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Huang CC, Lu TP, Wang YJ, Chen BF, Yang HT, Chang WP, Tseng LM. Identifying breast cancer risk factors and evaluating biennial mammography screening efficacy using big data analysis in Taiwan. Sci Rep 2025; 15:16250. [PMID: 40346112 PMCID: PMC12064733 DOI: 10.1038/s41598-025-00984-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2023] [Accepted: 05/02/2025] [Indexed: 05/11/2025] Open
Abstract
Most evidence and experience with mammography screening originate from Western countries, and the optimal prevention strategy for Taiwanese women remains uncertain. Currently, breast cancer susceptibility in Taiwan is primarily stratified by family history, which contrasts with the trend toward personalized screening. Additionally, the high false-positive and false-negative rates (and the resulting compromised positive predictive value) have hindered the widespread adoption of mammography among the general population. Consequently, there is an unmet need to identify breast cancer risk factors to develop a more efficient and tailored screening strategy that minimizes potential harm. This study aimed to identify breast cancer risk factors by analyzing big data, including National Health Insurance claims data, a screening database, a cancer registry from the Health Promotion Administration, and a death registry from census data. Between 2007 and 2017, 189,465 entries were extracted from the cancer registry, representing 133,546 breast cancer cases. The screening database contained 3,806,128 mammography episodes from 2004 to 2014. We identified subjects who had attended at least one screening session between January 2007 and September 2014, matching cancer cases to the registry. Screening intervals were extended by two years to August 2016. After excluding patients with pre-existing breast malignancies, 3,605,758 screening mammography episodes from 2,191,742 invitees were analyzed, resulting in the identification of 38,815 incident breast cancer cases. Multivariate analyses revealed that risk factors for breast cancer diagnosis included a family history of any cancer (odds ratio [OR]: 1.462), number of sisters with breast cancer (OR: 1.058), years of hormone replacement therapy (OR: 1.006), breast symptoms (OR: 3.843), breast examinations within two years (OR: 1.226), prior breast surgery (OR: 1.044), educational level (OR: 1.04), and breast density (OR: 1.096). Protective factors included menopausal status (OR: 0.935), breastfeeding (OR: 0.908), sonography within two years (OR: 0.899), comparison with prior mammography (OR: 0.775), number of mammography screenings (OR: 0.673), and screening via a mobile van (OR: 0.587). The model demonstrated an area under the receiver operating characteristic curve (AUC) of 0.6766. Among 50,831 breast cancer cases, 47.6% had undergone at least one mammography screening before diagnosis, which was associated with earlier disease stages. Clinically detected breast cancer was an independent risk factor for recurrence-free and overall survival, as well as breast cancer mortality. Big data analysis identified several risk factors for breast cancer development in Taiwanese women and confirmed the efficacy of mammography screening.
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Affiliation(s)
- Chi-Cheng Huang
- Comprehensive Breast Health Center and Division of Breast Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Tzu-Pin Lu
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Yu-Jen Wang
- Department of Radiation Oncology, Fu-Jen Catholic University Hospital, New Taipei, Taiwan
- School of Medicine, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Bo-Fang Chen
- Comprehensive Breast Health Center and Division of Breast Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
| | - Hui-Ting Yang
- Data Science Center, College of Medicine, Fu-Jen Catholic University, New Taipei, Taiwan
| | - Wei-Pin Chang
- School of Health Care Administration, College of Management, Taipei Medical University, Taipei, Taiwan
| | - Ling-Ming Tseng
- Comprehensive Breast Health Center and Division of Breast Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan.
- School of Medicine, College of Medicine, National Yang-Ming Chiao-Tung University, Taipei, Taiwan.
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Souni F, Mansouri F, Jafari F, Sharifi R, PourvatanDoust S, Shateri Z, Nouri M, Rashidkhani B. The association between plant-based diet indices and the risk of breast cancer: a case-control study. JOURNAL OF HEALTH, POPULATION, AND NUTRITION 2025; 44:127. [PMID: 40253371 PMCID: PMC12008985 DOI: 10.1186/s41043-025-00879-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2024] [Accepted: 04/11/2025] [Indexed: 04/21/2025]
Abstract
BACKGROUND Previous studies examining the relationship between plant-based diets and breast cancer (BrC) have provided conflicting evidence. To address these inconsistencies, we aimed to evaluate the association between the plant-based diet index (PDI), healthful PDI (hPDI), and unhealthy PDI (uPDI) with the odds of BrC in Iranian women. METHODS The current case-control research was performed on 133 Iranian women with BrC and 265 controls. The study subjects were selected from hospitals in Tehran. PDI, hPDI, and uPDI were categorized into eighteen food groups based on nutrient composition similarity. The relationship between PDIs and BrC was assessed using logistic regression. RESULTS After adjusting for confounding factors, the chance of developing BrC was lower in the highest tertile of hPDI compared to the lowest tertile (odds ratio (OR) = 0.495; 95% confidence interval (CI): 0.274-0.891; P = 0.019). In addition, postmenopausal women in the second and last tertiles of hPDI had lower odds of BrC than those in the first tertile (T) (T2: OR = 0.342; 95% CI: 0.141-0.828; P = 0.017- T3: OR = 0.262; 95% CI: 0.107-0.639; P = 0.003) in the adjusted model. Furthermore, in premenopausal women in the highest tertile of uPDI, the odds of BrC were increased compared to the lowest tertile (OR = 2.546; 95% CI: 1.051-6.167; P = 0.038) in the adjusted model. CONCLUSIONS Adherence to a healthy plant-based dietary pattern, including vegetables, fruits, whole grains, nuts, and legumes, seems to be beneficial for BrC prevention, particularly in postmenopausal women. Future prospective cohort studies that consider menopausal status and the type of BrC are needed to support these findings.
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Affiliation(s)
- Fateme Souni
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Mansouri
- Department of Clinical Nutrition, School of Nutrition and Food Sciences, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Fatemeh Jafari
- Department of Nutritional Sciences, The Pennsylvania State University, University Park, PA, USA
| | - Reza Sharifi
- Department of Prosthodontics, Faculty of Dentistry, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Sepideh PourvatanDoust
- Department of Food Science and Technology, Science and Research Branch, Islamic Azad University, Tehran, Iran
| | - Zainab Shateri
- Department of Nutrition and Biochemistry, School of Medicine, Ilam University of Medical Sciences, Ilam, Iran
| | - Mehran Nouri
- Infertility and Reproductive Health Research Center, Health Research Institute, Babol University of Medical sciences, Babol, Iran.
| | - Bahram Rashidkhani
- Department of Community Nutrition, Faculty of Nutrition and Food Technology, National Nutrition and Food Technology Research Institute, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Zhang Y, Wu H, Gan C, Rao H, Wang Q, Guo X. BRCA1 and BRCA2 germline mutations in Chinese Hakka breast cancer patients. BMC Med Genomics 2024; 17:3. [PMID: 38167124 PMCID: PMC10763220 DOI: 10.1186/s12920-023-01772-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 12/12/2023] [Indexed: 01/05/2024] Open
Abstract
OBJECTIVE To investigate the prevalence of BRCA1/2 gene variants and evaluate the clinical and pathological characteristics associated with these variants in Chinese Hakka breast cancer patients. METHODS A total of 409 breast cancer patients were analyzed based on next-generation sequencing results, with 337 categorized as non-carriers and 72 as carriers of BRCA1/2 variants. Data on the patients' BRCA1/2 gene mutation status, clinical and pathological characteristics, as well as menstrual and reproductive information, were collected, analyzed, compared, and tabulated. Logistic regression analysis was performed to explore the relationship between clinical characteristics and pathogenic variants. RESULTS Among the patients, 72 were identified as carriers of pathogenic or likely pathogenic variants in BRCA1/2, while 337 had likely benign or benign mutations. The BRCA1 c.2635G > T (p. Glu879*) variant was detected at a high frequency, accounting for 12.5% (4/32) of the BRCA1 mutations, while the c.5164_5165del (p.Ser1722Tyrfs*4) variant was common among the BRCA2 mutations, accounting for 17.5% (7/40). It was observed that a higher proportion of BRCA1 carriers had the triple-negative breast cancer subtype, whereas more BRCA2 carriers exhibited estrogen receptor (ER) + and progesterone receptor (PR) + subtypes. Multivariate logistic regression analysis revealed that a family history of cancer (OR = 2.36, 95% CI = 1.00-5.54), bilateral cancer (OR = 4.78, 95% CI 1.61-14.20), human epidermal growth factor receptor 2 (HER2)- (OR = 8.23, 95% CI 3.25-20.84), and Ki67 ≥ 15% (OR = 3.88, 95% CI 1.41-10.65) were associated with BRCA1/2 mutations, with the age at diagnosis, age at menarche, and premenopausal status serving as covariates. CONCLUSIONS The most common pathogenic variant of the BRCA1 and BRCA2 in breast cancer patients was c.2635G > T and c.5164_5165del, respectively. Additionally, a family history of cancer, bilateral cancer, HER2-, and Ki67 ≥ 15% were identified as independent predictors of BRCA1/2 pathogenic variants.
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Affiliation(s)
- Yinmei Zhang
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China
| | - Heming Wu
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China
| | - Caiyan Gan
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China
| | - Hui Rao
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China
| | - Qiuming Wang
- Department of Medical Oncology, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, Meizhou, People's Republic of China
| | - Xueming Guo
- Center for Precision Medicine, Meizhou People's Hospital (Huangtang Hospital), Meizhou Academy of Medical Sciences, No 63 Huangtang Road, Meijiang District, Meizhou, 514031, P. R. China.
- Guangdong Engineering Technological Research Center of Clinical Molecular Diagnosis and Antibody Drugs, Meizhou, China.
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Alkhayyat S, Khan M, Ahmad T, Haroon, Tariq H, Baig M. A bibliometric analysis of the top 100 most cited papers and research trends in breast cancer related BRCA1 and BRCA2 genes. Medicine (Baltimore) 2022; 101:e30576. [PMID: 36197199 PMCID: PMC9509046 DOI: 10.1097/md.0000000000030576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022] Open
Abstract
This study aimed to identify, characterize, and map the important attributes of the top 100 most cited papers on BRCA1 and BRCA2 genes. The scientific literature on BRCA1 and BRCA2 was searched in the Web of Science Core Collection database using the keywords "BRCA1" OR "BRCA2" (Title). The top 100 most cited papers were selected based on citations. The obtained data were exported into HistCiteTM, RStudio, and VOSviewer software for prerequisite analysis. The top 100 most cited papers on BRCA1 and BRCA2 were authored by 932 authors from 24 countries and published in 27 journals. These papers were cited 79,713 times, ranging from 441 to 4671 citations. The highly cited paper was cited 4671 times and published in Science (1994). The leading author, journal, publication year, institution, and country were Easton DF (n = 16), Nature Genetics (n = 11), 2002 (n = 11), University of Pennsylvania (n = 17), and the USA (n = 76), respectively. The results show that all the top 100 papers were produced in developed countries. The collaboration index among the authors was 9.49. The most frequently appeared keywords were ovarian-cancer, breast-cancer, mutations, gene, and familial breast. In recent times, the trend topics were patients, mutations, carriers, ovarian, and risk.
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Affiliation(s)
- Shadi Alkhayyat
- Department of Medicine, Faculty of Medicine, King Abdulaziz University Hospital, King Abdulaziz University, Jeddah, Saudi Arabia
| | - Muhammad Khan
- Department of Biotechnology and Genetic Engineering, Hazara University Mansehra, KP, Pakistan
| | - Tauseef Ahmad
- Vanke School of Public Health, Tsinghua University, Beijing, China
- Department of Epidemiology and Health Statistics, School of Public Health, Southeast University, Nanjing, China
- *Correspondence: Tauseef Ahmad, Vanke School of Public Health, Tsinghua University, Beijing 100084, China (e-mail: /)
| | - Haroon
- College of Life Science, Northwest University, Xian, China
| | - Huma Tariq
- Department of Zoology, Hazara University Mansehra, KP, Pakistan
| | - Mukhtiar Baig
- Department of Clinical Biochemistry, Faculty of Medicine, Rabigh, King Abdulaziz University, Jeddah, Saudi Arabia
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5
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Park SS, Uzelac A, Kotsopoulos J. Delineating the role of osteoprotegerin as a marker of breast cancer risk among women with a BRCA1 mutation. Hered Cancer Clin Pract 2022; 20:14. [PMID: 35418083 PMCID: PMC9008947 DOI: 10.1186/s13053-022-00223-3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 03/30/2022] [Indexed: 11/26/2022] Open
Abstract
Women with a pathogenic germline mutation in the BRCA1 gene face a very high lifetime risk of developing breast cancer, estimated at 72% by age 80. Prophylactic bilateral mastectomy is the only effective way to lower their risk; however, most women with a mutation opt for intensive screening with annual MRI and mammography. Given that the BRCA1 gene was identified over 20 years ago, there is a need to identify a novel non-surgical approach to hereditary breast cancer prevention. Here, we provide a review of the emerging preclinical and epidemiologic evidence implicating the dysregulation of progesterone-mediated receptor activator of nuclear factor κB (RANK) signaling in the pathogenesis of BRCA1-associated breast cancer. Experimental studies have demonstrated that RANK inhibition suppresses Brca1-mammary tumorigenesis, suggesting a potential target for prevention. Data from studies conducted among women with a BRCA1 mutation further support this pathway in BRCA1-associated breast cancer development. Progesterone-containing (but not estrogen-alone) hormone replacement therapy is associated with an increased risk of breast cancer in women with a BRCA1 mutation. Furthermore, BRCA1 mutation carriers have significantly lower levels of circulating osteoprotegerin (OPG), the decoy receptor for RANK-ligand (RANKL) and thus endogenous inhibitor of RANK signaling. OPG levels may be associated with the risk of disease, suggesting a role of this protein as a potential biomarker of breast cancer risk. This may improve upon current risk prediction models, stratifying women at the highest risk of developing the disease, and further identify those who may be targets for anti-RANKL chemoprevention. Collectively, the evidence supports therapeutic inhibition of the RANK pathway for the primary prevention of BRCA1-associated breast cancer, which may generate unique prevention strategies (without prophylactic surgery) and enhance quality of life.
