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Li Y, Xiao X, Li J, Han Y, Cheng C, Fernandes GF, Slewitzke SE, Rosenberg SM, Zhu M, Byun J, Bossé Y, McKay JD, Albanes D, Lam S, Tardon A, Chen C, Bojesen SE, Landi MT, Johansson M, Risch A, Bickeböller H, Wichmann HE, Christiani DC, Rennert G, Arnold SM, Goodman GE, Field JK, Davies MP, Shete S, Marchand LL, Liu G, Hung RJ, Andrew AS, Kiemeney LA, Sun R, Zienolddiny S, Grankvist K, Johansson M, Caporaso NE, Cox A, Hong YC, Lazarus P, Schabath MB, Aldrich MC, Schwartz AG, Gorlov I, Purrington KS, Yang P, Liu Y, Bailey-Wilson JE, Pinney SM, Mandal D, Willey JC, Gaba C, Brennan P, Xia J, Shen H, Amos CI. Lung Cancer in Ever- and Never-Smokers: Findings from Multi-Population GWAS Studies. Cancer Epidemiol Biomarkers Prev 2024; 33:389-399. [PMID: 38180474 PMCID: PMC10905670 DOI: 10.1158/1055-9965.epi-23-0613] [Citation(s) in RCA: 0] [Impact Index Per Article: 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: 05/26/2023] [Revised: 08/03/2023] [Accepted: 01/03/2024] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Clinical, molecular, and genetic epidemiology studies displayed remarkable differences between ever- and never-smoking lung cancer. METHODS We conducted a stratified multi-population (European, East Asian, and African descent) association study on 44,823 ever-smokers and 20,074 never-smokers to identify novel variants that were missed in the non-stratified analysis. Functional analysis including expression quantitative trait loci (eQTL) colocalization and DNA damage assays, and annotation studies were conducted to evaluate the functional roles of the variants. We further evaluated the impact of smoking quantity on lung cancer risk for the variants associated with ever-smoking lung cancer. RESULTS Five novel independent loci, GABRA4, intergenic region 12q24.33, LRRC4C, LINC01088, and LCNL1 were identified with the association at two or three populations (P < 5 × 10-8). Further functional analysis provided multiple lines of evidence suggesting the variants affect lung cancer risk through excessive DNA damage (GABRA4) or cis-regulation of gene expression (LCNL1). The risk of variants from 12 independent regions, including the well-known CHRNA5, associated with ever-smoking lung cancer was evaluated for never-smokers, light-smokers (packyear ≤ 20), and moderate-to-heavy-smokers (packyear > 20). Different risk patterns were observed for the variants among the different groups by smoking behavior. CONCLUSIONS We identified novel variants associated with lung cancer in only ever- or never-smoking groups that were missed by prior main-effect association studies. IMPACT Our study highlights the genetic heterogeneity between ever- and never-smoking lung cancer and provides etiologic insights into the complicated genetic architecture of this deadly cancer.
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Affiliation(s)
- Yafang Li
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Xiangjun Xiao
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Jianrong Li
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
| | - Younghun Han
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Chao Cheng
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Gail F. Fernandes
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Shannon E. Slewitzke
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Susan M. Rosenberg
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
- Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, Texas
| | - Meng Zhu
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, P.R. China
| | - Jinyoung Byun
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
| | - Yohan Bossé
- Institut universitaire de cardiologie et de pneumologie de Québec, Department of Molecular Medicine, Laval University, Quebec City, Canada
| | - James D. McKay
- Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Demetrios Albanes
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Stephen Lam
- Department of Integrative Oncology, University of British Columbia, Vancouver, British Columbia, Canada
| | - Adonina Tardon
- Public Health Department, University of Oviedo, ISPA and CIBERESP, Asturias, Spain
| | - Chu Chen
- Program in Epidemiology, Public Health Sciences Division, Fred Hutchinson Cancer Center, Seattle, Washington
| | - Stig E. Bojesen
- Department of Clinical Biochemistry, Copenhagen University Hospital, Copenhagen, Denmark
- Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Maria T. Landi
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Mattias Johansson
- Section of Genetics, International Agency for Research on Cancer, World Health Organization, Lyon, France
| | - Angela Risch
- Thoraxklinik at University Hospital Heidelberg, Heidelberg, Germany
- Translational Lung Research Center Heidelberg (TLRC-H), Heidelberg, Germany
- University of Salzburg and Cancer Cluster Salzburg, Salzburg, Austria
| | - Heike Bickeböller
- Department of Genetic Epidemiology, University Medical Center, Georg-August-University Göttingen, Göttingen, Germany
| | | | - David C. Christiani
- Departments of Environmental Health and Epidemiology, Harvard TH Chan School of Public Health, Boston, Massachusetts
| | - Gad Rennert
- Clalit National Cancer Control Center at Carmel Medical Center and Technion Faculty of Medicine, Haifa, Israel
| | | | | | - John K. Field
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Michael P.A. Davies
- Institute of Translational Medicine, University of Liverpool, Liverpool, United Kingdom
| | - Sanjay Shete
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas
- Department of Epidemiology, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Loïc Le Marchand
- Epidemiology Program, University of Hawaii Cancer Center, Honolulu, Hawaii
| | - Geoffrey Liu
- University Health Network- The Princess Margaret Cancer Centre, Toronto, California
| | - Rayjean J. Hung
- Luenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Canada
| | - Angeline S. Andrew
- Departments of Epidemiology and Community and Family Medicine, Dartmouth College, Hanover, New Hampshire
| | | | - Ryan Sun
- Department of Biostatistics, The University of Texas, MD Anderson Cancer Center, Houston, Texas
| | | | - Kjell Grankvist
- Department of Medical Biosciences, Umeå University, Umeå, Sweden
| | | | - Neil E. Caporaso
- Division of Cancer Epidemiology and Genetics, NCI, NIH, Bethesda, Maryland
| | - Angela Cox
- Department of Oncology and Metabolism, University of Sheffield, Sheffield, United Kingdom
| | - Yun-Chul Hong
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Republic of South Korea
| | - Philip Lazarus
- Department of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, Washington
| | - Matthew B. Schabath
- Department of Cancer Epidemiology, H. Lee Moffitt Cancer Center and Research Institute, Tampa, Florida
| | - Melinda C. Aldrich
- Department of Thoracic Surgery, Division of Epidemiology, Vanderbilt University Medical Center, Nashville, Tennessee
| | - Ann G. Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Karmanos Cancer Institute, Detroit, Michigan
| | - Ivan Gorlov
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | - Kristen S. Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Karmanos Cancer Institute, Detroit, Michigan
| | - Ping Yang
- Division of Epidemiology, Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Yanhong Liu
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
| | | | - Susan M. Pinney
- University of Cincinnati College of Medicine, Cincinnati, Ohio
| | - Diptasri Mandal
- Louisiana State University Health Sciences Center, New Orleans, Louisiana
| | - James C. Willey
- College of Medicine and Life Sciences, University of Toledo, Toledo, Ohio
| | - Colette Gaba
- The University of Toledo College of Medicine, Toledo, Ohio
| | - Paul Brennan
- Institut universitaire de cardiologie et de pneumologie de Québec, Department of Molecular Medicine, Laval University, Quebec City, Canada
| | - Jun Xia
- Creighton University School of Medicine, Omaha, Nebraska
| | - Hongbing Shen
- Department of Epidemiology and Biostatistics, Jiangsu Key Lab of Cancer Biomarkers, Prevention and Treatment, Collaborative Innovation Center for Cancer Personalized Medicine, School of Public Health, Nanjing Medical University, Nanjing, P.R. China
| | - Christopher I. Amos
- Institute for Clinical and Translational Research, Baylor College of Medicine, Houston, Texas
- Section of Epidemiology and Population Sciences, Department of Medicine, Baylor College of Medicine, Houston, Texas
- Dan L Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, Texas
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2
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Purrington KS, Hastert TA, Madhav KC, Nair M, Snider N, Ruterbusch JJ, Schwartz AG, Stoffel EM, Peters ES, Rozek LS. The role of area-level socioeconomic disadvantage in racial disparities in cancer incidence in metropolitan Detroit. Cancer Med 2023. [PMID: 37184135 DOI: 10.1002/cam4.6065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Revised: 04/17/2023] [Accepted: 04/30/2023] [Indexed: 05/16/2023] Open
Abstract
BACKGROUND Neighborhood deprivation is associated with both race and cancer incidence, but there is a need to better understand the effect of structural inequities on racial cancer disparities. The goal of this analysis was to evaluate the relationship between a comprehensive measure of neighborhood-level social disadvantage and cancer incidence within the racially diverse population of metropolitan Detroit. METHODS We estimated breast, colorectal, lung, and prostate cancer incidence rates using Metropolitan Detroit Cancer Surveillance System and US decennial census data. Neighborhood socioeconomic disadvantage was measured by the Area Deprivation Index (ADI) using Census Bureau's American Community Survey data at the Public Use Microdata Areas (PUMA) level. Associations between ADI at time of diagnosis and cancer incidence were estimated using Poisson mixed-effects models adjusting for age and sex. Attenuation of race-incidence associations by ADI was quantified using the "mediation" package in R. RESULTS ADI was inversely associated with incidence of breast cancer for both non-Hispanic White (NHW) and non-Hispanic Black (NHB) women (NHW: per-quartile RR = 0.92, 95% CI 0.88-0.96; NHB: per-quartile RR = 0.94, 95% CI 0.91-0.98) and with prostate cancer incidence only for NHW men (per-quartile RR = 0.94, 95% CI 0.90-0.97). ADI was positively associated with incidence of lung cancer for NHWs and NHBs (NHW: per-quartile RR = 1.12, 95% CI 1.04-1.21; NHB: per-quartile RR = 1.37, 95% CI 1.25-1.51) and incidence of colorectal cancer (CRC) only among NHBs (per-quartile RR = 1.11, 95% CI 1.02-1.21). ADI significantly attenuated the relationship between race and hormone receptor positive, HER2-negative breast cancer (proportion attenuated = 8.5%, 95% CI 4.1-16.6%) and CRC cancer (proportion attenuated = 7.3%, 95% CI 3.7 to 12.8%), and there was a significant interaction between race and ADI for lung (interaction RR = 1.22, p < 0.0001) and prostate cancer (interaction RR = 1.09, p = 0.00092). CONCLUSIONS Area-level socioeconomic disadvantage is associated with risk of common cancers in a racially diverse population and plays a role in racial differences in cancer incidence.
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Affiliation(s)
- Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Michigan, Detroit, USA
| | - Theresa A Hastert
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Michigan, Detroit, USA
| | - K C Madhav
- Department of Internal Medicine, Yale School of Medicine, Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, Connecticut, New Haven, USA
| | - Mrudula Nair
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
| | - Natalie Snider
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Michigan, Detroit, USA
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Michigan, Detroit, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Michigan, Detroit, USA
| | - Elena M Stoffel
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, Michigan, Ann Arbor, USA
| | - Edward S Peters
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska, USA
| | - Laura S Rozek
- Department of Oncology, Georgetown University School of Medicine, District of Columbia, Washington, USA
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Snider NG, Hastert TA, Nair M, Madhav K, Ruterbusch JJ, Schwartz AG, Peters ES, Stoffel EM, Rozek LS, Purrington KS. Area-level Socioeconomic Disadvantage and Cancer Survival in Metropolitan Detroit. Cancer Epidemiol Biomarkers Prev 2023; 32:387-397. [PMID: 36723416 PMCID: PMC10071652 DOI: 10.1158/1055-9965.epi-22-0738] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 07/13/2022] [Revised: 09/27/2022] [Accepted: 01/09/2023] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Racial segregation is linked to poorer neighborhood quality and adverse health conditions among minorities, including worse cancer outcomes. We evaluated relationships between race, neighborhood social disadvantage, and cancer survival. METHODS We calculated overall and cancer-specific survival for 11,367 non-Hispanic Black (NHB) and 29,481 non-Hispanic White (NHW) individuals with breast, colorectal, lung, or prostate cancer using data from the Metropolitan Detroit Cancer Surveillance System. The area deprivation index (ADI) was used to measure social disadvantage at the census block group level, where higher ADI is associated with poorer neighborhood factors. Associations between ADI and survival were estimated using Cox proportional hazards mixed-effects models accounting for geographic grouping and adjusting for demographic and clinical factors. RESULTS Increasing ADI quintile was associated with increased overall mortality for all four cancer sites in multivariable-adjusted models. Stratified by race, these associations remained among breast (NHW: HR = 1.16, P < 0.0001; NHB: HR = 1.20, P < 0.0001), colorectal (NHW: HR = 1.11, P < 0.0001; NHB: HR = 1.09, P = 0.00378), prostate (NHW: HR = 1.18, P < 0.0001; NHB: HR = 1.18, P < 0.0001), and lung cancers (NHW: HR = 1.06, P < 0.0001; NHB: HR = 1.07, P = 0.00177). Cancer-specific mortality estimates were similar to overall mortality. Adjustment for ADI substantially attenuated the effects of race on mortality for breast [overall proportion attenuated (OPA) = 47%, P < 0.0001; cancer-specific proportion attenuated (CSPA) = 37%, P < 0.0001] prostate cancer (OPA = 51%, P < 0.0001; CSPA = 56%, P < 0.0001), and colorectal cancer (OPA = 69%, P = 0.032; CSPA = 36%, P = 0.018). CONCLUSIONS Area-level socioeconomic disadvantage is related to cancer mortality in a racially diverse population, impacting racial differences in cancer mortality. IMPACT Understanding the role of neighborhood quality in cancer survivorship could improve community-based intervention practices.
