was followed up and the final outcome was recorded, including operative and histological findings. RESULTS Over the study period eight cases of cornual pregnancy were diagnosed. Six women had a single case of cornual pregnancy. One woman was managed expectantly in her first cornual pregnancy and subsequently suffered a recurrence. Surgical management varied depending on viability of the pregnancy and gestational age at presentation. In all the women who underwent surgery the diagnosis was eventually confirmed at operation and on histological examination. During the study period there were no false positive or false negative results in our unit using the above criteria. CONCLUSION The proposed ultrasound criteria appear accurate and may be applied in clinical practice to facilitate preoperative diagnosis of cornual ectopic pregnancy.
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Affiliation(s)
- D Mavrelos
- Early Pregnancy and Acute Gynaecology Assessment Unit, Golden Jubilee Wing, King's College Hospital, London, UK
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Jurkovic D, Ben-Nagi J, Ofilli-Yebovi D, Sawyer E, Helmy S, Yazbek J. Efficacy of Shirodkar cervical suture in securing hemostasis following surgical evacuation of Cesarean scar ectopic pregnancy. Ultrasound Obstet Gynecol 2007; 30:95-100. [PMID: 17559184 DOI: 10.1002/uog.4058] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/15/2023]
Abstract
OBJECTIVES To assess the efficacy of a Shirodkar cervical suture in arresting hemorrhage following surgical removal of a Cesarean scar ectopic pregnancy. METHODS The study included women with an ultrasound diagnosis of Cesarean scar ectopic pregnancy who were scheduled for surgical evacuation. After administration of general anesthetic, a Shirodkar cervical suture was inserted using the standard surgical technique. The suture was left untied and the Cesarean scar pregnancy was evacuated under ultrasound guidance using suction curettage. Once the pregnancy had been successfully removed, the suture was tied and 500 microg ergometrine was administered intravenously to ensure uterine contraction. The patients were prescribed prophylactic antibiotics and the suture was removed 7 days later in the outpatient setting, under local anesthetic. RESULTS Over a 4-year period a total of 33 Cesarean scar pregnancies were diagnosed, and 28 (85%) had surgical evacuation. A cervical suture was necessary to achieve hemostasis in 22/28 (79%; 95% CI, 64-94) cases. In the remaining 6/28 (21%; 95% CI, 6-36) cases, the bleeding was minimal and the suture was not tied. The median estimated intraoperative blood loss was 50 (range, 50-1500) mL. Six of 28 (21%; 95% CI, 6-36) women suffered blood loss > or = 300 mL and two (7%; 95% CI, 0-17) required blood transfusion. One woman (5%; 95% CI, 0-14) required repeat surgery because of retained products of conception. There were no other significant complications and the uterus was preserved successfully in all cases. CONCLUSIONS Insertion of a Shirodkar cervical suture during the evacuation of a Cesarean scar pregnancy is an effective method for securing hemostasis; it minimizes the need for blood transfusion and ensures preservation of fertility.
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Affiliation(s)
- D Jurkovic
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK.
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Ben Nagi J, Helmy S, Ofili-Yebovi D, Yazbek J, Sawyer E, Jurkovic D. Reproductive outcomes of women with a previous history of Caesarean scar ectopic pregnancies. Hum Reprod 2007; 22:2012-5. [PMID: 17449510 DOI: 10.1093/humrep/dem078] [Citation(s) in RCA: 90] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Caesarean scar ectopic pregnancy is associated with a number of significant complications. In this study, we report on subsequent reproductive outcomes in a group of women following successful treatment of their scar pregnancies. METHODS The study included those women who received treatment for their Caesarean scar pregnancies between April 1999 and October 2005. Their ability to conceive, the time it took to become pregnant and outcomes of subsequent pregnancies were all recorded. RESULTS 40 women with Caesarean scar pregnancies were managed in our unit. The uterus was conserved in 38/40 cases. Follow-up data were available in 29/38 (76%) of women. Twenty-four out of 29 (83%) attempted to become pregnant. Twenty-one out of 24 [88%, 95% confidence interval (CI): 75-100] women conceived spontaneously. Twenty out of 21 (95%, 95% CI: 86-100) pregnancies were intrauterine and one woman (5%, 95% CI: 0-14) had a recurrent scar ectopic. Thirteen out of 20 (65%, 95% CI: 44-86) intrauterine pregnancies appeared normal. Nine out of 13 (69%) were delivered by Caesarean section. Seven out of 20 (35%, 95% CI: 14-56) intrauterine pregnancies ended in spontaneous abortions. CONCLUSIONS Our study shows that reproductive outcomes following treatment of caesarean scar ectopic pregnancies are favourable. The risk of complications including recurrent scar implantation appears to be low.