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Affiliation(s)
- Sarah Sohyun Park
- Department of Nutritional Sciences, University of Toronto, Toronto, Ontario, Canada
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
| | - Aleksandra Uzelac
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, Canada
| | - Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, Ontario, Canada.
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada.
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6
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Sarnowski C, Cousminer DL, Franceschini N, Raffield LM, Jia G, Fernández-Rhodes L, Grant SFA, Hakonarson H, Lange LA, Long J, Sofer T, Tao R, Wallace RB, Wong Q, Zirpoli G, Boerwinkle E, Bradfield JP, Correa A, Kooperberg CL, North KE, Palmer JR, Zemel BS, Zheng W, Murabito JM, Lunetta KL. Large trans-ethnic meta-analysis identifies AKR1C4 as a novel gene associated with age at menarche. Hum Reprod 2021; 36:1999-2010. [PMID: 34021356 PMCID: PMC8213450 DOI: 10.1093/humrep/deab086] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Revised: 03/12/2021] [Indexed: 12/25/2022] Open
Abstract
STUDY QUESTION Does the expansion of genome-wide association studies (GWAS) to a broader range of ancestries improve the ability to identify and generalise variants associated with age at menarche (AAM) in European populations to a wider range of world populations? SUMMARY ANSWER By including women with diverse and predominantly non-European ancestry in a large-scale meta-analysis of AAM with half of the women being of African ancestry, we identified a new locus associated with AAM in African-ancestry participants, and generalised loci from GWAS of European ancestry individuals. WHAT IS KNOWN ALREADY AAM is a highly polygenic puberty trait associated with various diseases later in life. Both AAM and diseases associated with puberty timing vary by race or ethnicity. The majority of GWAS of AAM have been performed in European ancestry women. STUDY DESIGN, SIZE, DURATION We analysed a total of 38 546 women who did not have predominantly European ancestry backgrounds: 25 149 women from seven studies from the ReproGen Consortium and 13 397 women from the UK Biobank. In addition, we used an independent sample of 5148 African-ancestry women from the Southern Community Cohort Study (SCCS) for replication. PARTICIPANTS/MATERIALS, SETTING, METHODS Each AAM GWAS was performed by study and ancestry or ethnic group using linear regression models adjusted for birth year and study-specific covariates. ReproGen and UK Biobank results were meta-analysed using an inverse variance-weighted average method. A trans-ethnic meta-analysis was also carried out to assess heterogeneity due to different ancestry. MAIN RESULTS AND THE ROLE OF CHANCE We observed consistent direction and effect sizes between our meta-analysis and the largest GWAS conducted in European or Asian ancestry women. We validated four AAM loci (1p31, 6q16, 6q22 and 9q31) with common genetic variants at P < 5 × 10-7. We detected one new association (10p15) at P < 5 × 10-8 with a low-frequency genetic variant lying in AKR1C4, which was replicated in an independent sample. This gene belongs to a family of enzymes that regulate the metabolism of steroid hormones and have been implicated in the pathophysiology of uterine diseases. The genetic variant in the new locus is more frequent in African-ancestry participants, and has a very low frequency in Asian or European-ancestry individuals. LARGE SCALE DATA N/A. LIMITATIONS, REASONS FOR CAUTION Extreme AAM (<9 years or >18 years) were excluded from analysis. Women may not fully recall their AAM as most of the studies were conducted many years later. Further studies in women with diverse and predominantly non-European ancestry are needed to confirm and extend these findings, but the availability of such replication samples is limited. WIDER IMPLICATIONS OF THE FINDINGS Expanding association studies to a broader range of ancestries or ethnicities may improve the identification of new genetic variants associated with complex diseases or traits and the generalisation of variants from European-ancestry studies to a wider range of world populations. STUDY FUNDING/COMPETING INTEREST(S) Funding was provided by CHARGE Consortium grant R01HL105756-07: Gene Discovery For CVD and Aging Phenotypes and by the NIH grant U24AG051129 awarded by the National Institute on Aging (NIA). The authors have no conflict of interest to declare.
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Affiliation(s)
- C Sarnowski
- Boston University School of Public Health, Boston, MA, USA
- Department of Epidemiology, Human Genetics and Environmental Sciences, The University of Texas Health Science Center at Houston School of Public Health, Houston, TX, USA
| | - D L Cousminer
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - N Franceschini
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - L M Raffield
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - G Jia
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - L Fernández-Rhodes
- Department of Biobehavioral Health, College of Health and Human Development, Pennsylvania State University, University Park, PA, USA
| | - S F A Grant
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Endocrinology, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - H Hakonarson
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Pulmonary Medicine, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - L A Lange
- Department of Medicine, University of Colorado Denver, Anschutz Medical Campus, Aurora, CO, USA
| | - J Long
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - T Sofer
- Departments of Medicine and of Biostatistics, Harvard University, Boston, MA, USA
- Division of Sleep and Circadian Disorders, Departments of Medicine and Neurology, Brigham and Women’s Hospital, Boston, MA, USA
| | - R Tao
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, TN, USA
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
| | - R B Wallace
- University of Iowa College of Public Health, Iowa City, IA, USA
| | - Q Wong
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - G Zirpoli
- Slone Epidemiology Center at Boston University, Boston, MA, USA
- Section of Hematology/Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - E Boerwinkle
- Human Genetic Center and Department of Epidemiology, The University of Texas School of Public Health, Houston, TX, USA
| | - J P Bradfield
- Center for Applied Genomics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Quantinuum Research, LLC, Wayne, PA, USA
| | - A Correa
- Department of Medicine, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Pediatrics, University of Mississippi Medical Center, Jackson, MS, USA
- Department of Population Health Science, University of Mississippi Medical Center, Jackson, MS, USA
| | - C L Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - K E North
- Department of Epidemiology, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA
- Carolina Center for Genome Sciences, University of North Carolina, Chapel Hill, NC, USA
| | - J R Palmer
- Slone Epidemiology Center at Boston University, Boston, MA, USA
- Section of Hematology/Oncology, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - B S Zemel
- Department of Pediatrics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
- Division of Gastroenterology, Hepatology and Nutrition, The Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - W Zheng
- Division of Epidemiology, Department of Medicine, Vanderbilt Epidemiology Center, Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN, USA
| | - J M Murabito
- National Heart Lung and Blood Institute and Boston University’s Framingham Heart Study, Framingham, MA, USA
- Section of General Internal Medicine, Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - K L Lunetta
- Boston University School of Public Health, Boston, MA, USA
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7
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Rigi S, Mousavi SM, Benisi-Kohansal S, Azadbakht L, Esmaillzadeh A. The association between plant-based dietary patterns and risk of breast cancer: a case-control study. Sci Rep 2021; 11:3391. [PMID: 33564027 PMCID: PMC7873223 DOI: 10.1038/s41598-021-82659-6] [Citation(s) in RCA: 39] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2020] [Accepted: 01/20/2021] [Indexed: 12/23/2022] Open
Abstract
Limited data are available, linking the plant-based diets to breast cancer (BC). We examined the association of overall plant-based diet index (PDI), hypothesized healthful (hPDI) and unhealthful versions of a plant-based diet index (uPDI) with BC in Iranian women. This population-based case–control study included 350 cases with newly diagnosed BC and 700 age-matched apparently healthy controls. We collected dietary data using a validated, Willett-format semi-quantitative food frequency questionnaire. Using these data, we generated a PDI by dedicating positive scores to plant foods, and reverse scores to animal foods, hPDI by assigning positive scores to healthy plant foods and reverse scores to less healthy plant foods and animal foods, and finally uPDI in which positive scores were assigned to less healthy plant foods and reverse scores to healthy plant foods and animal foods. After controlling for potential confounders, individuals in the highest quartile of PDI had 67% lower odds of BC than those in the lowest quartile (OR 0.33; 95% CI 0.22–0.50). Individuals with the greatest adherence to hPDI were 36% less likely to have BC than those with the lowest adherence, in the fully adjusted model (OR 0.64; 95% CI 0.43–0.94). In terms of uPDI, women in the top quartile had a 2.23 times greater chance of BC than those in the bottom quartile (OR 2.23; 95% CI 1.48–3.36). Greater adherence to PDI and hPDI was inversely associated with the risk of BC, whereas uPDI was associated with an increased risk.
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Affiliation(s)
- Somaye Rigi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Seyed Mohammad Mousavi
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.,Students' Scientific Research Center (SSRC), Tehran University of Medical Sciences, Tehran, Iran
| | - Sanaz Benisi-Kohansal
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran
| | - Leila Azadbakht
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran.,Diabetes Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Ahmad Esmaillzadeh
- Department of Community Nutrition, School of Nutritional Sciences and Dietetics, Tehran University of Medical Sciences, P.O. Box 14155-6117, Tehran, Iran. .,Obesity and Eating Habits Research Center, Endocrinology and Metabolism Molecular-Cellular Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran. .,Department of Community Nutrition, School of Nutrition and Food Science, Isfahan University of Medical Sciences, Isfahan, Iran.
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8
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Sepahi I, Faust U, Sturm M, Bosse K, Kehrer M, Heinrich T, Grundman-Hauser K, Bauer P, Ossowski S, Susak H, Varon R, Schröck E, Niederacher D, Auber B, Sutter C, Arnold N, Hahnen E, Dworniczak B, Wang-Gorke S, Gehrig A, Weber BHF, Engel C, Lemke JR, Hartkopf A, Nguyen HP, Riess O, Schroeder C. Investigating the effects of additional truncating variants in DNA-repair genes on breast cancer risk in BRCA1-positive women. BMC Cancer 2019; 19:787. [PMID: 31395037 PMCID: PMC6686546 DOI: 10.1186/s12885-019-5946-0] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2018] [Accepted: 07/16/2019] [Indexed: 01/22/2023] Open
Abstract
Background Inherited pathogenic variants in BRCA1 and BRCA2 are the most common causes of hereditary breast and ovarian cancer (HBOC). The risk of developing breast cancer by age 80 in women carrying a BRCA1 pathogenic variant is 72%. The lifetime risk varies between families and even within affected individuals of the same family. The cause of this variability is largely unknown, but it is hypothesized that additional genetic factors contribute to differences in age at onset (AAO). Here we investigated whether truncating and rare missense variants in genes of different DNA-repair pathways contribute to this phenomenon. Methods We used extreme phenotype sampling to recruit 133 BRCA1-positive patients with either early breast cancer onset, below 35 (early AAO cohort) or cancer-free by age 60 (controls). Next Generation Sequencing (NGS) was used to screen for variants in 311 genes involved in different DNA-repair pathways. Results Patients with an early AAO (73 women) had developed breast cancer at a median age of 27 years (interquartile range (IQR); 25.00–27.00 years). A total of 3703 variants were detected in all patients and 43 of those (1.2%) were truncating variants. The truncating variants were found in 26 women of the early AAO group (35.6%; 95%-CI 24.7 - 47.7%) compared to 16 women of controls (26.7%; 95%-CI 16.1 to 39.7%). When adjusted for environmental factors and family history, the odds ratio indicated an increased breast cancer risk for those carrying an additional truncating DNA-repair variant to BRCA1 mutation (OR: 3.1; 95%-CI 0.92 to 11.5; p-value = 0.07), although it did not reach the conventionally acceptable significance level of 0.05. Conclusions To our knowledge this is the first time that the combined effect of truncating variants in DNA-repair genes on AAO in patients with hereditary breast cancer is investigated. Our results indicate that co-occurring truncating variants might be associated with an earlier onset of breast cancer in BRCA1-positive patients. Larger cohorts are needed to confirm these results. Electronic supplementary material The online version of this article (10.1186/s12885-019-5946-0) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Ilnaz Sepahi
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Ulrike Faust
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Marc Sturm
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Kristin Bosse
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Martin Kehrer
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Tilman Heinrich
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Kathrin Grundman-Hauser
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Peter Bauer
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,CENTOGENE AG, Rostock, Germany
| | - Stephan Ossowski
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.,Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Hana Susak
- Centre for Genomic Regulation (CRG), The Barcelona Institute of Science and Technology, Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain
| | - Raymonda Varon
- Institute of Medical and Human Genetics, Charité Universitätsmedizin Berlin, Berlin, Germany
| | | | - Dieter Niederacher
- Department of Obstetrics and Gynaecology, Düsseldorf University Hospital, Düsseldorf, Germany
| | - Bernd Auber
- Department of Human Genetics, Hannover Medical School, Hannover, Germany
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Norbert Arnold
- Department of Gynaecology and Obstetrics and Institute of Clinical Molecular Biology, University Hospital of Schleswig-Holstein, Christian-Albrechts-University of Kiel, Kiel, Germany
| | - Eric Hahnen
- Centre for Hereditary Breast and Ovarian Cancer, University of Cologne and University Hospital Cologne, Cologne, Germany
| | - Bernd Dworniczak
- Institute of Human Genetics, University Hospital Münster, Münster, Germany
| | - Shan Wang-Gorke
- Department of Gynaecology and Obstetrics, University Hospital Ulm, Ulm, Germany
| | - Andrea Gehrig
- Centre of Familial Breast and Ovarian Cancer, Department of Medical Genetics, Institute of Human Genetics, University Würzburg, Würzburg, Germany
| | - Bernhard H F Weber
- Institute of Human Genetics, University of Regensburg, Regensburg, Germany
| | - Christoph Engel
- Institute for Medical Informatics, Statistics and Epidemiology, University of Leipzig, Leipzig, Germany
| | - Johannes R Lemke
- Institute of Human Genetics, University of Leipzig Hospitals and Clinics, Leipzig, Germany
| | - Andreas Hartkopf
- Department of Obstetrics and Gynecology, University of Tuebingen, Tuebingen, Germany
| | - Huu Phuc Nguyen
- Department of Human Genetics, Ruhr-University Bochum, Bochum, Germany
| | - Olaf Riess
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany
| | - Christopher Schroeder
- Institute of Medical Genetics and Applied Genomics, University of Tübingen, Tübingen, Germany.