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Affiliation(s)
- Natalie G. Snider
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Theresa A. Hastert
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Mrudula Nair
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - K.C. Madhav
- Department of Internal Medicine, Yale School of Medicine, Cancer Outcomes, Public Policy, and Effectiveness Research (COPPER) Center, New Haven, Connecticut
| | - Julie J. Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Ann G. Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Edward S. Peters
- Department of Epidemiology, College of Public Health, University of Nebraska Medical Center, Omaha, Nebraska
| | - Elena M. Stoffel
- Division of Gastroenterology, Department of Internal Medicine, University of Michigan Health System, Ann Arbor, Michigan
| | - Laura S. Rozek
- Department of Oncology, Georgetown University School of Medicine, Washington, DC
| | - Kristen S. Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
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Abdallah N, Purrington KS, Tatineni S, Assad H, Petrucelli N, Simon MS. Racial and ethnic variation in BRCA1 and BRCA2 genetic test results among individuals referred for genetic counseling at a large urban comprehensive cancer center. Cancer Causes Control 2023; 34:141-149. [PMID: 36370215 DOI: 10.1007/s10552-022-01648-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 10/24/2022] [Indexed: 11/15/2022]
Abstract
PURPOSE The prevalence of pathogenic variants in BRCA1 and BRCA2 in populations other than Ashkenazi Jewish (AJ) is not well defined. We describe the racial and ethnic-specific prevalence of BRCA1/2 pathogenic variants and variants of uncertain significance (VUS) among individuals referred for genetic testing in a large urban comprehensive cancer center over a 20-year period. METHODS The population included 3,537 unrelated individuals who underwent genetic testing from January 1999 to October 2019 at the Karmanos Cancer Institute. We estimated the prevalence of pathogenic variants and VUS and evaluated associations with race and ethnicity for African American (AA), Arab, AJ and Hispanic individuals compared to Non-Hispanic Whites (NHW). We used multivariable models to adjust for other predictors of pathogenic variants. We also reported the most common pathogenic variants by racial and ethnic group. RESULTS The racial and ethnic breakdown of our population was: NHW (68.9%), AA (20.3%), AJ (2.5%), Arab (2.2%), Hispanic (1.0%), Asian Pacific Islander, Native American/Alaskan Native (4.7%), and < 1% unknown. The overall prevalence of pathogenic variants in BRCA1/2 was 8.9% and the prevalence of VUS was 5.6%. Compared to NHW, there were no racial or ethnic differences in the rate of pathogenic variants. However, AA individuals were more likely to have VUS in BRCA1 (adjusted OR 2.43, 95% CI 1.38-4.28) and AJ were more likely to have VUS in BRCA2 (adjusted OR 3.50, 95% CI 1.61-6.58). CONCLUSION These results suggest the continued need for genetic testing and variant reclassification for individuals of all racial and ethnic groups.
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Affiliation(s)
- Nadine Abdallah
- Department of Internal Medicine, Division of Oncology, Mayo Clinic, Rochester, MN, USA
| | - Kristen S Purrington
- Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Sushma Tatineni
- Department of Oncology, Minnesota Oncology, Minneapolis, MN, USA
| | - Hadeel Assad
- Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Nancie Petrucelli
- Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA
| | - Michael S Simon
- Department of Oncology, Karmanos Cancer Institute at Wayne State University, Detroit, MI, USA. .,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
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Wehbe A, Manning M, Assad H, Purrington KS, Simon MS. Uptake of genetic counseling and testing in a clinic-based population of women with breast cancer. Cancer Med 2022; 11:3304-3311. [PMID: 35322585 PMCID: PMC9468430 DOI: 10.1002/cam4.4684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [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: 09/17/2021] [Revised: 12/09/2021] [Accepted: 01/06/2022] [Indexed: 11/06/2022] Open
Abstract
Background The study was conducted to evaluate racial differences in referral and uptake of genetic counseling (GC) in a clinic‐based population of women with breast cancer. Methods Medical records of 150 breast cancer patients at the Karmanos Cancer Institute were reviewed to determine eligibility for GC according to National Comprehensive Cancer Network guidelines, GC referral rates, and appointment completion rates. Logistic regression was used to assess the relationship between demographic and clinical factors and GC eligibility and referral. Results The mean age at diagnosis was 57.1 (SD 12.6) and 66% of the women were Black. There were 91 women (60.7%) eligible for GC and of those, 54 (61.4%) were referred. After multivariable analyses, factors associated with reduced eligibility were older age at diagnosis (OR = 0.91, 95% CI [0.87,0.95]) and Black race (OR = 0.37, 95% CI [0.15, 0.96]). After additional multivariable analysis, eligibility was associated with an increased likelihood of referral (OR = 5.97, 95% CI [2.29, 15.56]), however, Medicare versus private insurance was associated with a lower likelihood for referral (OR = 0.32, 95% CI [0.12–0.80]. Of those referred, 49 (76.6%) completed an appointment, and 47 had genetic testing. Women with Medicare were also less likely to complete an appointment. Race had no impact on referral or appointment completion. Conclusions There were no racial differences in GC referral or appointment completion in a clinic‐based sample of women with breast cancer. Further interventions are needed to promote increased referral and appointment completion for women with breast cancer who are eligible for GC.
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Affiliation(s)
- Alexandra Wehbe
- Wayne State University School of Medicine, Detroit, Michigan, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Mark Manning
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA.,Department of Psychology, Oakland University, Rochester Hills, Michigan, USA
| | - Hadeel Assad
- Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Kristen S Purrington
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Michael S Simon
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA.,Department of Oncology, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Tatineni S, Tarockoff M, Abdallah N, Purrington KS, Assad H, Reagle R, Petrucelli N, Simon MS. Racial and ethnic variation in multigene panel testing in a cohort of BRCA1/2-negative individuals who had genetic testing in a large urban comprehensive cancer center. Cancer Med 2022; 11:1465-1473. [PMID: 35040284 PMCID: PMC8921894 DOI: 10.1002/cam4.4541] [Citation(s) in RCA: 5] [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: 05/02/2021] [Revised: 09/17/2021] [Accepted: 10/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background There is sparse clinical information on the racial and ethnic distribution of results of multigene panel testing among individuals at high risk for hereditary cancer. Methods We evaluated the results of multigene panel testing across eight clinical sites across the state of Michigan for individuals seen for genetic counseling from May 13, 2013 to October 31, 2019 at the Karmanos Cancer Institute's cancer genetics clinic. We estimated the prevalence of pathogenic variants and variants of uncertain significance (VUS) from genes other than BRCA1/2 among individuals of non‐Hispanic White (NHW), Black or African American (AA), Ashkenazi Jewish (AJ), Arab, Hispanic, and other ancestry. Results The racial and ethnic distribution of 2419 individuals who had panel testing included 68.8% NHW, 22.1% AA, 2.3% Arab, 2.2% AJ, 1.0% Hispanic, and 3.6% other. Of these, 11.2% had pathogenic variants and 17.5% had VUS. After multivariable analyses, compared to NHW, AA were less likely to have pathogenic variants (OR 95% CI, 0.38, 0.24–0.59, p < 0.001). Both AA and Arabs were more likely to have VUS (OR 95% CI, 1.53, 1.18–1.98, p = 0.001 and OR 95% CI, 2.28, 1.17–4.43, p = 0.015, respectively). There were no significant differences for other groups. The most common pathogenic variants were CHEK2 (n = 65), MUTYH (n = 45), ATM (n = 28), and MSH2 (n = 22); the most common pathogenic variants by race and ethnicity were CHEK2 (NHW), MSH2 and MUTYH (AA), MSH2 (Arab), MSH6 and CHEK2 (AJ), and MLH1 (Hispanic); the most common pathogenic variants by primary cancer site were CHEK2 (breast), MSH2 (colon), BRIP1 and MUTYH (ovarian), and MSH2 and MSH6 (endometrial). Conclusions Understanding the racial and ethnic distribution of pathogenic variants in multi‐gene panels has the potential to lead to better identification of individuals at risk for hereditary cancer.
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Affiliation(s)
| | - Meri Tarockoff
- Division of Hematology/Oncology, Memorial Healthcare System, Pembroke Pines, Florida, USA
| | - Nadine Abdallah
- Department of Oncology, Mayo Clinic, Rochester, Minnesota, USA
| | - Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Hadeel Assad
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | | | - Nancie Petrucelli
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
| | - Michael S Simon
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, USA
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Purrington KS, Schwartz AG, Ruterbusch JJ, Manning MA, Nair M, Wenzlaff AS, Pandolfi SS, Simon MS, Beebe-Dimmer J. Patterns of cancer family history and genetic counseling eligibility among African Americans with breast, prostate, lung, and colorectal cancers: A Detroit Research on Cancer Survivors cohort study. Cancer 2020; 126:4744-4752. [PMID: 32749684 DOI: 10.1002/cncr.33126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Revised: 07/02/2020] [Accepted: 07/08/2020] [Indexed: 11/05/2022]
Abstract
BACKGROUND Family history (FH) remains one of the strongest risk factors for many common cancers and is used to determine cancer genetic counseling (CGC) eligibility, but the understanding of familial cancer patterns in African Americans is limited. METHODS This study evaluated cancer FH among African Americans with invasive breast cancer, prostate cancer, lung cancer, or colorectal cancer (CRC) in the Detroit Research on Cancer Survivors (ROCS) cohort. Associations between participant cancer type, site-specific FH, and meeting national guidelines for CGC were evaluated via logistic regression. Cancer FH patterns were evaluating via hierarchical clustering. RESULTS Among 1500 ROCS participants, 71% reported at least 1 first-degree relative or grandparent with cancer. FHs of breast cancer, CRC, lung cancer, and prostate cancer were most common among participants with the same diagnosis (odds ratio [OR] for breast cancer, 1.14; P < .001; OR for CRC, 1.08; P = .003; OR for lung cancer, 1.09; P = .008; OR for prostate cancer, 1.14; P < .001). Nearly half of the participants (47%) met national CGC guidelines, and 24.4% of these participants met CGC criteria on the basis of their cancer FH alone. FH was particularly important in determining CGC eligibility for participants with prostate cancer versus breast cancer (OR for FH vs personal history alone, 2.91; 95% confidence interval, 1.94-4.35; P < .001). In clustering analyses, breast and prostate cancer FH-defined clusters were common across all participants. Clustering of CRC and breast cancer FHs was also observed. CONCLUSIONS ROCS participants reported high rates of cancer FH. The high rate of eligibility for CGC among ROCS participants supports the need for interventions to increase referrals and uptake of CGC among African Americans.
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Affiliation(s)
- Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Julie J Ruterbusch
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Mark A Manning
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Mrudula Nair
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Angela S Wenzlaff
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Stephanie S Pandolfi
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Michael S Simon
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Jennifer Beebe-Dimmer
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
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8
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Purrington KS, Raychaudhuri S, Simon MS, Clark J, Ratliff V, Dyson G, Craig DB, Boerner JL, Beebe-Dimmer JL, Schwartz AG. Heritable Susceptibility to Breast Cancer among African-American Women in the Detroit Research on Cancer Survivors Study. Cancer Epidemiol Biomarkers Prev 2020; 29:2369-2375. [PMID: 32868316 DOI: 10.1158/1055-9965.epi-20-0564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 07/16/2020] [Accepted: 08/26/2020] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND African-American women have high rates of breast cancer associated with hereditary features. However, no studies have reported the prevalence of inherited variation across all genes known to be breast cancer risk factors among African-American patients with breast cancer not selected for high-risk characteristics. METHODS We evaluated 182 African-American women diagnosed with invasive breast cancer in metropolitan Detroit via targeted capture and multiplex sequencing of 13 well-established breast cancer risk genes and five suggested breast cancer risk genes. RESULTS We identified 24 pathogenic variants in 23 women [12.6%; 95% confidence interval (CI), 8.2%-18.4%] and five genes (BRCA2, BRCA1, ATM, RAD50, CDH1). BRCA1 and BRCA2 accounted for 58.3% of all pathogenic variants. An additional six pathogenic variants were found in suggested breast cancer risk genes (MSH6, MUTYH, NF1, BRIP1). CONCLUSIONS The prevalence of germline pathogenic variants is relatively high among African-American patients with breast cancer unselected for high-risk characteristics across a broad spectrum of genes. IMPACT This study helps to define the genomic landscape of breast cancer susceptibility in African-American women who could benefit from enhanced surveillance and screening.
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Affiliation(s)
- Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan. .,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | | | - Michael S Simon
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Julie Clark
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Valerie Ratliff
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan
| | - Gregory Dyson
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan.,Bioinformatics & Biostatistics Core, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Douglas B Craig
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Bioinformatics & Biostatistics Core, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Julie L Boerner
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Jennifer L Beebe-Dimmer
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan.,Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan
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9
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Watza D, Lusk CM, Dyson G, Purrington KS, Wenzlaff AS, Neslund-Dudas C, Soubani AO, Gadgeel SM, Schwartz AG. COPD-dependent effects of genetic variation in key inflammation pathway genes on lung cancer risk. Int J Cancer 2020; 147:747-756. [PMID: 31709530 PMCID: PMC7211135 DOI: 10.1002/ijc.32780] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [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: 04/23/2019] [Revised: 10/10/2019] [Accepted: 10/21/2019] [Indexed: 12/14/2022]
Abstract
Genome-wide association studies (GWAS) have identified several loci contributing to lung cancer and COPD risk independently; however, inflammation-related pathways likely harbor additional lung cancer risk-associated variants in biologically relevant immune genes that differ dependent on COPD. We selected single nucleotide polymorphisms (SNPs) proximal to 2,069 genes within 48 immune pathways. We modeled the contribution of these variants to lung cancer risk in a discovery sample of 1,932 lung cancer cases and controls stratified by COPD status and validation sample of 953 cases and controls also stratified by COPD. There were 43 validated SNPs in those with COPD and 60 SNPs in those without COPD associated with lung cancer risk. Furthermore, 29 of 43 and 28 of 60 SNPs demonstrated a statistically significant interaction with COPD in the pooled sample. These variants demonstrated tissue-dependent effects on proximal gene expression, enhanced network connectivity and resided together in specific immune pathways. These results reveal that key inflammatory related genes and pathways, not found in prior GWAS, impact lung cancer risk in a COPD-dependent manner. Genetic variation identified in our study supplements prior lung cancer GWAS and serves as a foundation to further interrogate risk relationships in smoking and COPD populations.