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Affiliation(s)
- J Ben Nagi
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, Denmark Hill, London SE 5 8RX, UK
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Sawyer E, Ofuasia E, Ofili-Yebovi D, Helmy S, Gonzalez J, Jurkovic D. The value of measuring endometrial thickness and volume on transvaginal ultrasound scan for the diagnosis of incomplete miscarriage. Ultrasound Obstet Gynecol 2007; 29:205-9. [PMID: 17201018 DOI: 10.1002/uog.3914] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/13/2023]
Abstract
OBJECTIVE To identify ultrasound measurements that are the best predictors of the presence of retained products of conception (RPOC) within the uterine cavity in women with clinical diagnosis of incomplete miscarriage. METHODS This was a prospective observational study, set in a dedicated early pregnancy assessment unit in a London teaching hospital. Endometrial thickness and the volume of suspected retained products of conception were measured by transvaginal ultrasound scan preoperatively. Indications for surgical intervention were heavy vaginal bleeding or continuous bleeding lasting > 7 days. The main outcome measure was histological evidence of chorionic villi in surgical specimens. RESULTS Among the patients, 109 (85%) had evidence of chorionic villi on histology, whilst decidua was only found in the remaining 19 (15%). There was no identifiable cut-off for endometrial thickness or volume that could be used to differentiate between retained products of conception and decidua. CONCLUSION Measurements of endometrial thickness or volume on ultrasound scan are not good tests for diagnosing an incomplete miscarriage.
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Affiliation(s)
- E Sawyer
- Early Pregnancy and Gynaecology Assessment Unit, King's College Hospital, London, UK
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Ben Nagi J, Ofili-Yebovi D, Sawyer E, Aplin J, Jurkovic D. Successful treatment of a recurrent Cesarean scar ectopic pregnancy by surgical repair of the uterine defect. Ultrasound Obstet Gynecol 2006; 28:855-6. [PMID: 17031873 DOI: 10.1002/uog.3843] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/12/2023]
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Przydzial MJ, Pogozheva ID, Ho JC, Bosse KE, Sawyer E, Traynor JR, Mosberg HI. Design of high affinity cyclic pentapeptide ligands for kappa-opioid receptors. ACTA ACUST UNITED AC 2006; 66:255-62. [PMID: 16218993 DOI: 10.1111/j.1399-3011.2005.00295.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
Using results from our previously reported cyclic opioid peptide series and reliable models for mu-, delta-, and kappa-opioid receptors (MOR, DOR, and KOR, respectively) and their complexes with peptide ligands, we have designed and synthesized a series of cyclic pentapeptides of structure Tyr-C[D-Cys-Phe-Phe-X]-NH2, cyclized via disulfide, methylene, or ethylene dithioethers, and where X = D- or L-Cys; or D- or L-penicillamine (Pen; beta,beta-dimethylcysteine). Determination of binding affinities to MOR, DOR, and KOR revealed that members of this series with X = D- or L-Cys display KOR affinities in the low nanomolar range, demonstrating that a 'DPDPE-like' tetrapeptide scaffold is suitable not only for DOR and MOR ligands, but also for KOR ligands. The cyclic pentapeptides reported here are not, however, selective for KOR, rather they display significant selectivity and high affinity for MOR. Indeed, peptide 8, Tyr-C[D-Cys-Phe-Phe-Cys]-NH2-cyclized via a methylene dithioether, shows picomolar binding affinity for MOR ( = 16 pm) with more than 100-fold selectivity for MOR vs. DOR or KOR, and may be of interest as a high affinity, high selectivity MOR ligand. Nonetheless, the high affinity KOR peptides in this series represent excellent leads for the development of structurally related, selective KOR ligands designed to exploit structurally specific features of KOR, MOR, and DOR.