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9
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Khincha PP, Best AF, Fraumeni JF, Loud JT, Savage SA, Achatz MI. Reproductive factors associated with breast cancer risk in Li-Fraumeni syndrome. Eur J Cancer 2019; 116:199-206. [PMID: 31212162 DOI: 10.1016/j.ejca.2019.05.005] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2019] [Revised: 05/10/2019] [Accepted: 05/10/2019] [Indexed: 12/29/2022]
Abstract
Li-Fraumeni syndrome (LFS) is a rare autosomal dominant cancer predisposition syndrome with exceptionally high lifetime cancer risks, caused primarily by germline TP53 variants. Early-onset breast cancer is the most common cancer in women with LFS. Associations between female reproductive factors and breast cancer risk have been widely studied in the general population and BRCA1/2 mutation carriers but not in LFS. We evaluated whether reproductive factors are associated with breast cancer in LFS. Questionnaire data were collected for 152 women with confirmed germline TP53 variants enrolled in the National Cancer Institute's LFS study (NCT01443468); of which, 85 had breast cancer, confirmed by pathology/medical reports. Fisher's exact test and Cox proportional hazards were used to calculate the effect of reproductive factors on breast cancer risk. Lifetime breastfeeding for at least 7 months was associated with lower breast cancer risk (hazard ratio [HR] 0.57, p = 0.05). Parity did not independently change breast cancer risk (HR 1.08, p = 0.8) but suggested an increased risk with older age at first live birth (HR 2.14, p = 0.05). Age at menarche (HR 1.09, p = 0.24) and use of oral contraceptives (HR 0.88; p = 0.7) did not significantly affect breast cancer risk. In this first study of reproductive factors and breast cancer in women with LFS, breastfeeding was observed to be protective against breast cancer risk, especially with at least 7 months of lifetime breastfeeding. Older age at first live birth was suggested to slightly increase breast cancer risk. Larger prospective studies of reproductive factors are warranted in women with LFS before making definitive clinical recommendations.
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Affiliation(s)
- Payal P Khincha
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA.
| | - Ana F Best
- Biostatistics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA
| | - Joseph F Fraumeni
- Office of the Director, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA
| | - Jennifer T Loud
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA
| | - Sharon A Savage
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA
| | - Maria Isabel Achatz
- Clinical Genetics Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, 9609, Medical Center Drive, MSC 9772, Bethesda, 20892, USA; Centro de Oncologia, Hospital Sirio-Libanes, Rua Dona Adma Jafet, 115- Bela Vista, Sao Paulo, Brazil
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10
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The Effects of Exercise on Adolescent Physical Development, Brain Development and Adult Health in Underserved Populations. PHYSICIAN ASSISTANT CLINICS 2019. [DOI: 10.1016/j.cpha.2018.08.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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11
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Kotsopoulos J. BRCA Mutations and Breast Cancer Prevention. Cancers (Basel) 2018; 10:E524. [PMID: 30572612 PMCID: PMC6315560 DOI: 10.3390/cancers10120524] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 12/05/2018] [Accepted: 12/17/2018] [Indexed: 12/14/2022] Open
Abstract
Women who inherit a deleterious BRCA1 or BRCA2 mutation face substantially increased risks of developing breast cancer, which is estimated at 70%. Although annual screening with magnetic resonance imaging (MRI) and mammography promotes the earlier detection of the disease, the gold standard for the primary prevention of breast cancer remains bilateral mastectomy. In the current paper, I review the evidence regarding the management of healthy BRCA mutation carriers, including key risk factors and protective factors, and also discuss potential chemoprevention options. I also provide an overview of the key findings from the literature published to date, with a focus on data from studies that are well-powered, and preferably prospective in nature.
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Affiliation(s)
- Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, 76 Grenville Street, 6th Floor, Toronto, ON M5S 1B2, Canada.
- Dalla Lana School of Public Health, University of Toronto, 155 College St, Toronto, ON M5T 3M7, Canada.
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12
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Al-Mathkoori R, Albatineh A, Al-Shatti M, Al-Taiar A. Is age of menarche among school girls related to breastfeeding during infancy? Am J Hum Biol 2018; 30:e23122. [PMID: 29573011 DOI: 10.1002/ajhb.23122] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2017] [Revised: 02/02/2018] [Accepted: 03/04/2018] [Indexed: 11/06/2022] Open
Abstract
OBJECTIVES Breastfeeding has been linked to various disease conditions in adulthood. Age of menarche has been proposed to be an intermediary factor on the life-course path to these disease conditions, but the link between breastfeeding and age of menarche remains under debate. This study aimed to investigate the association between age of menarche and breastfeeding during infancy. METHODS A cross-sectional study was conducted in which 775 female high school students were randomly selected from private and public high schools in all provinces in Kuwait. Data on age of menarche were collected by self-administered questionnaires from the students, while data on breastfeeding were collected from their mothers through telephone interviews. Multiple linear regression was used to investigate the association between breastfeeding and age of menarche after adjusting for potential confounders. RESULTS Of the study group 496 mothers responded to the telephone interview. Duration of breastfeeding was not significantly associated with age of menarche before or after adjusting for potential confounders (P = .279 and P = .124 for crude and fully adjusted model, respectively). Similarly, no significant association was found between type of breastfeeding during the first four months of life and age of menarche before or after adjusting for potential confounders (P = .949 and P = .398 for crude and fully adjusted model, respectively). CONCLUSION No significant association was found between age of menarche and breastfeeding during infancy, which may suggest that the link between breastfeeding and disease conditions in adulthood is not necessarily mediated through age of menarche.
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Affiliation(s)
- Radhia Al-Mathkoori
- Department of Public Health, Communicable Diseases Control Unit, Ministry of Health, Kuwait
| | - Ahmed Albatineh
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait
| | | | - Abdullah Al-Taiar
- Department of Community Medicine and Behavioural Sciences, Faculty of Medicine, Kuwait University, Kuwait
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13
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Physical activity during adolescence and young adulthood and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 2018; 169:561-571. [PMID: 29404807 DOI: 10.1007/s10549-018-4694-1] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2018] [Accepted: 01/24/2018] [Indexed: 12/17/2022]
Abstract
BACKGROUND Physical activity is inversely associated with the risk of breast cancer among women in the general population. It is not clear whether or not physical activity is associated with the risk of BRCA-associated breast cancer. METHODS We conducted a case-control study of 443 matched pairs of BRCA mutation carriers to evaluate the association between physical activity and breast cancer risk. Moderate and vigorous physical activities at ages 12-13, ages 14-17, ages 18-22, ages 23-29 and ages 30-34 were determined using the Nurses' Health Study II Physical Activity Questionnaire. We estimated mean metabolic equivalent task hours/week for moderate, vigorous and total physical activities overall (ages 12-34), during adolescence (ages 12-17) and during early adulthood (ages 18-34). Logistic regression analysis was used to estimate the odds ratios (OR) and 95% confidence intervals (CI) for total, moderate and strenuous recreational physical activities and breast cancer risk, by menopausal status. RESULTS Overall, there was no significant association between total physical activity and subsequent breast cancer risk (ORQ4 vs. Q1 = 1.01, 95% CI 0.69-1.47; P-trend = 0.72). Moderate physical activity between ages 12-17 was associated with a 38% decreased risk of premenopausal breast cancer (ORQ4 vs. Q1 = 0.62; 95% CI 0.40-0.96; P-trend = 0.01). We found no association between exercise and breast cancer diagnosed after menopause. CONCLUSIONS These findings suggest that early-life physical activity is associated with a reduced risk of premenopausal breast cancer among BRCA mutation carriers. IMPACT Future prospective analyses, complemented by mechanistic evidence, are warranted in this high-risk population.
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14
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Park B, Hopper JL, Win AK, Dowty JG, Sung HK, Ahn C, Kim SW, Lee MH, Lee J, Lee JW, Kang E, Yu JH, Kim KS, Moon BI, Han W, Noh DY, Park SK. Reproductive factors as risk modifiers of breast cancer in BRCA mutation carriers and high-risk non-carriers. Oncotarget 2017; 8:102110-102118. [PMID: 29254229 PMCID: PMC5731939 DOI: 10.18632/oncotarget.22193] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2017] [Accepted: 09/21/2017] [Indexed: 11/25/2022] Open
Abstract
This study was conducted to identify the role of reproductive factors as environmental modifiers for breast cancer (BC) risk in clinic-based, East-Asian BRCA1 and BRCA2 mutation carriers and non-carriers with high-risk criteria of BRCA mutations (family history (FH) of BC, early-onset BC (aged ≤40 years)). A total of 581 women who were BRCA carriers (222 BRCA1 and 359 BRCA2), 1,083 non-carriers with FH, and 886 non-carriers with early-onset BC were enrolled and interviewed to examine the reproductive factors, from 2007 to 2014. The hazard ratio (HR) and its 95% confidence interval (CI) in the weighted Cox regression model were used to calculate the BC risk based on the reproductive factors. Earlier menarche increased BC risk by 3.49-fold in BRCA2 mutation carriers (95%CI=2.03-6.00) and 3.30-fold in non-carriers with FH (95%CI=1.73-6.34), but was insignificantly associated with BRCA1 carriers and non-carriers for early-onset BC (P-heterogeneity=0.047). Higher parity decreased BC risk in BRCA carriers and non-carriers with FH, especially in BRCA1 carriers (HR=0.27, 95% CI=0.09-0.83 for two parity; and HR=0.23, 95%CI=0.05-1.00 for ≥3 parity), but increased the early-onset BC risk (HR=4.63, 95%CI=2.56-8.51 for >3 parity, p-heterogeneity=0.045). Oral contraceptive (OC) use and longer estrogen exposure periods (≥30 years) were associated with an increased risk of early-onset BC (HR=3.99, 95%CI=1.65-9.67; HR=7.69, 95%CI=1.96-25.01), while OC use was not associated with BC risk in other groups and longer estrogen exposure had rather decreased risk for BC risk (both p-heterogeneity<0.001). Several reproductive factors as risk modifiers could heterogeneously be associated with BC among BRCA1/2 mutation carriers, non-carriers with FH, and early-onset BC non-carriers.
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Affiliation(s)
- Boyoung Park
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Gyeonggi-Do, Korea.,National Cancer Control Institute, National Cancer Center, Gyeonggi-Do, Korea
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Aung K Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - James G Dowty
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Ho Kyung Sung
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea
| | - Choonghyun Ahn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
| | - Sung-Won Kim
- Department of Surgery, Daerim-Sungmo Hospital, Seoul, Korea
| | - Min Hyuk Lee
- Department of Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Jihyoun Lee
- Department of Surgery, College of Medicine, Soonchunhyang University, Seoul, Korea
| | - Jong Won Lee
- Department of Surgery, College of Medicine, University of Ulsan and Asan Medical Center, Seoul, Korea
| | - Eunyoung Kang
- Department of Surgery, Breast and Endocrine Service, Seoul National University Bundang Hospital, Gyeonggi-Do, Korea
| | - Jong-Han Yu
- Division of Breast and Endocrine Surgery, Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Ku Sang Kim
- Breast-Thyroid Center, Ulsan City Hospital, Ulsan City Hospital Group, Ulsan, Korea
| | - Byung-In Moon
- Department of Surgery, Ewha Womans University Hospital, Seoul, Korea
| | - Wonshik Han
- Department of Surgery, Seoul National University College of Medicine, Seoul, Korea
| | - Dong-Young Noh
- Department of Cancer Control and Population Health, National Cancer Center Graduate School of Cancer Science and Policy, Gyeonggi-Do, Korea.,Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Sue K Park
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea.,Cancer Research Institute, Seoul National University, Seoul, Korea.,Department of Biomedical Science, Seoul National University Graduate School, Seoul, Korea
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15
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Al-Mathkoori R, Nur U, Al-Taiar A. Is age of menarche among school girls related to academic performance? Int J Adolesc Med Health 2017. [PMID: 28628477 DOI: 10.1515/ijamh-2016-0164] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Background There is strong evidence that the mean age of menarche has declined over the last few decades in developed and developing countries. This is of a major concern because of its enormous public health implications. This study aimed to estimate the age of menarche in Kuwait and investigate the association between menarcheal age and academic performance among high school girls in Kuwait. Methods A cross-sectional study was conducted on randomly selected female high school students from private and public high schools in all governorates in Kuwait. Data on the age of menarche were collected by self-administered questionnaire from the students, while data on academic performance were extracted from the students' academic records. Results Of the 907 students we selected, 800 (88.2%) responded. The mean age of menarche was 12.33 [95% confidence interval (CI) 12.18-12.49] years. There was no evidence for significant association between age of menarche and students' academic performance before or after adjusting for potential confounders. Conclusion The calculated age of menarche among contemporary girls in Kuwait is similar to that of the girls in industrialized countries. Early menarcheal age is unlikely to lead to adverse behavior that may affect academic performance in our setting.