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Affiliation(s)
- Donovan Watza
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Christine M. Lusk
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Gregory Dyson
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Kristen S. Purrington
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Angela S. Wenzlaff
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
| | - Christine Neslund-Dudas
- Department of Public Health Sciences, Henry Ford Health System and Henry Ford Cancer Institute, Detroit, MI 48202, USA
| | - Ayman O. Soubani
- Karmanos Cancer Institute, Detroit, MI 48201, USA
- Department of Internal Medicine, School of Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Shirish M. Gadgeel
- Comprehensive Cancer Center, University of Michigan, Ann Arbor, MI 48109, USA
| | - Ann G. Schwartz
- Department of Oncology Wayne State University School of Medicine, Detroit, MI 48201, USA
- Karmanos Cancer Institute, Detroit, MI 48201, USA
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10
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Teslow EA, Mitrea C, Bao B, Mohammad RM, Polin LA, Dyson G, Purrington KS, Bollig-Fischer A. Abstract B053: Expression of alternative mRNA splicing variant MBD2_v2 promotes triple-negative breast cancer tumor initiation and is associated with body mass index. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp18-b053] [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] Open
Abstract
Abstract
According to epidemiologic research, obesity is a risk factor for triple-negative breast cancer (TNBC). The underlying molecular biology remains unknown. We reasoned that obesity-induced chronic inflammation, reactive oxygen species (ROS) being central, serves as the general link to TNBC. We are the first to report that expression of the epigenetic reader methyl-CpG-binding domain protein 2 mRNA variant MBD2_v2 in TNBC cell cultures depends on ROS and is necessary to maintain and promote expansion of cancer stem cell-like cells (CSCs). The relevance of CSCs is that they are a subpopulation of cancer cells recognized as the source of malignant tumor initiation, and they give rise to drug resistance and metastatic recurrence. We also previously reported evidence that MBD2_v2 expression underlies TNBC resistance to EGFR inhibitor drugs. Now, having used a diet-induced obesity (DIO) mouse model that mimics human obesity, we report that MBD2_v2 and serine/arginine-rich mRNA splicing factor 2 (SRSF2) levels were increased in tumors that formed more frequently in DIO mice relative to lean controls. To more directly test if increased MBD2_v2 drives increased tumor initiation capacity, we stably modified MBD2_v2 or SRSF2 expression in TNBC cells prior to inoculation. MBD2_v2 overexpression increased tumor initiation while SRSF2 knockdown, resulting in decreased MBD2_v2 expression, attenuated tumor formation. In addition, our analysis of TNBC patient tumors revealed a significant positive association for MBD2_v2 expression and body mass index (BMI). African American (AA) women are 1.7 times more often obese relative to European American women, and a TNBC driver mechanism fueled by obesity-coupled inflammation could underlie the higher incidence of TNBC among AA women.
Citation Format: Emily A. Teslow, Cristina Mitrea, Bin Bao, Ramzi M. Mohammad, Lisa A. Polin, Greg Dyson, Kristen S. Purrington, Aliccia Bollig-Fischer. Expression of alternative mRNA splicing variant MBD2_v2 promotes triple-negative breast cancer tumor initiation and is associated with body mass index [abstract]. In: Proceedings of the Eleventh AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2018 Nov 2-5; New Orleans, LA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl):Abstract nr B053.
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Affiliation(s)
- Emily A. Teslow
- 1Karmanos Cancer Institute, Wayne State University, Detroit, MI,
| | | | - Bin Bao
- 1Karmanos Cancer Institute, Wayne State University, Detroit, MI,
| | | | - Lisa A. Polin
- 1Karmanos Cancer Institute, Wayne State University, Detroit, MI,
| | - Greg Dyson
- 1Karmanos Cancer Institute, Wayne State University, Detroit, MI,
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11
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Purrington KS, Ruterbusch JJ, Manning M, Simon MS, Beebe-Dimmer J, Schwartz AG. Abstract C042: Family history of cancer among African Americans with breast, prostate, lung, and colorectal cancers in the Detroit Research on Cancer Survivors cohort. Cancer Epidemiol Biomarkers Prev 2020. [DOI: 10.1158/1538-7755.disp19-c042] [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] Open
Abstract
Abstract
Individuals with familial cancers are at increased risk of second primary cancers, and there are clear clinical guidelines for treatment and follow-up. However, the literature on the patterns of cancer family history (FH) in African Americans (AAs) is sparse. Detroit Research on Cancer Survivors (ROCS) is a population-based cohort study of AAs residing in metropolitan Detroit diagnosed with a primary invasive cancer of the breast, colon/rectum, lung or prostate after January 1, 2013. ROCS participants complete baseline and yearly follow-up questionnaires that include assessment of participants’ family history of cancer. We examined the distribution of breast, prostate, colorectal, lung, kidney, liver, ovarian, pancreatic cancers among first degree relatives and grandparents of Detroit ROCS participants (i.e, probands). We also estimated the distribution of cancers involved in known hereditary cancer syndromes (hereditary breast and ovarian cancer (HBOC), Lynch, Peutz-Jeghers, Cowden, Li-Fraumeni) within these families. Associations between probands’ age of onset and cancer family history were evaluated using logistic regression. Among the first 1,500 ROCS participants recruited into the cohort (674 breast, 138 colorectal, 174 lung, 514 prostate), 71% reported at least one relative with a cancer of any type, which did not vary substantially by proband cancer site. FH of breast (p<0.001), colorectal (p=0.010), lung (p=0.022), prostate (p<0.001), and ovarian (p=0.044) cancers significantly varied by proband cancer site, where probands were most likely to report a FH of their index cancer site (breast: 30%, colorectal: 17%, lung: 25%, prostate: 28%). When restricted to older family members (parents + grandparents), a FH of cancer matching the probands’ cancer site increased the odds of being diagnosed under the age of 50 (Breast: Odds ratio (OR)=1.73, 95% confidence interval (CI) 1.01-2.96; colorectal: OR=3.71, 95% CI 0.71-19.41; prostate: OR=1.86, 95% CI 0.91-3.79). FH of HBOC cancers was most common among probands with breast (47%) and prostate (43%) cancer compared to other sites (28-34%, p<0.001), while FH of Li-Fraumeni cancers was most common among probands with breast cancers (31% vs. 17-22%, p<0.001). Probands with breast and colorectal cancers were more likely to report FH of Cowden cancers (36-38% vs. 24-25%, p<0.001). FH of Lynch and Peutz-Jeghers cancers were less commonly reported among probands with lung (23% vs. 32-38%, p=0.004) and prostate (39% vs. 48-53%, p<0.001) cancers, respectively. AAs with breast, prostate, lung, and colorectal cancers frequently report FH of cancer, and patterns of FH differ by index cancer site. A better understanding of cancer family history among AAs could provide insights into cancer etiology in this population.
Citation Format: Kristen S Purrington, Julie J Ruterbusch, Mark Manning, Michael S Simon, Jennifer Beebe-Dimmer, Ann G Schwartz. Family history of cancer among African Americans with breast, prostate, lung, and colorectal cancers in the Detroit Research on Cancer Survivors cohort [abstract]. In: Proceedings of the Twelfth AACR Conference on the Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically Underserved; 2019 Sep 20-23; San Francisco, CA. Philadelphia (PA): AACR; Cancer Epidemiol Biomarkers Prev 2020;29(6 Suppl_2):Abstract nr C042.
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12
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Purrington KS, Knight J, Dyson G, Ali-Fehmi R, Schwartz AG, Boerner JL, Bandyopadhyay S. CLCA2 expression is associated with survival among African American women with triple negative breast cancer. PLoS One 2020; 15:e0231712. [PMID: 32298355 PMCID: PMC7161959 DOI: 10.1371/journal.pone.0231712] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/30/2020] [Indexed: 12/31/2022] Open
Abstract
Purpose Black/African American (AA) women are twice as likely to be diagnosed with triple negative breast cancer (TNBC) compared to whites, an aggressive breast cancer subtype associated with poor prognosis. There are no routinely used targeted clinical therapies for TNBC; thus there is a clear need to identify prognostic markers and potential therapeutic targets. Methods We evaluated expression of 27,016 genes in 155 treatment-naïve TN tumors from AA women in Detroit. Associations with survival were evaluated using Cox proportional hazards models adjusting for stage and age at diagnosis, and p-values were corrected using a false discovery rate. Our validation sample consisted of 494 TN tumors using four publically available data sets. Meta-analyses were performed using summary statistics from the four validation results. Results In the Detroit AA cohort, CLCA2 [Hazard ratio (HR) = 1.56, 95% confidence interval (CI) 1.31–1.86, nominal p = 5.1x10-7, FDR p = 0.014], SPIC [HR = 1.47, 95%CI 1.26–1.73, nominal p = 1.8x10-6, FDR p = 0.022], and MIR4311 [HR = 1.57, 95% CI 1.31–1.92, nominal p = 2.5x10-5, FDR p = 0.022] expression were associated with overall survival. Further adjustment for treatment and breast cancer specific survival analysis did not substantially alter effect estimates. CLCA2 was also associated with increased risk of death in the validation cohorts [HR = 1.14, 95% CI 1.05–1.24, p = 0.038, p-heterogeneity = 0.88]. Conclusions We identified CLCA2 as a potential prognostic marker for TNBC in AA women.
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Affiliation(s)
- Kristen S. Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
- * E-mail:
| | - Jimmie Knight
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
| | - Gregory Dyson
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
| | - Rouba Ali-Fehmi
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
| | - Ann G. Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
| | - Julie L. Boerner
- Department of Oncology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
| | - Sudeshna Bandyopadhyay
- Department of Pathology, Wayne State University School of Medicine, Detroit, Michigan, United States of America
- Tumor Biology and Microenvironment Program, Barbara Ann Karmanos Cancer Institute, Detroit, Michigan, United States of America
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13
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Purrington KS, Gorski D, Simon MS, Hastert TA, Kim S, Rosati R, Schwartz AG, Ratnam M. Racial differences in estrogen receptor staining levels and implications for treatment and survival among estrogen receptor positive, HER2-negative invasive breast cancers. Breast Cancer Res Treat 2020; 181:145-154. [PMID: 32236827 DOI: 10.1007/s10549-020-05607-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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: 01/20/2020] [Accepted: 03/21/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND African American women (AAW) die more frequently from estrogen receptor (ER) positive breast cancer than European American women (EAW). We investigated the relationship between race, percent ER staining, treatment, and clinical outcomes. METHODS Percent ER staining (weakly ER+: 1-10%, moderately ER+: 11-50%, strongly ER+: > 50%) was abstracted from pathology reports for 1573 women with ER+/HER2- invasive breast cancer treated at a single cancer center in Detroit, MI from 2010 to 2017. Clinical outcomes and tumor characteristics were obtained from the Metropolitan Detroit Cancer Surveillance System. Associations of ER levels with demographic and clinical characteristics were evaluated using logistic regression. Overall and breast cancer-specific (BCS) survival were evaluated using Cox proportional hazards models. RESULTS AAW were more likely to have tumors with lower ER staining levels than EAW (weakly ER+: Odds ratio (OR) 2.19, p = 0.019; moderately ER+: OR 2.80, p = 0.005). Women with weakly compared to strongly ER+ tumors were less likely to receive endocrine therapy (ET) regardless of race (OR 0.79, p < 0.001). Mortality was predicted by both AA race (Overall hazard ratio (HR) = 1.72, p < 0.001; BCS HR 1.45, p = 0.08) and low (1-50%) ER (Overall HR 1.57, p = 0.083; BCS HR 2.11, p = 0.017) adjusting for clinic-pathologic characteristics. ET was associated with improved BCS survival in all women (1-50%: HR 0.11, p < 0.001; > 50%: HR 0.24, p < 0.001). CONCLUSION The biology of ER+/HER2- tumors varies by race, although this does not appear to account for racial differences in survival. Although ET substantially reduces mortality among women with weakly ER+ tumors, these women are less likely to be treated with ET and have poorer outcomes.
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MESH Headings
- Adult
- Black or African American/statistics & numerical data
- Antineoplastic Agents, Hormonal/therapeutic use
- Breast Neoplasms/ethnology
- Breast Neoplasms/mortality
- Breast Neoplasms/pathology
- Breast Neoplasms/therapy
- Carcinoma, Ductal, Breast/ethnology
- Carcinoma, Ductal, Breast/mortality
- Carcinoma, Ductal, Breast/pathology
- Carcinoma, Ductal, Breast/therapy
- Carcinoma, Lobular/ethnology
- Carcinoma, Lobular/mortality
- Carcinoma, Lobular/pathology
- Carcinoma, Lobular/therapy
- Combined Modality Therapy
- Female
- Follow-Up Studies
- Humans
- Mastectomy/mortality
- Middle Aged
- Prognosis
- Receptor, ErbB-2/metabolism
- Receptors, Estrogen/metabolism
- Receptors, Progesterone/metabolism
- Socioeconomic Factors
- Survival Rate
- White People/statistics & numerical data
- Young Adult
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Affiliation(s)
- Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA.