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Affiliation(s)
- M J Przydzial
- Department of Medicinal Chemistry, College of Pharmacy, University of Michigan, Ann Arbor, MI 48109, USA
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Halford S, Rowan A, Sawyer E, Talbot I, Tomlinson I. O(6)-methylguanine methyltransferase in colorectal cancers: detection of mutations, loss of expression, and weak association with G:C>A:T transitions. Gut 2005; 54:797-802. [PMID: 15888787 PMCID: PMC1774551 DOI: 10.1136/gut.2004.059535] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND AIMS O(6)-methylguanine methyltransferase (MGMT) repairs inappropriately methylated guanine in DNA. MGMT mutations have not previously been reported in cancers, but in colorectal tumours MGMT promoter methylation is common and has been associated with increased G:C>A:T transitions, a high frequency of K-ras mutations, and low level microsatellite instability (MSI low). However, some have suggested that MGMT changes are background or secondary events, with little importance for tumorigenesis. METHODS We have analysed fresh frozen colorectal cancers and colorectal cancer cell lines for MGMT changes: mutations, allelic loss, and protein expression. RESULTS Six of 113 cancers harboured somatic missense MGMT mutations, at least three of which probably caused reduced MGMT function and were accompanied by silencing or loss of the wild-type allele. Cancers with pathogenic MGMT mutations tended to harbour G:C>A:T somatic mutations at other loci. Overall, MGMT expression was reduced or lost in more than half of the cancers. We found no association between MGMT expression and the somatic mutation spectrum at APC, beta-catenin, K-ras, or p53, but decreased MGMT expression was weakly associated with the presence of a G:C>A:T change at any one of these loci. Reduced MGMT expression was not however associated with an increased frequency of K-ras mutations or with MSI low. CONCLUSION In summary, we found that mutation of MGMT contributes to decreased protein function. Our findings provide good evidence to show that MGMT changes, including methylation, are selected rather than background events, at least in some cases. Decreased MGMT expression or function probably has a weak or moderate effect on the mutation spectrum in colorectal cancers.
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Affiliation(s)
- S Halford
- Colorectal Cancer Unit, Cancer Research UK, St Mark's Hospital, Watford Rd, Harrow HA1 3UK, UK
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Walley RL, Wilson JB, Crane JM, Matthews K, Sawyer E, Hutchens D. A double-blind placebo controlled randomised trial of misoprostol and oxytocin in the management of the third stage of labour. BJOG 2000; 107:1111-5. [PMID: 11002954 DOI: 10.1111/j.1471-0528.2000.tb11109.x] [Citation(s) in RCA: 67] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To compare oral misoprostol 400 microg with intramuscular oxytocin 10 IU in the routine management of the third stage. DESIGN Double-blind placebo controlled trial. SETTING Main referral hospital and its associated polyclinics in Accra, Ghana. POPULATION Four hundred and one low risk women, in the second stage of labour with anticipated vaginal delivery, who entered labour spontaneously. METHODS After delivery of the anterior shoulder of the baby, the women were randomised to receive either: 1. misoprostol 400 microg powder in water orally and 1 mL normal saline intramuscular injection (placebo); or 2. powdered cellulose in water orally (placebo) and 1 mL oxytocin 10 IU intramuscular injection. MAIN OUTCOME MEASURES Change in haemoglobin concentration from before delivery to 12 hours postpartum. Secondary outcomes included need for additional oxytocics, blood loss > 500 mL and > 1,000 mL, operative intervention for postpartum haemorrhage, and side effects, including nausea, vomiting, diarrhoea, shivering and elevated temperature. RESULTS Demographic characteristics were similar. There was no significant difference in change in haemoglobin concentration between the two groups (0.60 g/dL for misoprostol and 0.55 g/dL for oxytocin; relative difference 9.6%; 95% CI 20.5-39.6%; P = 0.54). There were no significant differences in secondary outcomes with the exception of shivering, which occurred more frequently in the misoprostol group (22.2% vs 5.7%; relative risk 4.73; 95% CI 2.31-9.68; P < 0.0001). CONCLUSIONS In low risk women oral misoprostol appears to be as effective in minimising blood loss in the third stage of labour as intramuscular oxytocin. Shivering was noted more frequently with misoprostol use, but no other side effects were noted. Misoprostol has great potential for use in the third stage of labour especially in developing countries.
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Affiliation(s)
- R L Walley
- Department of Obstetrics and Gynaecology, St John's, Memorial University of Newfoundland, Canada
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Sawyer E. New frontier of AIDS activism: international trade rules and global access to medicines. Interview by John S. James. AIDS Treat News 1999:1, 5-8. [PMID: 11366992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Sawyer E. Where is your rage? Newsline People AIDS Coalit N Y 1998:6-11. [PMID: 11367100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Sawyer E. AIDS research leader lost on SwissAir Flight 111. Newsline People AIDS Coalit N Y 1998:52. [PMID: 11367494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
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Klicius R, Sawyer E. Balancing quality and cost: a public decision-making process. Dimens Health Serv 1986; 63:11-3. [PMID: 3732644] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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