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Affiliation(s)
- Radhia Al-Mathkoori
- Department of Public Health, Communicable Diseases Control Unit, Ministry of Health, Kuwait city, Kuwait
| | - Ula Nur
- Department of Public Health, College of Health Sciences, Qatar University, Doha, Qatar
| | - Abdullah Al-Taiar
- Department Community Medicine and Behavioural Sciences, Faculty of Medicine,Kuwait University, Box: 24923 Safat, Kuwait city, 13110Kuwait, Phone: +965-99905804, Fax: +965-5338948
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16
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Exercise and Sports Medicine Issues in Underserved Populations. Prim Care 2017; 44:141-154. [PMID: 28164813 DOI: 10.1016/j.pop.2016.09.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
Primary care providers can make a strong argument for exercise promotion in underserved communities. The benefits are vitally important in adolescent physical, cognitive, and psychological development as well as in adult disease prevention and treatment. In counseling such patients, we should take into account a patient's readiness for change and the barriers to exercise.
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17
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Earlier age at menarche in girls with rapid early life growth: cohort and within sibling analyses. Ann Epidemiol 2017; 27:187-193.e2. [PMID: 28215584 DOI: 10.1016/j.annepidem.2017.01.004] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2016] [Revised: 12/22/2016] [Accepted: 01/09/2017] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of the article was to examine the association of early life growth with age at menarche. METHODS Using data from a prospective birth cohort (n = 1134 women, 290 sibling sets), we assessed the association between postnatal growth at 4 months, 1 year, and 4 years and age at menarche, using generalized estimating equations and generalized linear random effects models. RESULTS Overall, 18% of the cohort experienced early menarche (<12 years). After accounting for postnatal growth in length, faster postnatal change in weight (per 10-percentile increase) in all three periods was associated with an increase (range 9%-20%) in the likelihood of having an early menarche. In adjusted linear models, faster weight gains in infancy and childhood were associated with an average age at menarche that was 1.1-1.3 months earlier compared with stable growth. The overall results were consistent for percentile and conditional growth models. Girls who experienced rapid growth (defined as increasing across two major Centers for Disease Control and Prevention growth percentiles) in early infancy had an average age at menarche that was 4.6 months earlier than girls whose growth was stable. CONCLUSIONS Faster postnatal weight gains in infancy and early childhood before the age of 4 years are associated with earlier age at menarche.
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18
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Kotsopoulos J, Huzarski T, Gronwald J, Singer CF, Moller P, Lynch HT, Armel S, Karlan B, Foulkes WD, Neuhausen SL, Senter L, Tung N, Weitzel JN, Eisen A, Metcalfe K, Eng C, Pal T, Evans G, Sun P, Lubinski J, Narod SA. Bilateral Oophorectomy and Breast Cancer Risk in BRCA1 and BRCA2 Mutation Carriers. J Natl Cancer Inst 2017; 109:2905636. [PMID: 27601060 PMCID: PMC6284253 DOI: 10.1093/jnci/djw177] [Citation(s) in RCA: 120] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Revised: 03/23/2016] [Accepted: 06/17/2016] [Indexed: 12/28/2022] Open
Abstract
Background Whether oophorectomy reduces breast cancer risk among BRCA mutation carriers is a matter of debate. We undertook a prospective analysis of bilateral oophorectomy and breast cancer risk in BRCA mutation carriers. Methods Subjects had no history of cancer, had both breasts intact, and had information on oophorectomy status (n = 3722). Women were followed until breast cancer diagnosis, prophylactic bilateral mastectomy, or death. A Cox regression model was used to estimate the hazard ratios (HRs) and 95% confidence intervals (CIs) of breast cancer associated with oophorectomy (coded as a time-dependent variable). All statistical tests were two-sided. Results Over a mean follow-up of 5.6 years, 350 new breast cancers were diagnosed. Among women with a BRCA1 or BRCA2 mutation, oophorectomy was not associated with breast cancer risk compared with women who did not undergo an oophorectomy. The age-adjusted hazard ratio associated with oophorectomy was 0.96 (95% CI = 0.73 to 1.26, P = 76) for BRCA1 and was 0.65 (95% CI = 0.37 to 1.16, P = 14) for BRCA2 mutation carriers. In stratified analyses, the effect of oophorectomy was statistically significant for breast cancer in BRCA2 mutation carriers diagnosed prior to age 50 years (age-adjusted HR = 0.18, 95% CI = 0.05 to 0.63, P = 007). Oophorectomy was not associated with risk of breast cancer prior to age 50 years among BRCA1 mutation carriers (age-adjusted HR = 0.79, 95% CI = 0.55 to 1.13, P = 51). Conclusions Findings from this large prospective study support a role of oophorectomy for the prevention of premenopausal breast cancer in BRCA2, but not BRCA1 mutation carriers. These findings warrant further evaluation.
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Affiliation(s)
- Joanne Kotsopoulos
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Tomasz Huzarski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Jacek Gronwald
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Christian F Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Pal Moller
- Department for Medical Genetics, Inherited Cancer Research Group, and Department of Tumor Biology, Institute of Cancer Research, Norwegian Radium Hospital; Oslo University Hospital, Oslo, Norway
| | - Henry T Lynch
- Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE
| | - Susan Armel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, ON, Canada
| | - Beth Karlan
- Gynecology Oncology, Cedars Sinai Medical Center, Los Angeles, CA
| | - William D Foulkes
- Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montréal, QC, Canada
| | - Susan L Neuhausen
- Department of Population Sciences, Beckman Research Institute of City of Hope, Duarte, CA
| | - Leigha Senter
- Division of Human Genetics, The Ohio State University Medical Center, Comprehensive Cancer Center, Columbus, OH
| | - Nadine Tung
- Beth Israel Deaconess Medical Center, Boston, MA
| | | | - Andrea Eisen
- Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada
| | | | - Charis Eng
- Genomic Medicine Institute and Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH
| | - Tuya Pal
- Moffitt Cancer Center, Departments of Cancer Epidemiology, Biostatistics, Anatomic Pathology, and Experimental Therapeutics, Tampa, FL
| | - Gareth Evans
- Genomic Medicine, Manchester Academic Health Science Centre, University of Manchester, Manchester, UK (GE)
| | - Ping Sun
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
| | - Jan Lubinski
- International Hereditary Cancer Center, Department of Genetics and Pathology, Pomeranian Medical University, Szczecin, Poland
| | - Steven A Narod
- Women's College Research Institute, Women's College Hospital, Toronto, ON, Canada
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Okuma HS, Yonemori K. BRCA Gene Mutations and Poly(ADP-Ribose) Polymerase Inhibitors in Triple-Negative Breast Cancer. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 1026:271-286. [DOI: 10.1007/978-981-10-6020-5_13] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
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20
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Milne RL, Antoniou AC. Modifiers of breast and ovarian cancer risks for BRCA1 and BRCA2 mutation carriers. Endocr Relat Cancer 2016; 23:T69-84. [PMID: 27528622 DOI: 10.1530/erc-16-0277] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Accepted: 08/15/2016] [Indexed: 12/20/2022]
Abstract
Pathogenic mutations in BRCA1 and BRCA2 are associated with high risks of breast and ovarian cancer. However, penetrance estimates for mutation carriers have been found to vary substantially between studies, and the observed differences in risk are consistent with the hypothesis that genetic and environmental factors modify cancer risks for women with these mutations. Direct evidence that this is the case has emerged in the past decade, through large-scale international collaborative efforts. Here, we describe the methodological challenges in the identification and characterisation of these risk-modifying factors, review the latest evidence on genetic and lifestyle/hormonal risk factors that modify breast and ovarian cancer risks for women with BRCA1 and BRCA2 mutations and outline the implications of these findings for cancer risk prediction. We also review the unresolved issues in this area of research and identify strategies of clinical implementation so that women with BRCA1 and BRCA2 mutations are no longer counselled on the basis of 'average' risk estimates.
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Affiliation(s)
- Roger L Milne
- Cancer Epidemiology CentreCancer Council Victoria, Melbourne, Australia Centre for Epidemiology and BiostatisticsMelbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Antonis C Antoniou
- Centre for Cancer Genetic EpidemiologyDepartment of Public Health and Primary Care, University of Cambridge, Cambridge, UK
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21
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Yoo JH. Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women. KOREAN JOURNAL OF PEDIATRICS 2016; 59:355-361. [PMID: 27721839 PMCID: PMC5052133 DOI: 10.3345/kjp.2016.59.9.355] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/29/2015] [Revised: 12/14/2015] [Accepted: 12/29/2015] [Indexed: 12/13/2022]
Abstract
The menarcheal age of Korean women has been rapidly decreasing for the last 50 years, and the average menarcheal age of women born in the 1990s is approaching 12.6 years. In addition, interest in early puberty has been increasing recently owing to the rapid increase in precocious puberty. Generally, out of concern for short stature and early menarche, idiopathic central precocious puberty in female adolescents is treated with gonadotropin-releasing hormone analogs. Studies to date have described the association between early menarche and psychosocial problems such as delinquency and risky sexual behavior, as well as physical health problems such as obesity, diabetes, cardiovascular diseases, and breast cancer throughout the lifespan of women. However, the pathophysiological mechanism underlying this association has not been clarified thus far. In this article, we review and discuss the existing literature to describe the current understanding of the effects of early menarche on the physical and psychosocial health of adolescent girls and adult women.
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Affiliation(s)
- Jae-Ho Yoo
- Department of Pediatrics, Dong-A University College of Medicine, Busan, Korea
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22
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Aziz MH, Chen X, Zhang Q, DeFrain C, Osland J, Luo Y, Shi X, Yuan R. Suppressing NRIP1 inhibits growth of breast cancer cells in vitro and in vivo. Oncotarget 2016; 6:39714-24. [PMID: 26492163 PMCID: PMC4741857 DOI: 10.18632/oncotarget.5356] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 10/03/2015] [Indexed: 11/25/2022] Open
Abstract
Earlier age at menarche is a major risk factor for breast cancer. Our previous study identified Nrip1 (also known as Rip140) as a candidate gene for delaying female sexual maturation (FSM) and found that knocking out Nrip1 could significantly delay FSM in mice. To investigate the effects of NRIP1 in breast cancer we used human cell lines and tissue arrays along with an in vivo study of DMBA-induced carcinogenesis in Nrip1 knockout mice. Analysis of tissue arrays found that NRIP1 is elevated in tumors compared to cancer adjacent normal tissue. Interestingly, in benign tumors NRIP1 levels are higher in the cytosol of stromal cells, but NRIP1 levels are higher in the nuclei of epithelial cells in malignancies. We also found overexpression of NRIP1 in breast cancer cell lines, and that suppression of NRIP1 by siRNA in these cells significantly induced apoptosis and inhibited cell growth. Furthermore, in vivo data suggests that NRIP1 is upregulated in DMBA-induced breast cancer. Importantly, we found that DMBA-induced carcinogenesis is suppressed in Nrip1 knockdown mice. These findings suggest that NRIP1 plays a critical role in promoting the progression and development of breast cancer and that it may be a potential therapeutic target for the new breast cancer treatments.
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Affiliation(s)
- Moammir H Aziz
- Division of Geriatrics, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA
| | - Xundi Chen
- Department of Medical Microbiology and Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA
| | - Qi Zhang
- Zhongda Hospital, Southeast University of China, Nanjing 210009, China
| | - Chad DeFrain
- Department of Pathology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA
| | - Jared Osland
- Division of Geriatrics, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA
| | - Yizhou Luo
- Department of Oncology, Nanjing Junxie Hospital, Nanjing 210002, China
| | - Xin Shi
- Zhongda Hospital, Southeast University of China, Nanjing 210009, China
| | - Rong Yuan
- Division of Geriatrics, Department of Internal Medicine, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA.,Department of Medical Microbiology and Immunology and Cell Biology, Southern Illinois University School of Medicine, Springfield, Illinois 62794-9628, USA
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Laamiri FZ, Hasswane N, Kerbach A, Aguenaou H, Taboz Y, Benkirane H, Mrabet M, Amina B. Risk factors associated with a breast cancer in a population of Moroccan women whose age is less than 40 years: a case control study. Pan Afr Med J 2016; 24:19. [PMID: 27583083 PMCID: PMC4992386 DOI: 10.11604/pamj.2016.24.19.8784] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Accepted: 03/17/2016] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Breast cancer is the most common cancer in morocco women were it occupies the first place in term of incidence and mortality. The aim of the present paper is to evaluate the risk factors associated with a breast cancer in a population of Moroccan women. METHODS A case-control study was conducted with population women whose age is less than 40 years during 2008-2010 at the National Institute of Oncology of Rabat. These women were interviewed for Epidemiological information and risk factor for breast cancer. RESULTS Included in this study were 124 cases and 148 age matched controls. No statistically significant case-control difference was found for the early age of menarche (OR = 2.474; CI 95%: 1.354- 4.521), and family antecedents of first degree of breast cancer (OR = 11.556; 95% CI: 2.548-52.411). However physical activity (OR = 0.507; 95% CI: 0.339 -0.757) early maternity age (OR = 0.212; 95% CI: 0.087 - 0.514), multiparity (OR = 0.742; 95% CI: 0.359 -1.539) and breastfeeding than 6 months (OR = 0.739; 95% CI: 0.357 -1.523) appear as significant protective factors. CONCLUSION This study show the criminalization of only part of the known risk factors of breast cancer in this age group and confirms the probable protective role of physical activity and factors related to life reproductive women in our study (early childbearing, multiparity and lactation).