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA.
| | - David Gorski
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Michael and Marian Ilitch Department of Surgery, Wayne State University School of Medicine, Detroit, MI, USA
- Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Michael S Simon
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Theresa A Hastert
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Seongho Kim
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Rayna Rosati
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Population Studies and Disparities Research Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
| | - Manohar Ratnam
- Department of Oncology, Wayne State University School of Medicine, 4100 John R, Detroit, MI, 48201, USA
- Molecular Therapeutics Program, Barbara Ann Karmanos Cancer Institute, Detroit, MI, USA
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Purrington KS, Gorski D, Simon MS, Kim S, Rosati R, Schwartz A, Ratnam M. Abstract P2-10-04: Racial differences in estrogen receptor expression, treatment, and survival among estrogen receptor positive, HER2-negative invasive breast cancers. Cancer Res 2020. [DOI: 10.1158/1538-7445.sabcs19-p2-10-04] [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: African American women (AAW) are more likely to die from hormone receptor positive, HER2-negative breast cancer than European American women (EAW), even when accounting for factors including tumor stage and other clinical characteristics, although the mechanisms underlying this disparity are unclear. We recently showed that AAW with this breast cancer subtype are 75% more likely to have high predicted risk of distant recurrence than EAW using a 21-gene recurrence score, providing evidence for underlying racial differences in tumor biology. Estrogen receptor (ER) positive tumors can vary widely in the percentage of cells staining positive for ER (1-100%), and tumors with lower percent ER staining are more likely to display basal-like features typically associated with triple negative disease, a subtype that is more common among AAW. The relationship between race, ER staining levels, and clinical treatment and outcomes remains unknown. Methods: We identified 1,625 women with ER+, HER2- invasive breast cancer who received treatment at the Karmanos Cancer Institute in Detroit, MI from 2010-2017 via the Metropolitan Detroit Cancer Surveillance System (MDCSS) registry. Percentage of cells staining positive for ER (weakly ER+ = 1-10%, moderately ER+ = 11-50%, strongly ER+ = >50%) was abstracted from pathology reports. Clinical outcomes and tumor characteristics were linked via the MDCSS registry. Associations between ER levels and demographic/clinical characteristics were evaluated using logistic regression models and breast cancer-specific survival was evaluated using Cox proportional hazards models. Results: Weakly, moderately, and strongly ER+ tumors accounted for 3.2%, 2.7%, and 94.1% of the sample, respectively. AAW were more than twice as likely to have weakly ER+ tumors (Odds ratio (OR)=2.39, 95% confidence interval (CI) 1.28-4.49, p=6.4 × 10−3) and moderately ER+ tumors (OR=2.79, 95% CI 1.40-5.58, p=3.7 × 10−3) than EAW. AAW with weakly ER+ tumors were 4-fold more likely to be node positive than EAW (OR=4.35, p=0.045) and AAW with moderately ER+ tumors were 3-fold more likely to be node positive than EAW (OR=3.01, p=0.28). Adjustment for tumor size at surgery did not affect the relationship between race and node status. In a multivariable logistic model predicting whether a women received endocrine therapy, women with weakly ER+ tumors were 20% less likely to receive endocrine therapy compared to those with strongly ER+ tumors (OR=0.77, p=9.4 × 10−8), and lymph node positive tumors were 15% less likely to receive endocrine therapy (OR=0.85, p=7.2 × 10−11). In contrast, receiving chemotherapy and having later stage tumors were each associated with a 10% increase in receiving endocrine therapy (chemo: OR=1.08, p=1.9 × 10−5; stage: OR=1.13. p=6.1 × 10−5). In a multivariable Cox regression analysis, race (Hazard ratio (HR)=1.70, 95% CI 1.15-2.51, p=0.0074), ER staining levels (1-10%: HR=2.72, p=0.0029; 11-50%: HR+2.41, p=0.062), node positivity (HR=3.36, p=0.0017), distant stage (HR=18.6, p=6.0 × 10−14), and endocrine therapy (HR=0.26, p=4.1 × 10−9) were significantly associated with breast cancer specific survival. While not statistically significant, the effects of both race (HR=3.94, 95% CI 0.62-25.2, p=0.15) and endocrine therapy (HR=0.11, 95% CI 0.01-1.06, p=0.056) were strongest among the weakly HR+ tumor group. Conclusions: The biology of ER+, HER2- tumors varies by race, and AAW are more likely to have weakly ER+, node-positive tumors- which are less likely to be treated with beneficial endocrine therapy- and predict poorer outcomes. A better understanding of the role of hormone signaling in these tumors would substantially affect racial differences in survival among with ER+/HER2- tumors.
Citation Format: Kristen S. Purrington, David Gorski, Michael S. Simon, Seongho Kim, Rayna Rosati, Ann Schwartz, Manohar Ratnam. Racial differences in estrogen receptor expression, treatment, and survival among estrogen receptor positive, HER2-negative invasive breast cancers [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-10-04.
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Teslow EA, Mitrea C, Bao B, Mohammad RM, Polin LA, Dyson G, Purrington KS, Bollig-Fischer A. Abstract 3680: SRSF2-dependent MBD2v2 expression is induced by obesity and promotes tumor-initiating triple negative breast cancer stem cells. Cancer Res 2019. [DOI: 10.1158/1538-7445.am2019-3680] [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
Obesity is a risk factor for triple negative breast cancer (TNBC) incidence and poor outcomes, the underlying molecular biology of which remains unknown. We previously identified in TNBC cell cultures that expression of epigenetic reader methyl-CpG-binding domain protein 2 (MBD2), specifically the alternative mRNA splicing variant MBD2v2, is dependent on reactive oxygen species (ROS) and is crucial for maintenance and expansion of cancer stem cell-like cells (CSCs). The relevance of CSCs is that they are a subpopulation of cancer cells recognized as the source of malignant tumor initiation, and give rise to drug resistance and metastatic recurrence. Because obesity is coupled with inflammation and ROS, we hypothesized that obesity could fuel an increase in MBD2v2 expression to promote the tumor-initiating CSC phenotype in TNBC cells in vivo. In this study we sought to characterize the role of obesity in regulating MBD2v2 expression in TNBC tumors, and better understand the mechanism regulating MBD2v2 expression in TNBC cells. Analysis of TNBC patient datasets revealed associations between high tumor MBD2v2 expression and high relapse rates and body mass index (BMI). Stable gene knockdown/overexpression methods were applied to TNBC cell lines to elucidate that MBD2v2 expression is governed by ROS-dependent expression of the serine and arginine-rich splicing factor 2 (SRSF2). Analysis of TNBC patient datasets also revealed an association between high tumor SRSF2 expression and high relapse rates and BMI. We employed a diet-induced obesity (DIO) mouse model to investigate if obesity influenced MBD2v2 expression and increased tumor initiation capacity of inoculated TNBC cell lines. MBD2v2 and SRSF2 levels were increased in TNBC cell line-derived tumors, which formed more frequently in DIO mice, relative to tumors in lean control mice. Stable MBD2v2 overexpression increased the CSC fraction in culture and increased TNBC cell line tumor initiation capacity in vivo. SRSF2 knockdown resulted in decreased MBD2v2 expression, decreased CSCs in TNBC cell cultures and hindered tumor formation DIO mice. The data provide concurring evidence that SRSF2-regulated MBD2v2 expression is induced by obesity and drives TNBC cell tumorigenicity, and thus provides molecular insights in support of the epidemiological evidence that obesity is a risk factor for TNBC. The majority of TNBC patients are obese and rising obesity rates threaten to further increase the burden of obesity-linked cancers, which reinforces the relevance of this study.
Citation Format: Emily A. Teslow, Cristina Mitrea, Bin Bao, Ramzi M. Mohammad, Lisa A. Polin, Gregory Dyson, Kristen S. Purrington, Aliccia Bollig-Fischer. SRSF2-dependent MBD2v2 expression is induced by obesity and promotes tumor-initiating triple negative breast cancer stem cells [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2019; 2019 Mar 29-Apr 3; Atlanta, GA. Philadelphia (PA): AACR; Cancer Res 2019;79(13 Suppl):Abstract nr 3680.
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Affiliation(s)
- Emily A. Teslow
- 1Karmanos Cancer Institute at Wayne State University SOM, Detroit, MI
| | | | - Bin Bao
- 1Karmanos Cancer Institute at Wayne State University SOM, Detroit, MI
| | - Ramzi M. Mohammad
- 1Karmanos Cancer Institute at Wayne State University SOM, Detroit, MI
| | - Lisa A. Polin
- 1Karmanos Cancer Institute at Wayne State University SOM, Detroit, MI
| | - Gregory Dyson
- 1Karmanos Cancer Institute at Wayne State University SOM, Detroit, MI
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Watza D, Lusk CM, Dyson G, Purrington KS, Chen K, Wenzlaff AS, Ratliff V, Neslund-Dudas C, Bepler G, Schwartz AG. Prognostic modeling of the immune-centric transcriptome reveals interleukin signaling candidates contributing to differential patient outcomes. Carcinogenesis 2019; 39:1447-1454. [PMID: 30202894 DOI: 10.1093/carcin/bgy119] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2018] [Accepted: 09/04/2018] [Indexed: 12/28/2022] Open
Abstract
Immunotherapy is a promising advancement in the treatment of non-small-cell lung carcinoma (NSCLC), although much of how lung tumors interact with the immune system in the natural course of disease remains unknown. We investigated the impact of the expression of immune-centric genes and pathways in tumors on patient survival to reveal novel candidates for immunotherapeutic research. Tumor transcriptomes and detailed clinical characteristics were obtained from patients with NSCLC who were participants of either the Inflammation, Health and Lung Epidemiology (INHALE) (discovery, N = 280) or The Cancer Genome Atlas (TCGA) Lung (replication, N = 1026) studies. Expressions of 2253 genes derived from 48 major immune pathways were assessed for association with patient prognosis using a multivariable Cox model and pathway effects were assessed with an in-house implementation of the Gene Set Enrichment Analysis (GSEA) algorithm. Prognosis-guided gene and pathway analysis of immune-centric expression in tumors revealed significant survival enrichments across both cohorts. The 'Interleukin Signaling' pathway, containing 430 genes, was found to be statistically and significantly enriched with prognostic signal in both the INHALE (P = 0.008) and TCGA (P = 0.039) datasets. Subsequent leading-edge analysis identified a subset of genes (N = 23) shared between both cohorts, driving the pathway enrichment. Cumulative expression of this leading-edge gene signature was a strong predictor of patient survival [discovery: hazard ratio (HR) = 1.59, P = 3.0 × 10-8; replication: HR = 1.29, P = 7.4 × 10-7]. These data demonstrate the impact of immune-centric expression on patient outcomes in NSCLC. Furthermore, prognostic gene effects were localized to discrete immune pathways, of which Interleukin Signaling had the greatest impact on overall survival and the subset of genes driving these effects have promise for future therapeutic intervention.
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Affiliation(s)
- Donovan Watza
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Christine M Lusk
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Gregory Dyson
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Kristen S Purrington
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Kang Chen
- Department of Obstetrics and Gynecology, Wayne State University, Detroit, MI, USA.,Department of Biochemistry Microbiology and Immunology, Wayne State University, Detroit, MI, USA.,Center for Molecular Medicine and Genetics, School of Medicine, Wayne State University.,Mucosal Immunology Studies Team, National Institute of Allergy and Infectious Diseases, National Institutes of Health, Detroit, MI, USA
| | - Angela S Wenzlaff
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Valerie Ratliff
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Christine Neslund-Dudas
- Department of Public Health Sciences, Henry Ford Health System, Detroit, MI, USA.,Henry Ford Cancer Institute, Henry Ford Health System, Detroit, MI, USA
| | - Gerold Bepler
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
| | - Ann G Schwartz
- Department of Oncology, Wayne State University, Detroit, MI, USA.,Barbara Ann Karmanos Cancer Institute, School of Medicine, Wayne State University, Detroit, MI, USA
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Teslow EA, Mitrea C, Bao B, Mohammad RM, Polin LA, Dyson G, Purrington KS, Bollig-Fischer A. Obesity-induced MBD2_v2 expression promotes tumor-initiating triple-negative breast cancer stem cells. Mol Oncol 2019; 13:894-908. [PMID: 30636104 PMCID: PMC6441886 DOI: 10.1002/1878-0261.12444] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 10/03/2018] [Revised: 12/05/2018] [Accepted: 12/21/2018] [Indexed: 12/26/2022] Open
Abstract
Obesity is a risk factor for triple‐negative breast cancer (TNBC) incidence and poor outcomes, but the underlying molecular biology remains unknown. We previously identified in TNBC cell cultures that expression of epigenetic reader methyl‐CpG‐binding domain protein 2 (MBD2), specifically the alternative mRNA splicing variant MBD variant 2 (MBD2_v2), is dependent on reactive oxygen species (ROS) and is crucial for maintenance and expansion of cancer stem cell‐like cells (CSCs). Because obesity is coupled with inflammation and ROS, we hypothesized that obesity can fuel an increase in MBD2_v2 expression to promote the tumor‐initiating CSC phenotype in TNBC cells in vivo. Analysis of TNBC patient datasets revealed associations between high tumor MBD2_v2 expression and high relapse rates and high body mass index (BMI). Stable gene knockdown/overexpression methods were applied to TNBC cell lines to elucidate that MBD2_v2 expression is governed by ROS‐dependent expression of serine‐ and arginine‐rich splicing factor 2 (SRSF2). We employed a diet‐induced obesity (DIO) mouse model that mimics human obesity to investigate whether obesity causes increased MBD2_v2 expression and increased tumor initiation capacity in inoculated TNBC cell lines. MBD2_v2 and SRSF2 levels were increased in TNBC cell line‐derived tumors that formed more frequently in DIO mice relative to tumors in lean control mice. Stable MBD2_v2 overexpression increased the CSC fraction in culture and increased TNBC cell line tumor initiation capacity in vivo. SRSF2 knockdown resulted in decreased MBD2_v2 expression, decreased CSCs in TNBC cell cultures, and hindered tumor formation in vivo. This report describes evidence to support the conclusion that MBD2_v2 expression is induced by obesity and drives TNBC cell tumorigenicity, and thus provides molecular insights into support of the epidemiological evidence that obesity is a risk factor for TNBC. The majority of TNBC patients are obese and rising obesity rates threaten to further increase the burden of obesity‐linked cancers, which reinforces the relevance of this report.