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Affiliation(s)
- Fatima Zahra Laamiri
- Faculty of Medicine and Pharmacy/Research Team in Maternal and Child Health and Nutrition, Mohammed V University, Rabat, Morocco
| | - Nadia Hasswane
- Faculty of Medicine and Pharmacy/Research Team in Maternal and Child Health and Nutrition, Mohammed V University, Rabat, Morocco
| | - Aicha Kerbach
- Faculty of Medicine and Pharmacy/Research Team in Maternal and Child Health and Nutrition, Mohammed V University, Rabat, Morocco
| | - Hassan Aguenaou
- Mixed Research Unit in Nutrition and Food URAC 39, (University Ibn Tufail-CNESTEN) Designated Regional Center of Nutrition Associate AFRA/IAEA, Kenitra, Morocco
| | - Youness Taboz
- Mixed Research Unit in Nutrition and Food URAC 39, (University Ibn Tufail-CNESTEN) Designated Regional Center of Nutrition Associate AFRA/IAEA, Kenitra, Morocco
| | - Hassna Benkirane
- Mixed Research Unit in Nutrition and Food URAC 39, (University Ibn Tufail-CNESTEN) Designated Regional Center of Nutrition Associate AFRA/IAEA, Kenitra, Morocco
| | - Mustapha Mrabet
- Laboratory of Hygiene and Community Medicine, Military Hospital of instruction Mohamed V in Rabat, Rabat, Morocco
| | - Barkat Amina
- Faculty of Medicine and Pharmacy/Research Team in Maternal and Child Health and Nutrition, Mohammed V University, Rabat, Morocco
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Nonneman DJ, Schneider JF, Lents CA, Wiedmann RT, Vallet JL, Rohrer GA. Genome-wide association and identification of candidate genes for age at puberty in swine. BMC Genet 2016; 17:50. [PMID: 26923368 PMCID: PMC4770536 DOI: 10.1186/s12863-016-0352-y] [Citation(s) in RCA: 32] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2015] [Accepted: 02/12/2016] [Indexed: 12/29/2022] Open
Abstract
Background Reproductive efficiency has a great impact on the economic success of pork production. Gilts comprise a significant portion of breeding females and gilts that reach puberty earlier tend to stay in the herd longer and be more productive. About 10 to 30 % of gilts never farrow a litter and the most common reasons for removal are anestrus and failure to conceive. Puberty in pigs is usually defined as the female’s first estrus in the presence of boar stimulation. Genetic markers associated with age at puberty will allow for selection on age at puberty and traits correlated with sow lifetime productivity. Results Gilts (n = 759) with estrus detection measurements ranging from 140–240 days were genotyped using the Illumina PorcineSNP60 BeadChip and SNP were tested for significant effects with a Bayesian approach using GenSel software. Of the available 8111 five-marker windows, 27 were found to be statistically significant with a comparison-wise error of P < 0.01. Ten QTL were highly significant at P < 0.005 level. Two QTL, one on SSC12 at 15 Mb and the other on SSC7 at 75 Mb, explained 16.87 % of the total genetic variance. The most compelling candidate genes in these two regions included the growth hormone gene (GH1) on SSC12 and PRKD1 on SSC7. Several loci confirmed associations previously identified for age at puberty in the pig and loci for age at menarche in humans. Conclusions Several of the loci identified in this study have a physiological role for the onset of puberty and a genetic basis for sexual maturation in humans. Understanding the genes involved in regulation of the onset of puberty would allow for the improvement of reproductive efficiency in swine. Because age at puberty is a predictive factor for sow longevity and lifetime productivity, but not routinely measured or selected for in commercial herds, it would be beneficial to be able to use genomic or marker-assisted selection to improve these traits. Electronic supplementary material The online version of this article (doi:10.1186/s12863-016-0352-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Dan J Nonneman
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
| | - James F Schneider
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
| | - Clay A Lents
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
| | - Ralph T Wiedmann
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
| | - Jeffrey L Vallet
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
| | - Gary A Rohrer
- United States Department of Agriculture, Agricultural Research Service, U.S. Meat Animal Research Center, Clay Center, NE, 68933, USA.
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Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: a case–control study. Breast Cancer Res Treat 2016; 155:365-73. [DOI: 10.1007/s10549-016-3685-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2016] [Accepted: 01/07/2016] [Indexed: 01/08/2023]
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26
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Riahi A, Gourabi ME, Chabouni-Bouhamed H. Dissimilarity between sporadic, non-BRCA1/2 families and hereditary breast cancer, linked to BRCA genes, in the Tunisian population. Breast Cancer 2015; 23:807-12. [PMID: 26476744 DOI: 10.1007/s12282-015-0648-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2015] [Accepted: 09/29/2015] [Indexed: 12/20/2022]
Abstract
BACKGROUND Most breast cancers (90 %) are sporadic. Only 5-10 % of all cancer cases can be attributed to genetic defects. BRCA genes are strongly incriminated in the hereditary predisposition to the disease. The purpose of our study was to provide more efficient approach to identify pathogenic BRCA mutation carriers and to determine subgroups within the non-BRCA tumor class. METHODS Different clinicopathological features, reproductive factors, as well as psychosocial ones were compared in women carrying mutations in the BRCA1/BRCA2 genes (12 cases) with non-BRCA1/2 family tumors (36 cases) and age-matched sporadic cases, unselected for family history (44 cases). RESULTS A BRCA-related class was yielded based on age at diagnosis (age ≤ 35 years; p = 0.1), molecular subtypes(the triple-negative subtype was predominant: 43 % of cases; p = 0.025) and age at menarche (p = 0.04). Furthermore, a "probably sporadic" class was distinguished using hormonal contraceptive use (through 30-40 years of age; p = 0.039), the number of full-term pregnancies (age ≥40 years; p = 0.01), age at menopause(age > 50 years; p = 0.04) and psychosocial factors (age ≥ 40 years; p = 0.01). However, analysis of non-BRCA1/2 family tumors indicated that they constitute a heterogeneous class, showing few perceptible differences with sporadic group, but distinct from BRCA1/2 tumors. CONCLUSIONS In Tunisian population, breast cancer can be classified with a high level of accuracy as sporadic or related to BRCA germline mutations by combining different clinicopathological features and reproductive factors. This can be clinically useful in genetic counseling and decision making for BRCA genetic test.
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Affiliation(s)
- Aouatef Riahi
- Laboratoire Génétique Humaine, Faculté de Médecine de Tunis, University Tunis El manar, 3, rue ALI DOUAGI, Tunis, Bardo, 2000, Tunisia.
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Semple J, Metcalfe KA, Lubinski J, Huzarski T, Gronwald J, Armel S, Lynch HT, Karlan B, Foulkes W, Singer CF, Neuhausen SL, Eng C, Iqbal J, Narod SA. Does the age of breast cancer diagnosis in first-degree relatives impact on the risk of breast cancer in BRCA1 and BRCA2 mutation carriers? Breast Cancer Res Treat 2015; 154:163-9. [DOI: 10.1007/s10549-015-3596-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Accepted: 10/05/2015] [Indexed: 12/28/2022]
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28
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Cybulski C, Lubinski J, Huzarski T, Lynch HT, Randall SA, Neuhausen SL, Senter L, Friedman S, Ainsworth P, Singer C, Foulkes WD, Narod SA, Sun P, Kotsopoulos J. Prospective evaluation of alcohol consumption and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res Treat 2015; 151:435-41. [PMID: 25935583 DOI: 10.1007/s10549-015-3393-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2015] [Accepted: 04/16/2015] [Indexed: 11/27/2022]
Abstract
Given the adverse effect of alcohol in the development of breast cancer among women in the general population, we evaluated whether a similar association exists among women with a BRCA1 or BRCA2 mutation. Information regarding baseline daily alcohol consumption was abstracted from a research questionnaire for 3067 BRCA mutation carriers enrolled in a prospective cohort study. Women were followed biennially until the date of the last follow-up questionnaire, date of breast cancer diagnosis, date of prophylactic bilateral mastectomy, or date of death. Cox proportional hazards models were used to estimate relative risks (RRs) and 95 % confidence intervals (CIs) for invasive breast cancer associated with alcohol consumed at or prior to completion of the baseline questionnaire. After a mean of 5.4 years of follow-up, we observed 259 incident cases of primary invasive breast cancer. Compared with non-users, the adjusted RRs were 1.06 (95 % CI 0.78-1.44) for ever use and 1.08 (0.79-1.47) for current alcohol use. For women in the highest versus lowest quintile of cumulative alcohol consumption, the RR was 0.94 (95 % CI 0.63-1.40; P trend = 0.65). Our findings suggest that alcohol consumption is not a risk factor for breast cancer among women with a BRCA1 or BRCA2 mutation.
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Affiliation(s)
- Cezary Cybulski
- Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
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Lecarpentier J, Noguès C, Mouret-Fourme E, Buecher B, Gauthier-Villars M, Stoppa-Lyonnet D, Bonadona V, Fricker JP, Berthet P, Caron O, Coupier I, Pujol P, Faivre L, Gesta P, Eisinger F, Mari V, Gladieff L, Lortholary A, Luporsi E, Leroux D, Venat-Bouvet L, Maugard CM, Colas C, Tinat J, Lasset C, Andrieu N. Breast Cancer Risk Associated with Estrogen Exposure and Truncating Mutation Location in BRCA1/2 Carriers. Cancer Epidemiol Biomarkers Prev 2015; 24:698-707. [PMID: 25613119 DOI: 10.1158/1055-9965.epi-14-0884] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/30/2014] [Accepted: 01/06/2015] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Mutations in BRCA1/2 confer a high risk of breast cancer, but literature values of this risk vary. A genotype-phenotype correlation has been found in both genes, and the effect of reproductive factors differs according to mutation location. Therefore, we hypothesize that such a variation may exist for other factors related to estrogen exposure. METHODS We used a weighted Cox regression model to assess variation in breast cancer risk with these factors using location of mutation in homogeneous breast cancer risk region of BRCA1/2 in the GENEPSO study. RESULTS We found that late age at menarche reduced breast cancer risk by 31% and that among BRCA1 carriers, a long or a short menstrual cycle increased risk (by 65% and 73%, respectively). Among premenopausal women, overweight was associated with a 45% decrease in risk whereas underweight was associated with an increased risk (HR, 2.40). A natural menopause, mainly after age 50, was associated with a high breast cancer risk (HR, 2.46), and a significant interaction between menopause status and the location of mutations was found leading up to 10% variation in absolute risk according to the age at menopause. CONCLUSIONS As observed in the general population, a late menarche, a long or a short menstrual cycle, over- or underweight, and being postmenopausal were associated with breast cancer risk in BRCA1/2 carriers. The association with the menopause was observed only when the mutation was located in the "high-risk" zones. IMPACT Taking into account modifier factors, location of mutation might be important for the clinical management of BRCA1/2 mutation carriers.
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Affiliation(s)
- Julie Lecarpentier
- Institut Curie, Paris, France. INSERM, U900, Paris, France. Mines ParisTech, Fontainebleau, France
| | | | | | - Bruno Buecher
- Institut Curie, Service de Génétique Oncologique, Paris, France
| | | | - Dominique Stoppa-Lyonnet
- Institut Curie, Service de Génétique Oncologique, Paris, France. Inserm, U830, Paris, France. Université Paris-Descartes, Paris, France
| | - Valérie Bonadona
- Université Claude Bernard Lyon 1, Villeurbanne, France. CNRS UMR 5558, Lyon, France. Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France
| | | | - Pascaline Berthet
- Centre François Baclesse, Unité de pathologie gynécologique, Caen, France
| | - Olivier Caron
- Institut de Cancérologie Gustave Roussy, Service d'Oncologie Génétique, Villejuif, France
| | - Isabelle Coupier
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique médicale et Oncogénétique, Montpellier, France. INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | - Pascal Pujol
- Hôpital Arnaud de Villeneuve, CHU Montpellier, Service de Génétique médicale et Oncogénétique, Montpellier, France. INSERM 896, CRCM Val d'Aurelle, Montpellier, France
| | - Laurence Faivre
- Centre Georges François Leclerc, Oncogénétique, Dijon, France. Hôpital d'enfants, Service de Génétique Médicale, Dijon, France
| | - Paul Gesta
- CH Georges Renon, Pôle Oncologie pour la consultation oncogénétique régionale Poitou-Charentes, Niort, France
| | - François Eisinger
- IPC, Département d'Anticipation et de Suivi des Cancers, Marseille, France. INSERM, UMR 912, Marseille, France
| | - Véronique Mari
- Centre Antoine Lacassagne, Unité d'Oncogénétique, Nice, France
| | - Laurence Gladieff
- Institut Claudius Regaud-IUCT-Oncopole, Service d'Oncologie Médicale, Toulouse, France
| | - Alain Lortholary
- Centre Catherine de Sienne, Service d'Oncologie Médicale, Nantes, France
| | - Elisabeth Luporsi
- ICL Alexis Vautrin, Unité d'Oncogénétique, Vandœuvre-lès-Nancy, France
| | - Dominique Leroux
- Hôpital Couple-Enfant, Département de Génétique, Grenoble, France
| | | | - Christine M Maugard
- Nouvel Hôpital Civil, Laboratoire de Diagnostic Génétique, Strasbourg, France
| | - Chrystelle Colas
- Groupe Hospitalier Pitié-Salpêtrière, Département de Génétique, APHP, Paris, France
| | - Julie Tinat
- Hôpital Universitaire de Rouen, Département de Génétique, Rouen, France
| | - Christine Lasset
- Université Claude Bernard Lyon 1, Villeurbanne, France. CNRS UMR 5558, Lyon, France. Centre Léon Bérard, Unité de Prévention et Epidémiologie Génétique, Lyon, France
| | - Nadine Andrieu
- Institut Curie, Paris, France. INSERM, U900, Paris, France. Mines ParisTech, Fontainebleau, France.
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Prosperi MCF, Ingham SL, Howell A, Lalloo F, Buchan IE, Evans DG. Can multiple SNP testing in BRCA2 and BRCA1 female carriers be used to improve risk prediction models in conjunction with clinical assessment? BMC Med Inform Decis Mak 2014; 14:87. [PMID: 25274085 PMCID: PMC4197237 DOI: 10.1186/1472-6947-14-87] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2014] [Accepted: 09/25/2014] [Indexed: 11/28/2022] Open
Abstract
BACKGROUND Several single nucleotide polymorphisms (SNPs) at different loci have been associated with breast cancer susceptibility, accounting for around 10% of the familial component. Recent studies have found direct associations between specific SNPs and breast cancer in BRCA1/2 mutation carriers. Our aim was to determine whether validated susceptibility SNP scores improve the predictive ability of risk models in comparison/conjunction to other clinical/demographic information. METHODS Female BRCA1/2 carriers were identified from the Manchester genetic database, and included in the study regardless of breast cancer status or age. DNA was extracted from blood samples provided by these women and used for gene and SNP profiling. Estimates of survival were examined with Kaplan-Meier curves. Multivariable Cox proportional hazards models were fit in the separate BRCA datasets and in menopausal stages screening different combinations of clinical/demographic/genetic variables. Nonlinear random survival forests were also fit to identify relevant interactions. Models were compared using Harrell's concordance index (1 - c-index). RESULTS 548 female BRCA1 mutation carriers and 523 BRCA2 carriers were identified from the database. Median Kaplan-Meier estimate of survival was 46.0 years (44.9-48.1) for BRCA1 carriers and 48.9 (47.3-50.4) for BRCA2. By fitting Cox models and random survival forests, including both a genetic SNP score and clinical/demographic variables, average 1 - c-index values were 0.221 (st.dev. 0.019) for BRCA1 carriers and 0.215 (st.dev. 0.018) for BRCA2 carriers. CONCLUSIONS Random survival forests did not yield higher performance compared to Cox proportional hazards. We found improvement in prediction performance when coupling the genetic SNP score with clinical/demographic markers, which warrants further investigation.
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Affiliation(s)
- Mattia CF Prosperi
- />Institute of Population Health, Centre for Health Informatics, University of Manchester, Manchester, UK
| | - Sarah L Ingham
- />Institute of Population Health, Centre for Health Informatics, University of Manchester, Manchester, UK
| | - Anthony Howell
- />Genesis Prevention Centre, University Hospital of South Manchester, Manchester, UK
| | - Fiona Lalloo
- />Department of Genetic Medicine, Manchester Academic Health Science Centre, St. Mary’s Hospital, University of Manchester, Manchester, UK
| | - Iain E Buchan
- />Institute of Population Health, Centre for Health Informatics, University of Manchester, Manchester, UK
| | - Dafydd Gareth Evans
- />Genesis Prevention Centre, University Hospital of South Manchester, Manchester, UK
- />Department of Genetic Medicine, Manchester Academic Health Science Centre, St. Mary’s Hospital, University of Manchester, Manchester, UK
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BRCA1 mRNA levels following a 4-6-week intervention with oral 3,3'-diindolylmethane. Br J Cancer 2014; 111:1269-74. [PMID: 25025957 PMCID: PMC4183839 DOI: 10.1038/bjc.2014.391] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2014] [Revised: 05/26/2014] [Accepted: 06/18/2014] [Indexed: 12/19/2022] Open
Abstract
Background: Haploinsufficiency may contribute to the development of breast cancer among women with a BRCA1 mutation. Thus, interventions that enhance BRCA1 expression may represent avenues for prevention. Studies have shown that 3,3′-diindolylmethane (DIM) can upregulate BRCA1 expression in breast cancer cells. This has yet to be demonstrated in vivo. Methods: We conducted a study to evaluate the ability of oral DIM to upregulate BRCA1 mRNA expression in white blood cells. A total of 18 women were enroled in the study, including 13 BRCA1 mutation carriers who received 300 mg per day of Rx Balance BioResponse DIM for 4–6 weeks (intervention group) and 5 BRCA1 mutation carriers who did not take DIM (control group). BRCA1 mRNA expression was assessed at baseline and at 4–6 weeks by real-time, quantitative PCR and the relative change in BRCA1 mRNA expression (that is, 2−ΔΔCT) was calculated. Results: The relative change in BRCA1 mRNA expression among women in the intervention group achieved borderline significance (P paired t-test=0.05). In the intervention group, BRCA1 mRNA expression increased in 10 of the participants, decreased in 2 and remained unchanged in 1 of the participants following DIM intervention (P sign test=0.02). On average, women in the intervention group experienced a 34% increase in BRCA1 mRNA expression (range −24 to 194%). There was no significant difference in the relative change in BRCA1 mRNA expression among women in the control group (P paired t-test=0.45). Conclusions: Under the tested conditions, oral DIM was associated with an increase in BRCA1 mRNA expression in women with a BRCA1 mutation. The possibility of mitigating the effect of an inherited deleterious BRCA1 mutation by increasing the physiologic expression of the gene and normalising protein levels represents a clinically important paradigm shift in the prevention strategies available to these high-risk women. Future studies with a larger sample size and higher doses of DIM are warranted.
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Friebel TM, Domchek SM, Rebbeck TR. Modifiers of cancer risk in BRCA1 and BRCA2 mutation carriers: systematic review and meta-analysis. J Natl Cancer Inst 2014; 106:dju091. [PMID: 24824314 DOI: 10.1093/jnci/dju091] [Citation(s) in RCA: 151] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND There is substantial variability in cancer risk in women who have inherited a BRCA1 or BRCA2 (BRCA1/2) mutation. Numerous factors have been hypothesized to modify these risks, but studies are of variable quality, and it remains unclear which of these may be of value in clinical risk assessment. METHODS PubMed and Web of Science databases were searched for articles published through September 2013. Fixed effects meta-analysis was done using the hazard ratios and/or odds ratios to estimate the pooled effect estimates (ES) and 95% confidence intervals (CIs) to identify factors that are associated with cancer risk modification in BRCA1/2 mutation carriers. RESULTS We identified 44 nonoverlapping studies that met predefined quality criteria. Sufficient evidence is available to make clinically relevant inferences about a number of cancer risk modifiers. The only variable examined that produced a probable association was late age at first live birth, a meta-analysis showed a decrease in the risk of breast cancer in BRCA1 mutation carriers with women aged 30 years or older vs. women younger than 30 years (ES = 0.65; 95% CI =0.42 to 0.99). The same was shown for women aged 25 to 29 years versus those aged less than 25 years (ES = 0.69; 95% CI = 0.48 to 0.99). Breastfeeding and tubal ligation were associated with reduced ovarian cancer risk in BRCA1 mutation carriers; oral contraceptives were associated with reduced risk among BRCA1/2 mutation carriers. Smoking was associated with increased breast cancer risk in BRCA2 mutation carriers only. CONCLUSIONS Data assessing many potential risk modifiers are inadequate, and many have not been externally validated. Although additional studies are required to confirm some associations, sufficient information is available for some risk factors to be used in risk counseling or lifestyle modification to minimize cancer risk in BRCA1/2 mutation carriers
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Narod SA, Tung N, Lubinski J, Huzarski T, Robson M, Lynch HT, Neuhausen SL, Ghadirian P, Kim-Sing C, Sun P, Foulkes WD. A prior diagnosis of breast cancer is a risk factor for breast cancer in BRCA1 and BRCA2 carriers. ACTA ACUST UNITED AC 2014; 21:64-8. [PMID: 24764694 DOI: 10.3747/co.21.1656] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND The risk of breast cancer in carriers of BRCA1 and BRCA2 mutations is influenced by factors other than the genetic mutation itself. Modifying factors include a woman's reproductive history and family history of cancer. Risk factors are more likely to be present in women with breast cancer than in women without breast cancer, and therefore the risk of cancer in the two breasts should not be independent. It is not clear to what extent modifying factors influence the risk of a first primary or a contralateral breast cancer in BRCA carriers. METHODS We conducted a matched case-control study of breast cancer among 3920 BRCA1 or BRCA2 mutation carriers. We asked whether a past history of breast cancer in the contralateral breast was a risk factor for breast cancer. RESULTS After adjustment for age, country of residence, and cancer treatment, a previous cancer of the right breast was found to be a significant risk factor for cancer of the left breast among BRCA1 or BRCA2 carriers (relative risk: 2.1; 95% confidence interval: 1.4 to 3.0; p < 0.0001). CONCLUSIONS In a woman with a BRCA1 or BRCA2 mutation who is diagnosed with breast cancer, the risk of cancer in the contralateral breast depends on the first diagnosis. That observation supports the hypothesis that there are important genetic or non-genetic modifiers of cancer risk in BRCA carriers. Discovering risk modifiers might lead to greater personalization of risk assessment and management recommendations for BRCA-positive patients.
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Affiliation(s)
- S A Narod
- Women's College Research Institute, University of Toronto, Toronto, ON
| | - N Tung
- Beth Israel Deaconness Hospital, Boston, MA, U.S.A
| | - J Lubinski
- Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - T Huzarski
- Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - M Robson
- Clinical Genetics Service, Memorial Sloan-Kettering Cancer Center, New York City, NY, U.S.A
| | - H T Lynch
- Department of Preventive Medicine, Creighton University, Omaha, NE, U.S.A
| | - S L Neuhausen
- Beckman Research Institute of the City of Hope, Duarte, CA, U.S.A
| | - P Ghadirian
- Epidemiology Research Unit, CHUM-Hôtel-Dieu, Montreal, QC
| | | | - P Sun
- Women's College Research Institute, University of Toronto, Toronto, ON
| | - W D Foulkes
- Departments of Medical Genetics and Oncology, McGill University, Montreal, QC
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Kotsopoulos J, Lubinski J, Moller P, Lynch HT, Singer CF, Eng C, Neuhausen SL, Karlan B, Kim-Sing C, Huzarski T, Gronwald J, McCuaig J, Senter L, Tung N, Ghadirian P, Eisen A, Gilchrist D, Blum JL, Zakalik D, Pal T, Sun P, Narod SA. Timing of oral contraceptive use and the risk of breast cancer in BRCA1 mutation carriers. Breast Cancer Res Treat 2014; 143:579-86. [PMID: 24458845 DOI: 10.1007/s10549-013-2823-4] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2013] [Accepted: 12/21/2013] [Indexed: 01/12/2023]
Abstract
It is not clear if early oral contraceptive use increases the risk of breast cancer among young women with a breast cancer susceptibility gene 1 (BRCA1) mutation. Given the benefit of oral contraceptives for the prevention of ovarian cancer, estimating age-specific risk ratios for oral contraceptive use and breast cancer is important. We conducted a case-control study of 2,492 matched pairs of women with a deleterious BRCA1 mutation. Breast cancer cases and unaffected controls were matched on year of birth and country of residence. Detailed information about oral contraceptive use was collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate the odds ratios (OR) and 95 % confidence intervals (CI) for the association between oral contraceptive and breast cancer, by age at first use and by age at diagnosis. Among BRCA1 mutation carriers, oral contraceptive use was significantly associated with an increased risk of breast cancer for women who started the pill prior to age 20 (OR 1.45; 95 % CI 1.20-1.75; P = 0.0001) and possibly between ages 20 and 25 as well (OR 1.19; 95 % CI 0.99-1.42; P = 0.06). The effect was limited to breast cancers diagnosed before age 40 (OR 1.40; 95 % CI 1.14-1.70; P = 0.001); the risk of early-onset breast cancer increased by 11 % with each additional year of pill use when initiated prior to age 20 (OR 1.11; 95 % CI 1.03-1.20; P = 0.008). There was no observed increase for women diagnosed at or after the age of 40 (OR 0.97; 95 % CI 0.79-1.20; P = 0.81). Oral contraceptive use before age 25 increases the risk of early-onset breast cancer among women with a BRCA1 mutation and the risk increases with duration of use. Caution should be taken when advising women with a BRCA1 mutation to take an oral contraceptive prior to age 25.
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Affiliation(s)
- Joanne Kotsopoulos
- Familial Breast Cancer Unit, Women's College Research Institute, 790 Bay Street, Room 750, Toronto, ON, M5G 1N8, Canada
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Pan H, He Z, Ling L, Ding Q, Chen L, Zha X, Zhou W, Liu X, Wang S. Reproductive factors and breast cancer risk among BRCA1 or BRCA2 mutation carriers: results from ten studies. Cancer Epidemiol 2013; 38:1-8. [PMID: 24332935 DOI: 10.1016/j.canep.2013.11.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2013] [Revised: 10/31/2013] [Accepted: 11/03/2013] [Indexed: 01/06/2023]
Abstract
Although reproductive factors are among the most well-established risk factors for breast cancer in the general population, it is still a matter for debate whether these factors act as risk modifiers among BRCA1 or BRCA2 mutation carriers. This meta-analysis is the first to be performed to determine the relationship between reproductive factors and breast cancer risk among BRCA1 and BRCA2 mutation carriers. We searched the PubMed database up to February 2013. A total of ten studies met the inclusion criteria. The results showed that the reproductive factors may be associated with breast cancer risk only among BRCA1 mutation carriers. No association was found between parity and breast cancer risk. Compared with women at the youngest age in the first-birth category, women in the oldest age category were at a 38% lower risk of breast cancer (RR=0.62, 95%CI=0.45-0.85). Breastfeeding for at least 1 or 2 years was associated with a 37% reduction in breast cancer risk (RR=0.63, 95%CI=0.46-0.86). Women at the oldest age in the menarche category were at a 34% lower risk of breast cancer (RR=0.66, 95%CI=0.53-0.81) than women in the youngest age category. However, none of the reproductive factors were associated with breast cancer risk among BRCA2 mutation carriers. In conclusion, late age at first birth, breastfeeding, and late age at menarche protect against breast cancer in BRCA1 mutation carriers only. Further studies are needed to explore the mechanisms.