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Affiliation(s)
- Emily A Teslow
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Cristina Mitrea
- Department of Computer Science, Wayne State University, Detroit, MI, USA
| | - Bin Bao
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ramzi M Mohammad
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Lisa A Polin
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Greg Dyson
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Kristen S Purrington
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
| | - Aliccia Bollig-Fischer
- Department of Oncology, Barbara Ann Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, MI, USA
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Holowatyj AN, Cote ML, Ruterbusch JJ, Ghanem K, Schwartz AG, Vigneau FD, Gorski DH, Purrington KS. Racial Differences in 21-Gene Recurrence Scores Among Patients With Hormone Receptor-Positive, Node-Negative Breast Cancer. J Clin Oncol 2018; 36:652-658. [PMID: 29341832 PMCID: PMC6366808 DOI: 10.1200/jco.2017.74.5448] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 01/22/2023] Open
Abstract
Purpose The 21-gene recurrence score (RS) breast cancer assay is clinically used to quantify risk of 10-year distant recurrence by category (low, < 18; intermediate, 18 to 30; high, ≥ 31) for treatment management among women diagnosed with hormone receptor-positive, human epidermal growth factor receptor 2-negative, lymph node-negative breast cancer. Although non-Hispanic black (NHB) women have worse prognosis compared with non-Hispanic white (NHW) women, the equivalency of 21-gene RS across racial groups remains unknown. Patients and Methods Using the Metropolitan Detroit Cancer Surveillance System, we identified women who were diagnosed with hormone receptor-positive, human epidermal growth factor receptor 2-negative, lymph node-negative invasive breast cancer between 2010 and 2014. Multinomial logistic regression was used to quantify racial differences in 21-gene RS category. Results We identified 2,216 women (1,824 NHW and 392 NHB) with invasive breast cancer who met clinical guidelines for and underwent 21-gene RS testing. The mean RS was significantly higher in NHBs compared with NHWs (19.3 v 17.0, respectively; P = .0003), where NHBs were more likely to present with high-risk tumors compared with NHWs (14.8% v 8.3%, respectively; P = .0004). These differences were limited to patients younger than 65 years at diagnosis, among whom NHBs had significantly higher RS compared with NHWs (20 to 49 years: 23.6 v 17.3, respectively; P < .001 and 50 to 64 years: 19.6 v 17.4, respectively; P = .023). NHBs remained more likely to have high-risk tumors compared with NHWs after adjusting for age, clinical stage, tumor grade, and histology (odds ratio [OR], 1.75; 95% CI, 1.18 to 2.59). Conclusion NHBs who met clinical criteria for 21-gene RS testing had tumors with higher estimated risks of distant recurrence compared with NHWs. Further study is needed to elucidate whether differences in recurrence are observed for these women, which would have clinical implications for 21-gene RS calibration and treatment recommendations in NHB patients.
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Watza D, Purrington KS, Chen K, Schwartz AG. Transcriptional programs of tumor infiltrating T-cells provide insight into mechanisms of immune response and new targets for immunotherapy. J Thorac Dis 2017; 9:4162-4164. [PMID: 29268459 DOI: 10.21037/jtd.2017.10.35] [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: 11/06/2022]
Affiliation(s)
- Donovan Watza
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
| | - Kang Chen
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA.,Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, MI, USA
| | - Ann G Schwartz
- Department of Oncology, Wayne State University School of Medicine, Detroit, MI, USA.,Karmanos Cancer Institute, Detroit, MI, USA
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Purrington KS, Visscher DW, Wang C, Yannoukakos D, Hamann U, Nevanlinna H, Cox A, Giles GG, Eckel-Passow JE, Lakis S, Kotoula V, Fountzilas G, Kabisch M, Rüdiger T, Heikkilä P, Blomqvist C, Cross SS, Southey MC, Olson JE, Gilbert J, Deming-Halverson S, Kosma VM, Clarke C, Scott R, Jones JL, Zheng W, Mannermaa A, Eccles DM, Vachon CM, Couch FJ. Genes associated with histopathologic features of triple negative breast tumors predict molecular subtypes. Breast Cancer Res Treat 2016; 157:117-31. [PMID: 27083182 DOI: 10.1007/s10549-016-3775-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2015] [Accepted: 03/30/2016] [Indexed: 01/07/2023]
Abstract
Distinct subtypes of triple negative (TN) breast cancer have been identified by tumor expression profiling. However, little is known about the relationship between histopathologic features of TN tumors, which reflect aspects of both tumor behavior and tumor microenvironment, and molecular TN subtypes. The histopathologic features of TN tumors were assessed by central review and 593 TN tumors were subjected to whole genome expression profiling using the Illumina Whole Genome DASL array. TN molecular subtypes were defined based on gene expression data associated with histopathologic features of TN tumors. Gene expression analysis yielded signatures for four TN subtypes (basal-like, androgen receptor positive, immune, and stromal) consistent with previous studies. Expression analysis also identified genes significantly associated with the 12 histological features of TN tumors. Development of signatures using these markers of histopathological features resulted in six distinct TN subtype signatures, including an additional basal-like and stromal signature. The additional basal-like subtype was distinguished by elevated expression of cell motility and glucose metabolism genes and reduced expression of immune signaling genes, whereas the additional stromal subtype was distinguished by elevated expression of immunomodulatory pathway genes. Histopathologic features that reflect heterogeneity in tumor architecture, cell structure, and tumor microenvironment are related to TN subtype. Accounting for histopathologic features in the development of gene expression signatures, six major subtypes of TN breast cancer were identified.
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Affiliation(s)
- Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, USA.,Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Daniel W Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | - Chen Wang
- Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research "Demokritos", Athens, Greece
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Angela Cox
- Department of Oncology, University of Sheffield, Sheffield, UK
| | - Graham G Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Jeanette E Eckel-Passow
- Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Sotiris Lakis
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Vassiliki Kotoula
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - George Fountzilas
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Maria Kabisch
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Thomas Rüdiger
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | - Päivi Heikkilä
- Department of Pathology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Simon S Cross
- Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Melissa C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Melbourne, Australia
| | - Janet E Olson
- Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Judy Gilbert
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | - Sandra Deming-Halverson
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Veli-Matti Kosma
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland
| | - Christine Clarke
- Centre for Cancer Research, University of Sydney at the Westmead Millennium Institute, Westmead, Australia
| | - Rodney Scott
- Division of Genetics, Hunter Area Pathology Service and University of Newcastle, Newcastle, Australia
| | - J Louise Jones
- Barts Cancer Research Institute, Queen Mary University of London, London, UK
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Arto Mannermaa
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland.,School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, Biocenter Kuopio, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland
| | | | - Diana M Eccles
- Faculty of Medicine and NIHR/CRUK Clinical Trials Unit, University of Southampton, Southampton, UK
| | - Celine M Vachon
- Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA
| | - Fergus J Couch
- Department of Health Sciences Research, Mayo Clinic, Stabile 2-42, Mayo Clinic, 200 First Street SW, Rochester, MN, 55905, USA. .,Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA.
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Lusk CM, Wenzlaff AS, Dyson G, Purrington KS, Watza D, Land S, Soubani AO, Gadgeel SM, Schwartz AG. Whole-exome sequencing reveals genetic variability among lung cancer cases subphenotyped for emphysema. Carcinogenesis 2015; 37:139-144. [PMID: 26717996 DOI: 10.1093/carcin/bgv248] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2015] [Accepted: 12/13/2015] [Indexed: 11/13/2022] Open
Abstract
Lung cancer continues to be a major public health challenge in the United States despite efforts to decrease the prevalence of smoking; outcomes are especially poor for African-American patients compared to other races/ethnicities. Chronic obstructive pulmonary disease (COPD) co-occurs with lung cancer frequently, but not always, suggesting both shared and distinct risk factors for these two diseases. To identify germline genetic variation that distinguishes between lung cancer in the presence and absence of emphysema, we performed whole-exome sequencing on 46 African-American lung cancer cases (23 with and 23 without emphysema frequency matched on age, sex, histology and pack years). Using conditional logistic regression, we found 6305 variants (of 168 150 varying sites) significantly associated with lung cancer subphenotype (P ≤ 0.05). Next, we validated 10 of these variants in an independent set of 612 lung cancer cases (267 with emphysema and 345 without emphysema) from the same population of inference as the sequenced cases. We found one variant that was significantly associated with lung cancer subphenotype in the validation sample. These findings contribute to teasing apart shared genetic factors from independent genetic factors for lung cancer and COPD.
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Affiliation(s)
- Christine M Lusk
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Angela S Wenzlaff
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Greg Dyson
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Kristen S Purrington
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Donovan Watza
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Susan Land
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Ayman O Soubani
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and.,Department of Internal Medicine, Division of Pulmonary, Critical Care and Sleep Medicine, Wayne State University, Detroit, MI 48201, USA
| | - Shirish M Gadgeel
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
| | - Ann G Schwartz
- Karmanos Cancer Institute, Detroit, MI 48201, USA.,Department of Oncology, School of Medicine and
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Seibold P, Schmezer P, Behrens S, Michailidou K, Bolla MK, Wang Q, Flesch-Janys D, Nevanlinna H, Fagerholm R, Aittomäki K, Blomqvist C, Margolin S, Mannermaa A, Kataja V, Kosma VM, Hartikainen JM, Lambrechts D, Wildiers H, Kristensen V, Alnæs GG, Nord S, Borresen-Dale AL, Hooning MJ, Hollestelle A, Jager A, Seynaeve C, Li J, Liu J, Humphreys K, Dunning AM, Rhenius V, Shah M, Kabisch M, Torres D, Ulmer HU, Hamann U, Schildkraut JM, Purrington KS, Couch FJ, Hall P, Pharoah P, Easton DF, Schmidt MK, Chang-Claude J, Popanda O. A polymorphism in the base excision repair gene PARP2 is associated with differential prognosis by chemotherapy among postmenopausal breast cancer patients. BMC Cancer 2015; 15:978. [PMID: 26674097 PMCID: PMC4682235 DOI: 10.1186/s12885-015-1957-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [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: 06/02/2015] [Accepted: 11/27/2015] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Personalized therapy considering clinical and genetic patient characteristics will further improve breast cancer survival. Two widely used treatments, chemotherapy and radiotherapy, can induce oxidative DNA damage and, if not repaired, cell death. Since base excision repair (BER) activity is specific for oxidative DNA damage, we hypothesized that germline genetic variation in this pathway will affect breast cancer-specific survival depending on treatment. METHODS We assessed in 1,408 postmenopausal breast cancer patients from the German MARIE study whether cancer specific survival after adjuvant chemotherapy, anthracycline chemotherapy, and radiotherapy is modulated by 127 Single Nucleotide Polymorphisms (SNPs) in 21 BER genes. For SNPs with interaction terms showing p<0.1 (likelihood ratio test) using multivariable Cox proportional hazard analyses, replication in 6,392 patients from nine studies of the Breast Cancer Association Consortium (BCAC) was performed. RESULTS rs878156 in PARP2 showed a differential effect by chemotherapy (p=0.093) and was replicated in BCAC studies (p=0.009; combined analysis p=0.002). Compared to non-carriers, carriers of the variant G allele (minor allele frequency=0.07) showed better survival after chemotherapy (combined allelic hazard ratio (HR)=0.75, 95% 0.53-1.07) and poorer survival when not treated with chemotherapy (HR=1.42, 95% 1.08-1.85). A similar effect modification by rs878156 was observed for anthracycline-based chemotherapy in both MARIE and BCAC, with improved survival in carriers (combined allelic HR=0.73, 95% CI 0.40-1.32). None of the SNPs showed significant differential effects by radiotherapy. CONCLUSIONS Our data suggest for the first time that a SNP in PARP2, rs878156, may together with other genetic variants modulate cancer specific survival in breast cancer patients depending on chemotherapy. These germline SNPs could contribute towards the design of predictive tests for breast cancer patients.
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Affiliation(s)
- Petra Seibold
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Peter Schmezer
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69124, Heidelberg, Germany.
| | - Sabine Behrens
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Kyriaki Michailidou
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Manjeet K Bolla
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Qin Wang
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Dieter Flesch-Janys
- Department of Cancer Epidemiology/Clinical Cancer Registry, University Cancer Center Hamburg (UCCH), Hamburg, Germany.
- Department of Medical Biometrics and Epidemiology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
| | - Heli Nevanlinna
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Rainer Fagerholm
- Department of Obstetrics and Gynecology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Kristiina Aittomäki
- Department of Clinical Genetics, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland.
| | - Sara Margolin
- Department of Oncology - Pathology, Karolinska Institutet, Stockholm, Sweden.
| | - Arto Mannermaa
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
- Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland.
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
- Central Finland Health Care District, Jyväskylä Central Hospital, Jyväskylä, Finland.
| | - Veli-Matti Kosma
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
- Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland.
| | - Jaana M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine, University of Eastern Finland, Kuopio, Finland.
- Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland.
- Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, Kuopio, Finland.
| | - Diether Lambrechts
- Vesalius Research Center (VRC), VIB, Leuven, Belgium.
- Department of Oncology, Laboratory for Translational Genetics, University of Leuven, Leuven, Belgium.
| | - Hans Wildiers
- Department of General Medical Oncology, Multidisciplinary Breast Center, University Hospitals Leuven, Leuven, Belgium.
| | - Vessela Kristensen
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
- Institute of Clinical Medicine, K.G. Jebsen Center for Breast Cancer Research, Faculty of Medicine, University of Oslo (UiO), Oslo, Norway.
- Department of Clinical Molecular Biology (EpiGen), Akershus University Hospital, University of Oslo (UiO), Oslo, Norway.
| | - Grethe Grenaker Alnæs
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - Silje Nord
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
| | - Anne-Lise Borresen-Dale
- Department of Cancer Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway.
- Institute of Clinical Medicine, K.G. Jebsen Center for Breast Cancer Research, Faculty of Medicine, University of Oslo (UiO), Oslo, Norway.
| | - Maartje J Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Antoinette Hollestelle
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Agnes Jager
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Caroline Seynaeve
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands.
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore.
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore.
| | - Keith Humphreys
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Alison M Dunning
- Department of Oncology, Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Valerie Rhenius
- Department of Oncology, Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Mitul Shah
- Department of Oncology, Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Maria Kabisch
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogota, Colombia.
| | | | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Joellen M Schildkraut
- Department of Community and Family Medicine, Duke University Medical Center, Durham, North Carolina, USA.
| | - Kristen S Purrington
- Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, Michigan, USA.
| | - Fergus J Couch
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, Michigan, USA.
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
| | - Paul Pharoah
- Department of Oncology, Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Doug F Easton
- Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge, UK.
| | - Marjanka K Schmidt
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands.
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg, Germany.
| | - Odilia Popanda
- Division of Epigenomics and Cancer Risk Factors, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69124, Heidelberg, Germany.