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Affiliation(s)
- Hong Pan
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
| | - Zhongyuan He
- Department of Emergency, The First Affiliated Hospital of Soochow University, 188 Shizi Road, 215000 Suzhou, China
| | - Lijun Ling
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
| | - Qiang Ding
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
| | - Lin Chen
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
| | - Xiaoming Zha
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
| | - Wenbin Zhou
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
| | - Xiaoan Liu
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China.
| | - Shui Wang
- Department of Breast Surgery, The First Affiliated Hospital with Nanjing Medical University, 300 Guangzhou Road, 210029 Nanjing, China
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Meaney-Delman D, Bellcross CA. Hereditary breast/ovarian cancer syndrome: a primer for obstetricians/gynecologists. Obstet Gynecol Clin North Am 2013; 40:475-512. [PMID: 24021253 DOI: 10.1016/j.ogc.2013.05.009] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
An understanding of the diagnosis and clinical management of hereditary breast and ovarian cancer syndrome (HBOC) is essential for obstetricians/gynecologists. This article provides practical information regarding collecting a family history, cancer risk assessment and genetic testing, BRCA-associated cancer prognosis and treatment, screening recommendations, and prevention strategies. Through appropriate cancer risk assessment, women with BRCA1/2 mutations can be identified, and screening and prevention strategies can be used before a diagnosis of cancer occurs. Women's health providers with a strong working knowledge of HBOC are able to improve the quality of care for women and families impacted by BRCA1/2 mutations.
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Affiliation(s)
- Dana Meaney-Delman
- Department of Gynecology and Obstetrics, Emory University School of Medicine, 49 Jesse Hill Jr Drive, Atlanta, GA 30303, USA.
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Demerath EW, Liu CT, Franceschini N, Chen G, Palmer JR, Smith EN, Chen CTL, Ambrosone CB, Arnold AM, Bandera EV, Berenson GS, Bernstein L, Britton A, Cappola AR, Carlson CS, Chanock SJ, Chen W, Chen Z, Deming SL, Elks CE, Evans MK, Gajdos Z, Henderson BE, Hu JJ, Ingles S, John EM, Kerr KF, Kolonel LN, Le Marchand L, Lu X, Millikan RC, Musani SK, Nock NL, North K, Nyante S, Press MF, Rodriquez-Gil JL, Ruiz-Narvaez EA, Schork NJ, Srinivasan SR, Woods NF, Zheng W, Ziegler RG, Zonderman A, Heiss G, Gwen Windham B, Wellons M, Murray SS, Nalls M, Pastinen T, Rajkovic A, Hirschhorn J, Adrienne Cupples L, Kooperberg C, Murabito JM, Haiman CA. Genome-wide association study of age at menarche in African-American women. Hum Mol Genet 2013; 22:3329-46. [PMID: 23599027 DOI: 10.1093/hmg/ddt181] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
African-American (AA) women have earlier menarche on average than women of European ancestry (EA), and earlier menarche is a risk factor for obesity and type 2 diabetes among other chronic diseases. Identification of common genetic variants associated with age at menarche has a potential value in pointing to the genetic pathways underlying chronic disease risk, yet comprehensive genome-wide studies of age at menarche are lacking for AA women. In this study, we tested the genome-wide association of self-reported age at menarche with common single-nucleotide polymorphisms (SNPs) in a total of 18 089 AA women in 15 studies using an additive genetic linear regression model, adjusting for year of birth and population stratification, followed by inverse-variance weighted meta-analysis (Stage 1). Top meta-analysis results were then tested in an independent sample of 2850 women (Stage 2). First, while no SNP passed the pre-specified P < 5 × 10(-8) threshold for significance in Stage 1, suggestive associations were found for variants near FLRT2 and PIK3R1, and conditional analysis identified two independent SNPs (rs339978 and rs980000) in or near RORA, strengthening the support for this suggestive locus identified in EA women. Secondly, an investigation of SNPs in 42 previously identified menarche loci in EA women demonstrated that 25 (60%) of them contained variants significantly associated with menarche in AA women. The findings provide the first evidence of cross-ethnic generalization of menarche loci identified to date, and suggest a number of novel biological links to menarche timing in AA women.
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Affiliation(s)
- Ellen W Demerath
- Division of Epidemiology and Community Health, School of Public Health, University of Minnesota, Minneapolis, MN, USA.
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Euhus DM, Robinson L. Genetic Predisposition Syndromes and Their Management. Surg Clin North Am 2013; 93:341-62. [DOI: 10.1016/j.suc.2013.01.005] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
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ADULT ANTHROPOMETRIC MEASURES AND SOCIO-DEMOGRAPHIC FACTORS INFLUENCING AGE AT MENARCHE OF UNIVERSITY STUDENTS IN MALAYSIA. J Biosoc Sci 2013; 45:705-17. [DOI: 10.1017/s0021932013000060] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
SummaryEarly onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010–11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45±1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height (p<0.05) and negatively associated with BMI (p<0.001). Students from urban areas attained menarche earlier than those from rural areas (p<0.05). Students from small-sized families attained menarche earlier than those from larger families (p<0.05). First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight (p<0.01). The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts.
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Senst N, Llacuachaqui M, Lubinski J, Lynch H, Armel S, Neuhausen S, Ghadirian P, Sun P, Narod SA. Parental origin of mutation and the risk of breast cancer in a prospective study of women with aBRCA1orBRCA2mutation. Clin Genet 2012; 84:43-6. [DOI: 10.1111/cge.12037] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2012] [Revised: 09/06/2012] [Accepted: 10/02/2012] [Indexed: 01/01/2023]
Affiliation(s)
- N Senst
- Women's College Research Institute; Toronto; Ontario; Canada
| | - M Llacuachaqui
- Women's College Research Institute; Toronto; Ontario; Canada
| | - J Lubinski
- Hereditary Cancer Center; Pomeranian Medical University; Szczecin; Poland
| | - H Lynch
- Department of Preventive Medicine and Public Health; Creighton University School of Medicine; Omaha; NE; USA
| | - S Armel
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology; University of Toronto; Toronto; Ontario; Canada
| | - S Neuhausen
- City of Hope National Medical Center; Beckman Research Institute; Duarte; CA; USA
| | - P Ghadirian
- Epidemiology Research Unit; Research Center of the University of Montreal Hospital Centre (CRCHUM); Montreal; QC; Canada
| | - P Sun
- Women's College Research Institute; Toronto; Ontario; Canada
| | - SA Narod
- Women's College Research Institute; Toronto; Ontario; Canada
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Kotsopoulos J, Kim YI, Narod SA. Folate and breast cancer: what about high-risk women? Cancer Causes Control 2012; 23:1405-20. [DOI: 10.1007/s10552-012-0022-y] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2012] [Accepted: 06/20/2012] [Indexed: 12/31/2022]
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Lubinski J, Huzarski T, Byrski T, Lynch HT, Cybulski C, Ghadirian P, Stawicka M, Foulkes WD, Kilar E, Kim-Sing C, Neuhausen SL, Armel S, Gilchrist D, Sweet K, Gronwald J, Eisen A, Gorski B, Sun P, Narod SA, Hereditary Breast Cancer Clinical Study Group. The risk of breast cancer in women with a BRCA1 mutation from North America and Poland. Int J Cancer 2012; 131:229-34. [PMID: 21834074 PMCID: PMC3334396 DOI: 10.1002/ijc.26369] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2011] [Accepted: 05/20/2011] [Indexed: 11/09/2022]
Abstract
Women with a BRCA1 mutation face a high lifetime risk of breast cancer. It is unknown to what extent environmental factors modify the inherent genetic risk. If women from different countries, but with similar mutations, experience different levels of cancer risk, nongenetic risk modifiers are likely to be present. Study subjects were a cohort of 1477 women with a BRCA1 mutation, from Canada (n = 358), the United States (n = 256) and Poland (n = 863). The women were followed for a mean of 4.3 years and 130 incident cases of breast cancer were recorded. Annual cancer incidence rates were calculated, and based on these, penetrance curves were constructed for women from North America and Poland. In a Cox proportional hazards model, residence in Poland, versus North America, was associated with an adjusted hazard ratio of 0.54 (95% CI 0.34-0.86; p = 0.01). The risk of breast cancer to age 70 was estimated to be 49% for women from Poland and 72% for women from North America. Among women with BRCA1 mutations, the risk of breast cancer in women who reside in Poland is less than that of women who reside in North America. The reasons for the difference are unknown, but this observation suggests that environmental factors or genetic modifiers are important in determining risk.
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Affiliation(s)
- Jan Lubinski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Huzarski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Tomasz Byrski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Henry T Lynch
- Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE
| | - Cezary Cybulski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Parviz Ghadirian
- Epidemiology Research Unit, Research Centre of the University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada
| | | | - William D Foulkes
- Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, QC, Canada
| | - Ewa Kilar
- Regional Oncology Center, Swidnica, Poland
| | | | | | - Susan Armel
- Department of Gynecology Oncology, University Health Network, University of Toronto
| | - Dawna Gilchrist
- Department of Medical Genetics, University of Alberta, Edmonton, Alberta
| | - Kevin Sweet
- Department of Medical Genetics, Ohio State University, Columbus OH
| | - Jacek Gronwald
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Andrea Eisen
- Sunnybrook Regional Cancer Centre, Toronto, Ontario
| | - Bohdan Gorski
- International Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Ping Sun
- Women’s College Research Institute, Toronto, ON, Canada
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Kotsopoulos J, Lubinski J, Lynch HT, Kim-Sing C, Neuhausen S, Demsky R, Foulkes WD, Ghadirian P, Tung N, Ainsworth P, Senter L, Karlan B, Eisen A, Eng C, Weitzel J, Gilchrist DM, Blum JL, Zakalik D, Singer C, Fallen T, Ginsburg O, Huzarski T, Sun P, Narod SA. Oophorectomy after menopause and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Cancer Epidemiol Biomarkers Prev 2012; 21:1089-96. [PMID: 22564871 PMCID: PMC3593267 DOI: 10.1158/1055-9965.epi-12-0201] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND To evaluate the effect of the cumulative number of ovulatory cycles and its contributing components on the risk of breast cancer among BRCA mutation carriers. METHODS We conducted a matched case-control study on 2,854 pairs of women with a BRCA1 or BRCA2 mutation. Conditional logistic regression was used to estimate the association between the number of ovulatory cycles and various exposures and the risk of breast cancer. Information from a subset of these women enrolled in a prospective cohort study was used to calculate age-specific breast cancer rates. RESULTS The annual risk of breast cancer decreased with the number of ovulatory cycles experienced (ρ = -0.69; P = 0.03). Age at menarche and duration of breastfeeding were inversely related with risk of breast cancer among BRCA1 (P(trend) < 0.0001) but not among BRCA2 (P(trend) ≥ 0.28) mutation carriers. The reduction in breast cancer risk associated with surgical menopause [OR, 0.52; 95% confidence interval (CI), 0.40-0.66; P(trend) < 0.0001] was greater than that associated with natural menopause (OR, 0.81; 95% CI, 0.62-1.07; P(trend) = 0.14). There was a highly significant reduction in breast cancer risk among women who had an oophorectomy after natural menopause (OR, 0.13; 95% CI, 0.02-0.54; P = 0.006). CONCLUSIONS These data challenge the hypothesis that breast cancer risk can be predicted by the lifetime number of ovulatory cycles in women with a BRCA mutation. Both pre- and postmenopausal oophorectomy protect against breast cancer. IMPACT Understanding the basis for the protective effect of oophorectomy has important implications for chemoprevention.
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Affiliation(s)
| | - Jan Lubinski
- Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Henry T. Lynch
- Department of Preventive Medicine and Public Health, Creighton University School of Medicine, Omaha, NE, USA
| | | | | | - Rochelle Demsky
- Division of Gynecologic Oncology, Department of Obstetrics and Gynecology, University of Toronto, ON, Canada
| | - William D. Foulkes
- Program in Cancer Genetics, Department of Oncology and Human Genetics, McGill University, Montréal, QC, Canada
| | - Parviz Ghadirian
- Epidemiology Research Unit, Research Center of the University of Montreal Hospital Centre (CRCHUM), Montreal, QC, Canada
| | - Nadine Tung
- Beth Israel Deaconess Hospital, Boston, MA, USA
| | | | - Leigha Senter
- Division of Human Genetics, The Ohio State University Medical Center, Comprehensive Cancer Center, Columbus, OH, USA
| | - Beth Karlan
- Gynecology Oncology, Cedars Sinai Medical Center, Los Angeles, CA, USA
| | - Andrea Eisen
- Toronto-Sunnybrook Regional Cancer Center, Toronto, ON, Canada
| | - Charis Eng
- Genomic Medicine Institute and Center for Personalized Genetic Healthcare, Cleveland Clinic, Cleveland, OH, USA
| | | | - Dawna M. Gilchrist
- Department of Medicine Genetics, University of Alberta, Edmonton, AB, Canada
| | - Joanne L. Blum
- Baylor-Sammons Cancer Center, Texas Oncology, U.S. Oncology Research, Dallas, TX, USA
| | - Dana Zakalik
- Cancer Genetics Program, Beaumont Hospital, Royal Oak, MI, USA
| | - Christian Singer
- Department of Obstetrics and Gynecology and Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - Taya Fallen
- Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL, USA
| | - Ophira Ginsburg
- Women's College Research Institute, Toronto, ON, Canada
- Department of Medicine, University of Toronto, ON, Canada
| | - Tomasz Huzarski
- Hereditary Cancer Center, Pomeranian Medical University, Szczecin, Poland
| | - Ping Sun
- Women's College Research Institute, Toronto, ON, Canada
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Qiu J, Yang R, Rao Y, Du Y, Kalembo FW. Risk factors for breast cancer and expression of insulin-like growth factor-2 (IGF-2) in women with breast cancer in Wuhan City, China. PLoS One 2012; 7:e36497. [PMID: 22662119 PMCID: PMC3360739 DOI: 10.1371/journal.pone.0036497] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2012] [Accepted: 04/06/2012] [Indexed: 11/28/2022] Open
Abstract
Purpose The purpose of this study was to explore the risk factors for breast cancer and establish the expression rate of IGF-2 in female patients. Methods A case control study with 500 people in case group and 500 people in control group. A self-administered questionnaire was used to investigate risk factors for breast cancer. All cases were interviewed during a household survey. Immune-histochemical method was used to inspect the expression of IGF-2 in different tissues (benign breast lesions, breast cancer and tumor-adjacent tissue). Results Multivariate adjusted odds ratios and 95% confidence intervals were calculated using unconditional logistic regression. High body mass index (OR = 1.012,95%CI = 1.008–1.016), working attributes (OR = 1.004, 95%CI = 1.002 = 1.006), long menstrual period (OR = 1.007, 95%CI = 1.005–1.009), high parity OR = 1.003, 95%CI = 1.001–1.005) , frequent artificial abortion (OR = 1.004, 95%CI = 1.001–1.005), family history of cancer (OR = 1.003, 95%CI = 1.000–1.005), period of night shift (OR = 1.003, 95%CI = 1.001–1.006), live in high risk environment (OR = 1.005, 95%CI = 1.002–1.008), and family problems (OR = 1.010, 95%CI = 1.005–1.014) were associated with increased risk for breast cancer. In this study, good sleeping status, positive coping strategies, subjective support, and utility degree of social support were associated with reduced risk for breast cancer (OR = 0.998, 0.997, 0.985, 0.998 respectively; 95%CI = 0.996–1.000, 0.994–1.000, 0.980–0.989, 0.996–1.000, respectively). In benign breast lesions, breast cancer and tumor-adjacent tissue, IGF-2 was mainly expressed in the cytoplasm, but its expression rate was different (p<0.05). Conclusions The incidence of breast cancer is a common result of multiple factors. IGF-2 is involved in the development of breast cancer, and its expression varies in different tissues (benign breast lesions, breast cancer and tumor-adjacent tissue).