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23
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Vachon CM, Pankratz VS, Scott CG, Haeberle L, Ziv E, Jensen MR, Brandt KR, Whaley DH, Olson JE, Heusinger K, Hack CC, Jud SM, Beckmann MW, Schulz-Wendtland R, Tice JA, Norman AD, Cunningham JM, Purrington KS, Easton DF, Sellers TA, Kerlikowske K, Fasching PA, Couch FJ. The contributions of breast density and common genetic variation to breast cancer risk. J Natl Cancer Inst 2015; 107:dju397. [PMID: 25745020 PMCID: PMC4598340 DOI: 10.1093/jnci/dju397] [Citation(s) in RCA: 144] [Impact Index Per Article: 16.0] [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: 05/17/2014] [Revised: 07/18/2014] [Accepted: 10/27/2014] [Indexed: 01/18/2023] Open
Abstract
We evaluated whether a 76-locus polygenic risk score (PRS) and Breast Imaging Reporting and Data System (BI-RADS) breast density were independent risk factors within three studies (1643 case patients, 2397 control patients) using logistic regression models. We incorporated the PRS odds ratio (OR) into the Breast Cancer Surveillance Consortium (BCSC) risk-prediction model while accounting for its attributable risk and compared five-year absolute risk predictions between models using area under the curve (AUC) statistics. All statistical tests were two-sided. BI-RADS density and PRS were independent risk factors across all three studies (P interaction = .23). Relative to those with scattered fibroglandular densities and average PRS (2(nd) quartile), women with extreme density and highest quartile PRS had 2.7-fold (95% confidence interval [CI] = 1.74 to 4.12) increased risk, while those with low density and PRS had reduced risk (OR = 0.30, 95% CI = 0.18 to 0.51). PRS added independent information (P < .001) to the BCSC model and improved discriminatory accuracy from AUC = 0.66 to AUC = 0.69. Although the BCSC-PRS model was well calibrated in case-control data, independent cohort data are needed to test calibration in the general population.
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Affiliation(s)
- Celine M Vachon
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF).
| | - V Shane Pankratz
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Christopher G Scott
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Lothar Haeberle
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Elad Ziv
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Matthew R Jensen
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Kathleen R Brandt
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Dana H Whaley
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Janet E Olson
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Katharina Heusinger
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Carolin C Hack
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Sebastian M Jud
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Matthias W Beckmann
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Ruediger Schulz-Wendtland
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Jeffrey A Tice
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Aaron D Norman
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Julie M Cunningham
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Kristen S Purrington
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Douglas F Easton
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Thomas A Sellers
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Karla Kerlikowske
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Peter A Fasching
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
| | - Fergus J Couch
- Affiliations of authors: Department of Health Sciences Research, Division of Epidemiology, Mayo Clinic (CMV, VSP, CGS, MRJ, JEO, ADN, FJC); Department of Gynecology and Obstetrics, University Hospital Erlangen Friedrich-Alexander-University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany (LH, KH, CCH, SMJ, MWB, PAF); Department of Medicine, Institute for Human Genetics, Helen Diller Family Comprehensive Cancer Center, University of California, San Francisco, CA (EZ); Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs and Division of General Internal Medicine (EZ, JAT, KK); Division of Breast Imaging, Department of Radiology, Mayo Clinic College of Medicine, Rochester, MN (KRB, DHW); Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany (RS-W); Division of Experimental Pathology, Department of Laboratory Medicine and Pathology, Mayo Clinic College of Medicine, Rochester, MN (JMC, FJC); Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, MI (KSP); University of Cambridge, Centre for Cancer Genetic Epidemiology, Cambridge, UK (DFE); Moffitt Cancer Center, Tampa, Florida (TAS); University of California at Los Angeles, Department of Medicine, Division Hematology/Oncology, David Geffen School of Medicine, Los Angeles, CA (PAF)
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24
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Purrington KS, Slettedahl S, Bolla MK, Michailidou K, Czene K, Nevanlinna H, Bojesen SE, Andrulis IL, Cox A, Hall P, Carpenter J, Yannoukakos D, Haiman CA, Fasching PA, Mannermaa A, Winqvist R, Brenner H, Lindblom A, Chenevix-Trench G, Benitez J, Swerdlow A, Kristensen V, Guénel P, Meindl A, Darabi H, Eriksson M, Fagerholm R, Aittomäki K, Blomqvist C, Nordestgaard BG, Nielsen SF, Flyger H, Wang X, Olswold C, Olson JE, Mulligan AM, Knight JA, Tchatchou S, Reed MWR, Cross SS, Liu J, Li J, Humphreys K, Clarke C, Scott R, Fostira F, Fountzilas G, Konstantopoulou I, Henderson BE, Schumacher F, Le Marchand L, Ekici AB, Hartmann A, Beckmann MW, Hartikainen JM, Kosma VM, Kataja V, Jukkola-Vuorinen A, Pylkäs K, Kauppila S, Dieffenbach AK, Stegmaier C, Arndt V, Margolin S, Balleine R, Arias Perez JI, Pilar Zamora M, Menéndez P, Ashworth A, Jones M, Orr N, Arveux P, Kerbrat P, Truong T, Bugert P, Toland AE, Ambrosone CB, Labrèche F, Goldberg MS, Dumont M, Ziogas A, Lee E, Dite GS, Apicella C, Southey MC, Long J, Shrubsole M, Deming-Halverson S, Ficarazzi F, Barile M, Peterlongo P, Durda K, Jaworska-Bieniek K, Tollenaar RAEM, Seynaeve C, Brüning T, Ko YD, Van Deurzen CHM, Martens JWM, Kriege M, Figueroa JD, Chanock SJ, Lissowska J, Tomlinson I, Kerin MJ, Miller N, Schneeweiss A, Tapper WJ, Gerty SM, Durcan L, Mclean C, Milne RL, Baglietto L, dos Santos Silva I, Fletcher O, Johnson N, Van'T Veer LJ, Cornelissen S, Försti A, Torres D, Rüdiger T, Rudolph A, Flesch-Janys D, Nickels S, Weltens C, Floris G, Moisse M, Dennis J, Wang Q, Dunning AM, Shah M, Brown J, Simard J, Anton-Culver H, Neuhausen SL, Hopper JL, Bogdanova N, Dörk T, Zheng W, Radice P, Jakubowska A, Lubinski J, Devillee P, Brauch H, Hooning M, García-Closas M, Sawyer E, Burwinkel B, Marmee F, Eccles DM, Giles GG, Peto J, Schmidt M, Broeks A, Hamann U, Chang-Claude J, Lambrechts D, Pharoah PDP, Easton D, Pankratz VS, Slager S, Vachon CM, Couch FJ. Genetic variation in mitotic regulatory pathway genes is associated with breast tumor grade. Hum Mol Genet 2014; 23:6034-46. [PMID: 24927736 PMCID: PMC4204763 DOI: 10.1093/hmg/ddu300] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [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: 11/19/2013] [Revised: 05/20/2014] [Accepted: 06/10/2014] [Indexed: 01/01/2023] Open
Abstract
Mitotic index is an important component of histologic grade and has an etiologic role in breast tumorigenesis. Several small candidate gene studies have reported associations between variation in mitotic genes and breast cancer risk. We measured associations between 2156 single nucleotide polymorphisms (SNPs) from 194 mitotic genes and breast cancer risk, overall and by histologic grade, in the Breast Cancer Association Consortium (BCAC) iCOGS study (n = 39 067 cases; n = 42 106 controls). SNPs in TACC2 [rs17550038: odds ratio (OR) = 1.24, 95% confidence interval (CI) 1.16-1.33, P = 4.2 × 10(-10)) and EIF3H (rs799890: OR = 1.07, 95% CI 1.04-1.11, P = 8.7 × 10(-6)) were significantly associated with risk of low-grade breast cancer. The TACC2 signal was retained (rs17550038: OR = 1.15, 95% CI 1.07-1.23, P = 7.9 × 10(-5)) after adjustment for breast cancer risk SNPs in the nearby FGFR2 gene, suggesting that TACC2 is a novel, independent genome-wide significant genetic risk locus for low-grade breast cancer. While no SNPs were individually associated with high-grade disease, a pathway-level gene set analysis showed that variation across the 194 mitotic genes was associated with high-grade breast cancer risk (P = 2.1 × 10(-3)). These observations will provide insight into the contribution of mitotic defects to histological grade and the etiology of breast cancer.
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Affiliation(s)
- Kristen S Purrington
- Department of Health Sciences Research, Department of Oncology, Wayne State University School of Medicine and Karmanos Cancer Institute, Detroit, USA
| | | | - Manjeet K Bolla
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care
| | - Kyriaki Michailidou
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care
| | - Kamila Czene
- Department of Medical Epidemiology and Biostatistics
| | | | - Stig E Bojesen
- Copenhagen General Population Study, Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | - Irene L Andrulis
- Ontario Cancer Genetics Network, Department of Molecular Genetics
| | - Angela Cox
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology
| | - Per Hall
- Department of Medical Epidemiology and Biostatistics
| | | | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research 'Demokritos', Athens, Greece
| | - Christopher A Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Peter A Fasching
- University Breast Center Franconia, Department of Gynecology and Obstetrics, David Geffen School of Medicine, Department of Medicine Division of Hematology and Oncology, University of California at Los Angeles, Los Angeles, USA
| | - Arto Mannermaa
- School of Medicine, Institute of Clinical Medicine, Oncology, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland, Imaging Center, Department of Clinical Pathology
| | - Robert Winqvist
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital/NordLab Oulu, Oulu, Finland
| | - Hermann Brenner
- Division of Clinical Epidemiology and Aging Research, German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | | | - Javier Benitez
- Human Genetics Group, Human Cancer Genetics Program, Spanish National Cancer Research Centre (CNIO), Madrid, Spain, Centro de Investigación en Red de Enfermedades Raras (CIBERER), Valencia, Spain
| | - Anthony Swerdlow
- Division of Genetics and Epidemiology, Division of Breast Cancer Research, Institute of Cancer Research, Sutton, UK
| | - Vessela Kristensen
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway, Faculty of Medicine (Faculty Division Ahus), University of Oslo (UiO), Oslo, Norway
| | - Pascal 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
| | - Alfons Meindl
- Division of Gynaecology and Obstetrics, Technische Universität München, Munich, Germany
| | - Hatef Darabi
- Department of Medical Epidemiology and Biostatistics
| | | | - Rainer Fagerholm
- Department of Obstetrics and Gynecology, Oncology and Clinical Genetics
| | | | - Carl Blomqvist
- Department of Oncology, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Børge G Nordestgaard
- Department of Clinical Biochemistry, Herlev Hospital, Copenhagen University Hospital, University of Copenhagen, Copenhagen, Denmark
| | | | - Henrik Flyger
- Department of Breast Surgery, Herlev Hospital, Copenhagen University Hospital, Copenhagen, Denmark
| | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA
| | | | | | - Anna Marie Mulligan
- Department of Laboratory Medicine and Pathobiology, Laboratory Medicine Program, University Health Network, Toronto, Canada
| | - Julia A Knight
- Prosserman Centre for Health Research, Division of Epidemiology, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Sandrine Tchatchou
- Lunenfeld-Tanenbaum Research Institute of Mount Sinai Hospital, Toronto, Canada
| | - Malcolm W R Reed
- CRUK/YCR Sheffield Cancer Research Centre, Department of Oncology
| | - Simon S Cross
- Academic Unit of Pathology, Department of Neuroscience, University of Sheffield, Sheffield, UK
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
| | - Jingmei Li
- Human Genetics Division, Genome Institute of Singapore, Singapore, Singapore
| | | | - Christine Clarke
- Westmead Institute for Cancer Research, Sydney Medical School Westmead, University of Sydney at the Westmead Millennium Institute, Westmead, Australia
| | - Rodney Scott
- Division of Genetics, Hunter Area Pathology Service and University of Newcastle, Newcastle, Australia
| | - Florentia Fostira
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research 'Demokritos', Athens, Greece
| | - George Fountzilas
- Department of Medical Oncology, "Papageorgiou" Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki, Greece
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research 'Demokritos', Athens, Greece
| | - Brian E Henderson
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Fredrick Schumacher
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Loic Le Marchand
- Epidemiology Program, Cancer Research Center, University of Hawaii, Honolulu, USA
| | | | - Arndt Hartmann
- Institute of Pathology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Comprehensive Cancer Center Erlangen-EMN, Erlangen, Germany
| | | | - Jaana M Hartikainen
- School of Medicine, Institute of Clinical Medicine, Oncology, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland, Imaging Center, Department of Clinical Pathology
| | - Veli-Matti Kosma
- School of Medicine, Institute of Clinical Medicine, Oncology, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland, Imaging Center, Department of Clinical Pathology
| | - Vesa Kataja
- School of Medicine, Institute of Clinical Medicine, Oncology, Cancer Center of Eastern Finland, University of Eastern Finland, Kuopio, Finland, Cancer Center, Kuopio University Hospital, Kuopio, Finland
| | | | - Katri Pylkäs
- Laboratory of Cancer Genetics and Tumor Biology, Department of Clinical Chemistry and Biocenter Oulu, University of Oulu, Oulu University Hospital/NordLab Oulu, Oulu, Finland
| | - Saila Kauppila
- Department of Pathology, Oulu University Hospital, University of Oulu, Oulu, Finland
| | - Aida Karina Dieffenbach
- Division of Clinical Epidemiology and Aging Research, German Cancer Consortium (DKTK), Heidelberg, Germany
| | | | - Volker Arndt
- Division of Clinical Epidemiology and Aging Research
| | - Sara Margolin
- Department of Oncology-Pathology, Karolinska Institutet, Stockholm, Sweden
| | - Rosemary Balleine
- Westmead Millenium Institute for Medical Research, Sydney, Australia
| | | | - M Pilar Zamora
- Servicio de Oncología Médica, Hospital Universitario La Paz, Madrid, Spain
| | | | - Alan Ashworth
- Breakthrough Breast Cancer Research Centre and Division of Breast Cancer Research
| | | | - Nick Orr
- Breakthrough Breast Cancer Research Centre and Division of Breast Cancer Research
| | - Patrick Arveux
- Center Georges-Francois Leclerc, Registry of Gynecologic Tumors, Dijon, France
| | - Pierre Kerbrat
- Centre Eugène Marquis, Department of Medical Oncology, Rennes, 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, Villejuif, France, University Paris-Sud, UMRS 1018, Villejuif, France
| | - Peter Bugert
- German Red Cross Blood Service of Baden-Württemberg-Hessen, Mannheim, Germany, Medical Faculty Mannheim, Institute of Transfusion Medicine and Immunology, Heidelberg University, Heidelberg, Germany
| | - Amanda E Toland
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
| | | | - France Labrèche
- Department of Environmental & Occupational Health and of Social & Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Canada
| | - Mark S Goldberg
- Department of Medicine, McGill University, Montreal, Canada, Division of Clinical Epidemiology, McGill University Health Centre, Royal Victoria Hospital, Montreal, Canada
| | - Martine Dumont
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec Research Center and Laval University, Quebec City, Canada
| | - Argyrios Ziogas
- Department of Epidemiology, University of California Irvine, Irvine, USA
| | - Eunjung Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, USA
| | - Gillian S Dite
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health
| | - Carmel Apicella
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health
| | | | - Jirong Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Martha Shrubsole
- Department of Molecular Virology, Immunology and Medical Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, USA
| | - Sandra Deming-Halverson
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Filomena Ficarazzi
- Cogentech Cancer Genetic Test Laboratory, Milan, Italy, IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Monica Barile
- Division of Cancer Prevention and Genetics, Istituto Europeo di Oncologia (IEO), Milan, Italy
| | - Paolo Peterlongo
- IFOM, Fondazione Istituto FIRC di Oncologia Molecolare, Milan, Italy
| | - Katarzyna Durda
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | | | | | - Caroline Seynaeve
- Family Cancer Clinic, Department of Medical Oncology, Erasmus MC-Daniel den Hoed Cancer Centrer, Rotterdam, The Netherlands
| | - Thomas Brüning
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance (IPA), Bochum, Germany
| | - Yon-Dschun Ko
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn, Germany
| | | | - John W M Martens
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Mieke Kriege
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | - Jonine D Figueroa
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Stephen J Chanock
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, USA
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, M. Sklodowska-Curie Memorial Cancer Center & Institute of Oncology, Warsaw, Poland
| | - Ian Tomlinson
- Wellcome Trust Centre for Human Genetics and Oxford Biomedical Research Centre, University of Oxford, Oxford, UK
| | - Michael J Kerin
- Clinical Science Institute, University Hospital Galway, Galway, Ireland
| | - Nicola Miller
- Clinical Science Institute, University Hospital Galway, Galway, Ireland
| | - Andreas Schneeweiss
- Department of Obstetrics and Gynecology, National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | | | - Susan M Gerty
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Lorraine Durcan
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Catriona Mclean
- Anatomical Pathology, The Alfred Hospital, Melbourne, Australia
| | - Roger L Milne
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Australia, Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Laura Baglietto
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Australia, Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Isabel dos Santos Silva
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Olivia Fletcher
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | - Nichola Johnson
- Breakthrough Breast Cancer Research Centre, The Institute of Cancer Research, London, UK
| | - Laura J Van'T Veer
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Sten Cornelissen
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Asta Försti
- Division of Molecular Genetic Epidemiology, Center for Primary Health Care Research, University of Lund, Malmö, Sweden
| | - Diana Torres
- Molecular Genetics of Breast Cancer, Institute of Human Genetics, Pontificia University Javeriana, Bogota, Colombia
| | - Thomas Rüdiger
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Karlsruhe, Germany
| | | | - Dieter Flesch-Janys
- Department of Cancer Epidemiology/Clinical Cancer Registry and Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg, Germany
| | | | | | | | - Matthieu Moisse
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Leuven, Belgium, Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | - Joe Dennis
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care
| | - Qin Wang
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care
| | - Alison M Dunning
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Mitul Shah
- Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Judith Brown
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care
| | - Jacques Simard
- Cancer Genomics Laboratory, Centre Hospitalier Universitaire de Québec Research Center and Laval University, Quebec City, Canada
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California Irvine, Irvine, USA
| | | | - John L Hopper
- Centre for Molecular, Environmental, Genetic and Analytic Epidemiology, Melbourne School of Population Health
| | | | - Thilo Dörk
- Department of Obstetrics and Gynaecology, Hannover Medical School, Hannover, Germany
| | - Wei Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, USA
| | - Paolo 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 and
| | - Anna Jakubowska
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jan Lubinski
- Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Peter Devillee
- Department of Human Genetics & Department of Pathology, Leiden University Medical Center, Leiden, The Netherlands
| | - Hiltrud Brauch
- Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart, Germany, University of Tübingen, Tübingen, Germany
| | - Maartje Hooning
- Department of Medical Oncology, Erasmus MC Cancer Institute, Rotterdam, The Netherlands
| | | | - Elinor Sawyer
- Division of Cancer Studies, Kings College London, Guy's Hospital, London, UK
| | - Barbara Burwinkel
- Department of Obstetrics and Gynecology, Molecular Epidemiology Group, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Frederick Marmee
- Department of Obstetrics and Gynecology, National Center for Tumor Diseases, University of Heidelberg, Heidelberg, Germany
| | - Diana M Eccles
- Faculty of Medicine, University of Southampton, Southampton, UK
| | - Graham G Giles
- Centre for Molecular, Environmental, Genetic, and Analytic Epidemiology, The University of Melbourne, Melbourne, Australia, Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Australia
| | - Julian Peto
- Non-communicable Disease Epidemiology Department, London School of Hygiene and Tropical Medicine, London, UK
| | - Marjanka Schmidt
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | - Annegien Broeks
- Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, The Netherlands
| | | | | | - Diether Lambrechts
- Laboratory for Translational Genetics, Department of Oncology, University of Leuven, Leuven, Belgium, Vesalius Research Center (VRC), VIB, Leuven, Belgium
| | - Paul D P Pharoah
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | - Douglas Easton
- Centre for Cancer Genetic Epidemiology, Department of Public Health and Primary Care, Centre for Cancer Genetic Epidemiology, Department of Oncology, University of Cambridge, Cambridge, UK
| | | | | | | | - Fergus J Couch
- Department of Health Sciences Research, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, USA,
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25
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Purrington KS, Yannoukakos D, Carpenter J, Nevanlinna H, Cox A, Severi G, Ambrosone C, Toland AE, Godwin AK, Brauch H, Fasching PA, Miron P, Chang-Claude J, Martin NG, Montgomery GW, Kristensen V, Anton-Culver H, Goodfellow P, Olson JE, Sicotte H, Prodduturi N, Visscher DW, Eckel-Passow JE, Anderson SK, Slettedahl S, Olswold C, Wang X, Pankratz VS, Slager S, Zheng W, Mannermaa A, Hamann U, Eccles DM, Vachon CM, Couch FJ. Abstract 3266: Expression quantitative trait locus analysis of triple negative breast cancer. Cancer Res 2014. [DOI: 10.1158/1538-7445.am2014-3266] [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
Recent studies have shown that associations between common genetic variation and gene expression in breast tumors provide insight into the functional mechanisms underlying breast cancer risk loci. However, the relationship between genetic variation, gene expression, and risk of triple negative (TN) breast cancer remains largely unexplored. We performed a genome-wide expression quantitative trait locus (eQTL) analysis of TN breast cancer using 668 formalin-fixed paraffin embedded TN tumors from the Triple Negative Breast Cancer Consortium (TNBCC) to identify novel genes relevant to TN breast cancer risk and to further explore the biology underlying known TN risk loci. Cis-eQTLs were defined as correlations between single nucleotide polymorphisms (SNP) and expression of genes within 1Mb, and trans-eQTLs were defined as the remainder of all SNP-gene correlations. In a genome-wide analysis, we identified 68,012 cis-eQTLs, representing correlations between 42,193 SNPs and 2,092 genes that were significant at a 10% false discovery rate (FDR). We also identified 70 trans-eQTLs across two unique genes at the same FDR threshold. Five cis-eQTLs involved SNPs previously associated with TN breast cancer risk (p<5.0x10-5) in 3,700 TN cases and 4,700 controls from the TNBCC. Three of these, located on chromosomes 5p (cis-eQTL p=4.8x10-34; risk p=1.1x10-7), 7p (cis-eQTL p=6.1x10-10; risk p=1.3x10-7), and 17q (cis-eQTL p=1.8x10-15; risk p=2.9x10-7), have previously been reported in public databases of normal tissue. The remaining two TN breast cancer cis-eQTLs, located on chromosomes 8q (cis-eQTL p=6.3x10-6, risk p=8.3x10-6) and 14q (cis-eQTL p=3.1x10-6, risk p=1.2x10-5), have not been reported as eQTLs in other tissues. In addition, 12 of 25 known TN breast cancer risk loci (PEX14, MDM4, 2q31.1, ESR1, 11q13.1, 11q24.3, 12p13.1, PTHLH, NTN4, 12q24, 19p13.1, MLK1), contained at least one significant cis-eQTL. In summary, we have identified five cis-eQTLs that may identify novel risk loci for TN breast cancer.
Citation Format: Kristen S. Purrington, Drakoulis Yannoukakos, Jane Carpenter, Heli Nevanlinna, Angela Cox, Gianluca Severi, Christine Ambrosone, Amanda Ewart Toland, Andrew K. Godwin, Hiltrud Brauch, Peter A. Fasching, Penelope Miron, Jenny Chang-Claude, Nicholas G. Martin, Grant W. Montgomery, Vessela Kristensen, Hoda Anton-Culver, Paul Goodfellow, Janet E. Olson, Hugues Sicotte, Naresh Prodduturi, Daniel W. Visscher, Jeanette E. Eckel-Passow, S. Keith Anderson, Seth Slettedahl, Curtis Olswold, Xianshu Wang, V. Shane Pankratz, Susan Slager, Wei Zheng, Arto Mannermaa, Ute Hamann, Diana M. Eccles, Celine M. Vachon, Fergus J. Couch. Expression quantitative trait locus analysis of triple negative breast cancer. [abstract]. In: Proceedings of the 105th Annual Meeting of the American Association for Cancer Research; 2014 Apr 5-9; San Diego, CA. Philadelphia (PA): AACR; Cancer Res 2014;74(19 Suppl):Abstract nr 3266. doi:10.1158/1538-7445.AM2014-3266
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Affiliation(s)
| | | | - Jane Carpenter
- 3University of Sydney at the Westmead Millennium Institute, Westmead, Australia
| | - Heli Nevanlinna
- 4University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Angela Cox
- 5Cancer Research UK/Yorkshire Cancer Research Sheffield Cancer Research Centre, University of Sheffield, Sheffield, United Kingdom
| | | | | | | | | | - Hiltrud Brauch
- 10Dr. Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Germany, Suttgart, Germany
| | - Peter A. Fasching
- 11University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen, Germany
| | | | | | | | | | - Vessela Kristensen
- 15Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo, Norway
| | | | - Paul Goodfellow
- 17Washington University School of Medicine, Barnes-Jewish Hospital and Siteman Cancer Center, St. Louis, MO
| | | | | | | | | | | | | | | | | | | | | | | | - Wei Zheng
- 19Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University School of Medicine, Nashville, TN
| | | | - Ute Hamann
- 13German Cancer Research Center (DKFZ), Heidelberg, Germany
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26
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Purrington KS, Slager S, Eccles D, Yannoukakos D, Fasching PA, Miron P, Carpenter J, Chang-Claude J, Martin NG, Montgomery GW, Kristensen V, Anton-Culver H, Goodfellow P, Tapper WJ, Rafiq S, Gerty SM, Durcan L, Konstantopoulou I, Fostira F, Vratimos A, Apostolou P, Konstanta I, Kotoula V, Lakis S, Dimopoulos MA, Skarlos D, Pectasides D, Fountzilas G, Beckmann MW, Hein A, Ruebner M, Ekici AB, Hartmann A, Schulz-Wendtland R, Renner SP, Janni W, Rack B, Scholz C, Neugebauer J, Andergassen U, Lux MP, Haeberle L, Clarke C, Pathmanathan N, Rudolph A, Flesch-Janys D, Nickels S, Olson JE, Ingle JN, Olswold C, Slettedahl S, Eckel-Passow JE, Anderson S, Visscher DW, Cafourek VL, Sicotte H, Prodduturi N, Weiderpass E, Bernstein L, Ziogas A, Ivanovich J, Giles GG, Baglietto L, Southey M, Kosma VM, Fischer HP, Reed MW, Cross SS, Deming-Halverson S, Shrubsole M, Cai Q, Shu XO, Daly M, Weaver J, Ross E, Klemp J, Sharma P, Torres D, Rüdiger T, Wölfing H, Ulmer HU, Försti A, Khoury T, Kumar S, Pilarski R, Shapiro CL, Greco D, Heikkilä P, Aittomäki K, Blomqvist C, Irwanto A, Liu J, Pankratz VS, Wang X, Severi G, Mannermaa A, Easton D, Hall P, Brauch H, Cox A, Zheng W, Godwin AK, Hamann U, Ambrosone C, Toland AE, Nevanlinna H, Vachon CM, Couch FJ. Genome-wide association study identifies 25 known breast cancer susceptibility loci as risk factors for triple-negative breast cancer. Carcinogenesis 2014; 35:1012-9. [PMID: 24325915 PMCID: PMC4004200 DOI: 10.1093/carcin/bgt404] [Citation(s) in RCA: 112] [Impact Index Per Article: 11.2] [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: 08/05/2013] [Revised: 11/04/2013] [Accepted: 11/27/2013] [Indexed: 11/14/2022] Open
Abstract
Triple-negative (TN) breast cancer is an aggressive subtype of breast cancer associated with a unique set of epidemiologic and genetic risk factors. We conducted a two-stage genome-wide association study of TN breast cancer (stage 1: 1529 TN cases, 3399 controls; stage 2: 2148 cases, 1309 controls) to identify loci that influence TN breast cancer risk. Variants in the 19p13.1 and PTHLH loci showed genome-wide significant associations (P < 5 × 10(-) (8)) in stage 1 and 2 combined. Results also suggested a substantial enrichment of significantly associated variants among the single nucleotide polymorphisms (SNPs) analyzed in stage 2. Variants from 25 of 74 known breast cancer susceptibility loci were also associated with risk of TN breast cancer (P < 0.05). Associations with TN breast cancer were confirmed for 10 loci (LGR6, MDM4, CASP8, 2q35, 2p24.1, TERT-rs10069690, ESR1, TOX3, 19p13.1, RALY), and we identified associations with TN breast cancer for 15 additional breast cancer loci (P < 0.05: PEX14, 2q24.1, 2q31.1, ADAM29, EBF1, TCF7L2, 11q13.1, 11q24.3, 12p13.1, PTHLH, NTN4, 12q24, BRCA2, RAD51L1-rs2588809, MKL1). Further, two SNPs independent of previously reported signals in ESR1 [rs12525163 odds ratio (OR) = 1.15, P = 4.9 × 10(-) (4)] and 19p13.1 (rs1864112 OR = 0.84, P = 1.8 × 10(-) (9)) were associated with TN breast cancer. A polygenic risk score (PRS) for TN breast cancer based on known breast cancer risk variants showed a 4-fold difference in risk between the highest and lowest PRS quintiles (OR = 4.03, 95% confidence interval 3.46-4.70, P = 4.8 × 10(-) (69)). This translates to an absolute risk for TN breast cancer ranging from 0.8% to 3.4%, suggesting that genetic variation may be used for TN breast cancer risk prediction.