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Affiliation(s)
- Jun Qiu
- Department of Maternal and Child Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
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Kotsopoulos J, Lubinski J, Salmena L, Lynch HT, Kim-Sing C, Foulkes WD, Ghadirian P, Neuhausen SL, Demsky R, Tung N, Ainsworth P, Senter L, Eisen A, Eng C, Singer C, Ginsburg O, Blum J, Huzarski T, Poll A, Sun P, Narod SA. Breastfeeding and the risk of breast cancer in BRCA1 and BRCA2 mutation carriers. Breast Cancer Res 2012; 14:R42. [PMID: 22405187 PMCID: PMC3446376 DOI: 10.1186/bcr3138] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 01/26/2012] [Accepted: 03/09/2012] [Indexed: 12/23/2022] Open
Abstract
Introduction Breastfeeding has been inversely related to breast cancer risk in the general population. Clarifying the role of breastfeeding among women with a BRCA1 or BRCA2 mutation may be helpful for risk assessment and for recommendations regarding prevention. We present an updated analysis of breastfeeding and risk of breast cancer using a large matched sample of BRCA mutation carriers. Methods We conducted a case-control study of 1,665 pairs of women with a deleterious mutation in either BRCA1 (n = 1,243 pairs) or BRCA2 (n = 422 pairs). Breast cancer cases and unaffected controls were matched on year of birth, mutation status, country of residence and parity. Information about reproductive factors, including breastfeeding for each live birth, was collected from a routinely administered questionnaire. Conditional logistic regression was used to estimate the association between ever having breastfed, as well as total duration of breastfeeding, and the risk of breast cancer. Results Among BRCA1 mutation carriers, breastfeeding for at least one year was associated with a 32% reduction in risk (OR = 0.68; 95% CI 0.52 to 0.91; P = 0.008); breastfeeding for two or more years conferred a greater reduction in risk (OR = 0.51; 95% CI 0.35 to 0.74). Among BRCA2 mutation carriers, there was no significant association between breastfeeding for at least one year and breast cancer risk (OR = 0.83; 95% CI 0.53 to 1.31; P = 0.43). Conclusions These data extend our previous findings that breastfeeding protects against BRCA1-, but not BRCA2-associated breast cancer. BRCA mutation carriers should be advised of the benefit of breastfeeding in terms of reducing breast cancer risk.
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Dvornyk V, Waqar-ul-Haq. Genetics of age at menarche: a systematic review. Hum Reprod Update 2012; 18:198-210. [PMID: 22258758 DOI: 10.1093/humupd/dmr050] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Menarche is the first menstrual period of a girl at puberty. The timing of menarche is important for health in later life. Age at menarche is a complex trait and has a strong genetic component. This review summarizes the results of the genetic studies of age at menarche conducted to date, highlights existing problems in this area and outlines prospects of future studies on genetic factors for the trait. METHODS PubMed and Google Scholar were searched until May 2011 using the keywords: 'menarche', 'puberty' and 'age at menarche' in combination with the keywords 'polymorphism', 'candidate gene', 'genome-wide association study' and 'linkage'. RESULTS Our search yielded 170 papers, 35 of which were selected for further analysis. Several large-scale genome-wide association studies along with a powerful meta-analysis of their aggregated data identified about 50 candidate genes for the trait. Some genes were replicated in different studies of Caucasians (e.g. LIN28B, TMEM38B) or in different ethnicities (e.g. SPOCK, RANK and RANKL). However, despite the large volume of results obtained, there is a huge gap in relevant data on ethnic groups other than Caucasians. CONCLUSIONS The reviewed studies laid a solid basis for future research on genetics of age at menarche. However, as yet specific genes for this trait have not been identified consistently in all ethnicities and types of studies. We suggest expanding the research to different ethnicities and propose several methodologies to increase the efficiency of studies in this area, including a systems approach, which combines existing high-throughput methods in a single pipeline.
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Affiliation(s)
- Volodymyr Dvornyk
- School of Biological Sciences, University of Hong Kong, Pokfulam, Hong Kong SAR, PR China.
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Moorman PG, Iversen ES, Marcom PK, Marks JR, Wang F, Lee E, Ursin G, Rebbeck TR, Domchek SM, Arun B, Susswein L, Isaacs C, Garber JE, Visvanathan K, Griffin CA, Sutphen R, Brzosowicz J, Gruber S, Finkelstein DM, Schildkraut JM. Evaluation of established breast cancer risk factors as modifiers of BRCA1 or BRCA2: a multi-center case-only analysis. Breast Cancer Res Treat 2010; 124:441-51. [PMID: 20309627 DOI: 10.1007/s10549-010-0842-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2010] [Accepted: 03/08/2010] [Indexed: 11/28/2022]
Abstract
The incomplete penetrance of mutations in BRCA1 and BRCA2 suggests that some combination of environmental and genetic factors modifies the risk of breast cancer in mutation carriers. This study sought to identify possible interactions between established breast cancer risk factors and BRCA1 or BRCA2 mutations using a case-only study design. Breast cancer cases that had been tested for BRCA1 and BRCA2 mutations were identified from 11 collaborating centers. Comparisons of reproductive and lifestyle risk factors were made between women with breast cancer who were positive for BRCA1 mutations (n = 283), BRCA2 mutations (n = 204), or negative for both BRCA1 and BRCA2 mutations (n = 894). Interaction risk ratios (IRRs) were calculated using multinominal logistic regression models. Compared with non-carriers, statistically significant IRRs were observed for later age at menarche among BRCA2 mutation carriers, for a greater number of pregnancies among both BRCA1 and BRCA2 mutation carriers, and for alcohol use among BRCA1 mutation carriers. Our data suggest that the risk for breast cancer among BRCA1 or BRCA2 carriers may be modified by reproductive characteristics and alcohol use. However, our results should be interpreted cautiously given the overall inconsistency in the epidemiologic literature on modifiers of BRCA1 and BRCA2.
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Affiliation(s)
- Patricia G Moorman
- Cancer Prevention Detection and Control Research Program, Department of Community and Family Medicine, Duke University Medical Center, Durham, NC 27705, USA.
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Poynter JN, Langholz B, Largent J, Mellemkjaer L, Bernstein L, Malone KE, Lynch CF, Borg A, Concannon P, Teraoka SN, Xue S, Diep AT, Törngren T, Begg CB, Capanu M, Haile RW, Bernstein JL. Reproductive factors and risk of contralateral breast cancer by BRCA1 and BRCA2 mutation status: results from the WECARE study. Cancer Causes Control 2010; 21:839-46. [PMID: 20130978 DOI: 10.1007/s10552-010-9510-0] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2009] [Accepted: 01/15/2010] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Reproductive factors, such as early age at menarche, late age at menopause, and nulliparity are known risk factors for breast cancer. Previously, we reported these factors to be associated with risk of developing contralateral breast cancer (CBC). In this study, we evaluated the association between these factors and CBC risk among BRCA1 and BRCA2 (BRCA1/2) mutation carriers and non-carriers. METHODS The WECARE Study is a population-based multi-center case-control study of 705 women with CBC (cases) and 1,397 women with unilateral breast cancer (controls). All participants were screened for BRCA1/2 mutations and 181 carriers were identified. Conditional logistic regression models were used to evaluate associations between reproductive factors and CBC for mutation carriers and non-carriers. RESULTS None of the associations between reproductive factors and CBC risk differed between mutation carriers and non-carriers. The increase in risk with younger age at menarche and decrease in risk in women with more than two full-term pregnancies seen in non-carriers were not significantly different in carriers (adjusted RRs = 1.31, 95% CI 0.65-2.65 and 0.53, 95% CI 0.19-1.51, respectively). No significant associations between the other reproductive factors and CBC risk were observed in mutation carriers or non-carriers. CONCLUSION For two reproductive factors previously shown to be associated with CBC risk, we observed similar associations for BRCA1/2 carriers. This suggests that reproductive variables that affect CBC risk may have similar effects in mutation carriers and non-carriers.
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Affiliation(s)
- Jenny N Poynter
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA.
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Xing P, Li J, Jin F. A case-control study of reproductive factors associated with subtypes of breast cancer in Northeast China. Med Oncol 2009; 27:926-31. [PMID: 19771534 DOI: 10.1007/s12032-009-9308-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2009] [Accepted: 09/09/2009] [Indexed: 12/26/2022]
Abstract
Based on the expression of estrogen receptor (ER), progesterone receptor (PR) and HER2/neu (HER2), breast cancer is classified into several subtypes: luminal A (ER+ and/or PR+, HER2-), luminal B (ER+ and/or PR+, HER2+), HER2-overexpressing (ER-, PR-, and HER2+) and triple-negative (ER-, PR-, and HER2-). The aim of this case-control study is to determine reproductive factors associated with breast cancer subtypes in Chinese women. A total of 1,417 patients diagnosed with breast cancer in the First Affiliated Hospital, China Medical University, Shenyang, China between 2001 and 2009 and 1,587 matched controls without a prior breast cancer were enrolled. Personal interviews were conducted to obtain information on reproductive characteristics and clinical history. Relationships between the factors and the subtypes of breast cancer were examined using logistic regression to compute odds ratios (OR) and 95% confidence intervals (CI). Notably, luminal A (50.0%) was the most prevalent subtype relative to luminal B (15.10%), HER2-overexpressing (10.87%) and triple-negative (23.08%). Menarche at an early age was associated with a reduced risk of luminal A (OR, 2.35; 95% CI, 1.45-3.81). Breastfeeding protected parous women from any subtype of breast cancer. Postmenopause and spontaneous abortion were inversely associated with the risk of luminal tumors. By contrast, multiparity, family history of breast cancer and induced abortion increased the risk of breast cancer. Collectively, our findings suggest that reproductive factors such as age at menarche, parity, breastfeeding, menopausal status and abortion history have different effects on the subtypes of breast cancer in Chinese women.
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Affiliation(s)
- Peng Xing
- Department of Oncology, The First Affiliated Hospital, China Medical University, 110001, Shenyang, China
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Lee E, Ma H, McKean-Cowdin R, Van Den Berg D, Bernstein L, Henderson BE, Ursin G. Effect of reproductive factors and oral contraceptives on breast cancer risk in BRCA1/2 mutation carriers and noncarriers: results from a population-based study. Cancer Epidemiol Biomarkers Prev 2009; 17:3170-8. [PMID: 18990759 DOI: 10.1158/1055-9965.epi-08-0396] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Multiparity and breast-feeding reduce breast cancer risk, whereas oral contraceptive use may slightly increase breast cancer risk in the general population. However, the effects of these factors in BRCA1 and BRCA2 mutation carriers are less clear. METHODS Case patients were 1,469 women from Los Angeles County ages 20 to 49 years with newly diagnosed breast cancer. Control subjects were 444 women without breast cancer, individually matched to a subset of cases on race, age, and neighborhood. BRCA1/2 genes were sequenced in the cases, and odds ratios of breast cancer associated with various reproductive and hormonal factors in BRCA1/2 mutation carriers and noncarriers were estimated using multivariable logistic regression. RESULTS Ninety-four women had a deleterious BRCA1 or BRCA2 mutation. Number of full-term pregnancies was inversely associated with breast cancer risk regardless of BRCA1/2 mutation status. Longer breast-feeding duration was protective among noncarriers but not among mutation carriers; however, this apparent effect modification was not statistically significant (P = 0.23). Neither oral contraceptive use overall nor the use of low-dose oral contraceptives was associated with an increased risk of breast cancer in any subgroup. CONCLUSIONS Our results suggest that parity protects against breast cancer in BRCA1/2 mutation carriers, whereas breast-feeding does not. Our data suggest no association between oral contraceptive use and breast cancer risk in BRCA1/2 mutation carriers. Further confirmation that currently available low-dose oral contraceptives do not increase breast cancer risk in carriers is important from a public health perspective given the high prevalence of oral contraceptive use in the United States.
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Affiliation(s)
- Eunjung Lee
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California/Norris Comprehensive Cancer Center, Room 4407, 1441 Eastlake Avenue, Los Angeles, CA 90089, USA
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