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Affiliation(s)
| | - Susan Slager
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Diana Eccles
- Faculty of Medicine, University of Southampton SO17 1BJ, Southampton, UK
| | - Drakoulis Yannoukakos
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | - Peter A. Fasching
- Department of Medicine, Division of Hematology/Oncology, University of California at Los Angeles, David Geffen School of Medicine, Los Angeles, CA 90095, USA
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Penelope Miron
- Department of Cancer Biology, Dana-Farber Cancer Institute, Boston, MA 02215, USA
| | - Jane Carpenter
- Australian Breast Cancer Tissue Bank, University of Sydney at the Westmead Millennium Institute, Westmead, New South Wales, NSW 2145 Australia
| | - Jenny Chang-Claude
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Nicholas G. Martin
- QIMR GWAS Collective, Queensland Institute of Medical Research, Brisbane, Queensland, QLD 4006 Australia
| | - Grant W. Montgomery
- QIMR GWAS Collective, Queensland Institute of Medical Research, Brisbane, Queensland, QLD 4006 Australia
| | - Vessela Kristensen
- Department of Genetics, Institute for Cancer Research, Oslo University Hospital, Radiumhospitalet, Oslo 0316, Norway
- Faculty of Medicine (Faculty Division Ahus), Universitetet i Oslo, Oslo 0316, Norway
| | - Hoda Anton-Culver
- Department of Epidemiology, University of California–Irvine, Irvine, CA 92697, USA
| | - Paul Goodfellow
- Washington University School of Medicine, Barnes-Jewish Hospital and Siteman Cancer Center, St Louis, MO 63110, USA
| | - William J. Tapper
- Faculty of Medicine, University of Southampton SO17 1BJ, Southampton, UK
| | - Sajjad Rafiq
- Faculty of Medicine, University of Southampton SO17 1BJ, Southampton, UK
| | - Susan M. Gerty
- Faculty of Medicine, University of Southampton SO17 1BJ, Southampton, UK
| | - Lorraine Durcan
- Faculty of Medicine, University of Southampton SO17 1BJ, Southampton, UK
| | - Irene Konstantopoulou
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | - Florentia Fostira
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | - Athanassios Vratimos
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | - Paraskevi Apostolou
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | - Irene Konstanta
- Molecular Diagnostics Laboratory INRASTES, National Centre for Scientific Research “Demokritos”, Athens 153 10, Greece
| | | | - Sotiris Lakis
- Laboratory of Molecular Oncology, Hellenic Foundation for Cancer Research, Aristotle University of Thessaloniki School of Medicine, Thessaloniki 54124, Greece
| | - Meletios A. Dimopoulos
- Department of Clinical Therapeutics, “Alexandra” Hospital, University of Athens School of Medicine, Athens 115 27, Greece
| | - Dimosthenis Skarlos
- Second Department of Medical Oncology, “Metropolitan” Hospital, Athens 151 25, Greece
| | - Dimitrios Pectasides
- Second Department of Internal Medicine, Oncology Section, “Hippokration” Hospital, University of Athens School of Medicine, Athens 115 27, Greece
| | - George Fountzilas
- Department of Medical Oncology, “Papageorgiou” Hospital, Aristotle University of Thessaloniki School of Medicine, Thessaloniki 54124, Greece
| | - Matthias W. Beckmann
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Alexander Hein
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Matthias Ruebner
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | | | | | - Ruediger Schulz-Wendtland
- Institute of Diagnostic Radiology, University Hospital Erlangen, Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Stefan P. Renner
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Wolfgang Janni
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm 89069, Germany
| | - Brigitte Rack
- Department of Gynecology and Obstetrics, University Hospital Ludwig Maximilians University, Campus Innenstadt, Munich 80539, Germany
| | - Christoph Scholz
- Department of Gynecology and Obstetrics, University Hospital Ulm, Ulm 89069, Germany
| | - Julia Neugebauer
- Department of Gynecology and Obstetrics, University Hospital Ludwig Maximilians University, Campus Innenstadt, Munich 80539, Germany
| | - Ulrich Andergassen
- Department of Gynecology and Obstetrics, University Hospital Ludwig Maximilians University, Campus Innenstadt, Munich 80539, Germany
| | - Michael P. Lux
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Lothar Haeberle
- Department of Gynecology and Obstetrics, University Breast Center Franconia, University Hospital Erlangen; Friedrich-Alexander University Erlangen-Nuremberg, Erlangen D-91012, Germany
| | - Christine Clarke
- Westmead Institute for Cancer Research, Sydney Medical School Westmead, University of Sydney at the Westmead Millennium Institute, Westmead, New South Wales NSW 2145, Australia
| | - Nirmala Pathmanathan
- Westmead Breast Cancer Institute, Westmead Hospital, Westmead, New South Wales NSW 2145, Australia
| | - Anja Rudolph
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Dieter Flesch-Janys
- Institute for Medical Biometrics and Epidemiology, University Clinic Hamburg-Eppendorf, Hamburg 20246, Germany
| | - Stefan Nickels
- Division of Cancer Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Janet E. Olson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Curtis Olswold
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Seth Slettedahl
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | | | - S.Keith Anderson
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Daniel W. Visscher
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Hugues Sicotte
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Naresh Prodduturi
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Elisabete Weiderpass
- Department of Community Medicine, University of Tromsø, Tromsø 9019, Norway
- Folkhälsan Research Cancer Centre, Helsinki 00250, Finland
- Cancer Registry of Norway, Oslo N-0304, Norway
| | - Leslie Bernstein
- Department of Population Sciences, Division of Cancer Etiology, Beckman Research Institute, City of Hope, Duarte 91010, USA
| | - Argyrios Ziogas
- Department of Epidemiology, University of California–Irvine, Irvine, CA 92697, USA
| | - Jennifer Ivanovich
- Washington University School of Medicine, Barnes-Jewish Hospital and Siteman Cancer Center, St Louis, MO 63110, USA
| | - Graham G. Giles
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria VIC 3053, Australia
| | - Laura Baglietto
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria VIC 3053, Australia
| | - Melissa Southey
- Department of Pathology, The University of Melbourne, Melbourne, Victoria VIC 3053, Australia
| | - Veli-Matti Kosma
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine; Biocenter Kuopio, Cancer Center of Eastern Finland, and Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, University of Eastern Finland, Kuopio 80130, Finland
| | - Hans-Peter Fischer
- Department of Pathology, Medical Faculty University Bonn, Bonn 53127, Germany
| | - The GENICA Network
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen 72074, Germany, 72074
- Department of Internal Medicine, Evangelische Kliniken Bonn gGmbH, Johanniter Krankenhaus, Bonn 53127, Germany
- Institute for Occupational Medicine and Maritime Medicine, University Medical Center Hamburg-Eppendorf, Hamburg 20246, Germany
- Institute for Prevention and Occupational Medicine of the German Social Accident Insurance, Institute of the Ruhr University Bochum (IPA), Bochum D-44789, Germany
- Institute of Pathology, Medical Faculty of the University of Bonn, Bonn 53127, Germany
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Malcom W.R. Reed
- Department of Oncology, Cancer Research UK/Yorkshire Cancer Research Sheffield Cancer Research Centre and
| | - Simon S. Cross
- Department of Neuroscience, University of Sheffield, Sheffield S10 2TN, UK
| | - Sandra Deming-Halverson
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Martha Shrubsole
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Qiuyin Cai
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Xiao-Ou Shu
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Mary Daly
- Department of Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA
| | - JoEllen Weaver
- PennMed Biobank, University of Pennsylvania School of Medicine, Philadelphia, PA 19104, USA
| | - Eric Ross
- Department of Biostatistics and Bioinformatics, Fox Chase Cancer Center, Philadelphia, PA 19111-2497, USA
| | - Jennifer Klemp
- Department of Oncology/Hematology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Priyanka Sharma
- Department of Oncology/Hematology, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Diana Torres
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
- Institute of Human Genetics, Pontificia University Javeriana, Bogota D.C. 11001000, Colombia
| | - Thomas Rüdiger
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Karlsruhe 76133, Germany
| | - Heidrun Wölfing
- Institute of Pathology, Städtisches Klinikum Karlsruhe, Karlsruhe 76133, Germany
| | - Hans-Ulrich Ulmer
- Frauenklinik der Stadtklinik Baden-Baden, Baden-Baden 76530, Germany
| | - Asta Försti
- Center for Primary Health Care Research, University of Lund, Malmö 223 63, Sweden
- Division of Molecular Genetic Epidemiology, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | | | - Shicha Kumar
- Department of Surgical Oncology, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Robert Pilarski
- Department of Internal Medicine, Division of Human Genetics and
| | - Charles L. Shapiro
- Department of Internal Medicine, Division of Medical Oncology, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | | | | | | | - Carl Blomqvist
- Department of Oncology, Helsinki University Central Hospital, Helsinki 00014, Finland
| | - Astrid Irwanto
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672 Singapore
| | - Jianjun Liu
- Human Genetics Division, Genome Institute of Singapore, Singapore 138672 Singapore
| | | | - Xianshu Wang
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
| | - Gianluca Severi
- Cancer Epidemiology Centre, The Cancer Council Victoria, Melbourne, Victoria VIC 3053, Australia
| | - Arto Mannermaa
- School of Medicine, Institute of Clinical Medicine, Pathology and Forensic Medicine; Biocenter Kuopio, Cancer Center of Eastern Finland, and Imaging Center, Department of Clinical Pathology, Kuopio University Hospital, University of Eastern Finland, Kuopio 80130, Finland
| | - Douglas Easton
- Department of Public Health and Primary Care, Department of Oncology, Centre for Cancer Genetic Epidemiology, University of Cambridge, Cambridge CB2 1TN, UK
| | - Per Hall
- Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm 171 77, Sweden
| | - Hiltrud Brauch
- Dr Margarete Fischer-Bosch-Institute of Clinical Pharmacology, Stuttgart and University of Tuebingen, Tuebingen 72074, Germany, 72074
| | - Angela Cox
- Department of Oncology, Cancer Research UK/Yorkshire Cancer Research Sheffield Cancer Research Centre and
| | - Wei Zheng
- Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Division of Epidemiology, Vanderbilt University School of Medicine, Nashville, TN 37232, USA
| | - Andrew K. Godwin
- Department of Pathology and Laboratory Medicine, University of Kansas Medical Center, Kansas City, KS 66160, USA
| | - Ute Hamann
- Molecular Genetics of Breast Cancer, German Cancer Research Center (DKFZ), Heidelberg 69120, Germany
| | - Christine Ambrosone
- Department of Cancer Prevention and Control, Roswell Park Cancer Institute, Buffalo, NY 14263, USA
| | - Amanda Ewart Toland
- Departments of Internal Medicine and Molecular Virology, Immunology and Medical Genetics, Division of Human Cancer Genetics, Comprehensive Cancer Center, The Ohio State University, Columbus, OH 43210, USA
| | | | - Celine M. Vachon
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
| | - Fergus J. Couch
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN 55905, USA
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN 55905, USA
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27
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Glatz AC, Purrington KS, Klinger A, King AR, Hellinger J, Zhu X, Gruber SB, Gruber PJ. Cumulative exposure to medical radiation for children requiring surgery for congenital heart disease. J Pediatr 2014; 164:789-794.e10. [PMID: 24321535 DOI: 10.1016/j.jpeds.2013.10.074] [Citation(s) in RCA: 66] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2013] [Revised: 09/23/2013] [Accepted: 10/28/2013] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To describe cumulative radiation exposure in a large single-center cohort of children with congenital heart disease (CHD) and identify risk factors for greater exposure. STUDY DESIGN A detailed medical radiation exposure history was collected retrospectively for patients aged <18 years who underwent surgery for CHD between January 1, 2001, and July 22, 2009. Cumulative per patient exposure was quantified as the effective dose in millisieverts (mSv) and annualized (mSv/year). RESULTS A total of 4132 patients were subjected to 134,715 radiation examinations at a median follow-up of 4.3 years (range, 0-8.6 years). Exposure clustered around the time of surgery. The median exposure was 14 radiologic tests (the majority of which were plain film radiographs) at an effective dose of 0.96 mSv (the majority of which was from cardiac catheterization), although this distribution had a very wide range. Almost three-quarters (73.7%) were exposed to <3 mSv/year, and 5.3% were exposed to >20 mSv/year. Neonates, children with genetic syndromes, and children requiring surgery for cardiomyopathy, pulmonary valve, single ventricle, or tricuspid valve diseases were more likely to have higher exposure levels, and those requiring surgery for aortic arch anomalies or atrioventricular septal defects were more likely to have lower levels. CONCLUSION Children with CHD requiring surgery are exposed to numerous medical forms of ionizing radiation. Although the majority of patients receive <3 mSv/year, there are identifiable risk factors for higher exposure levels. This may have important health implications as these patients age.
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Affiliation(s)
- Andrew C Glatz
- Division of Cardiology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Pediatrics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA
| | | | | | | | - Jeffrey Hellinger
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Xiaowei Zhu
- Department of Radiology, The Children's Hospital of Philadelphia, Philadelphia, PA
| | - Stephen B Gruber
- Departments of Epidemiology, Internal Medicine, and Human Genetics, University of Michigan, Ann Arbor, MI
| | - Peter J Gruber
- Section of Pediatric Cardiothoracic Surgery, University of Utah, Salt Lake City, UT
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