1
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Chae EY, Jung MR, Cha JH, Shin HJ, Choi WJ, Kim HH. A predictive model using MRI and clinicopathologic features for breast cancer recurrence in young women treated with upfront surgery. Eur Radiol 2024; 34:7092-7103. [PMID: 38787429 DOI: 10.1007/s00330-024-10805-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2023] [Revised: 03/20/2024] [Accepted: 04/08/2024] [Indexed: 05/25/2024]
Abstract
OBJECTIVES To identify preoperative breast MR imaging and clinicopathological variables related to recurrence and develop a risk prediction model for recurrence in young women with breast cancer treated with upfront surgery. METHODS This retrospective study analyzed 438 consecutive women with breast cancer aged 35 years or younger between January 2007 and December 2016. Breast MR images before surgery were independently reviewed by breast radiologists blinded to patient outcomes. The clinicopathological data including patient demographics, clinical features, and tumor characteristics were reviewed. Univariate and multivariate logistic regression analyses were used to identify the independent factors associated with recurrence. The risk prediction model for recurrence was developed, and the discrimination and calibration abilities were assessed. RESULTS Of 438 patients, 95 (21.7%) developed recurrence after a median follow-up of 65 months. Tumor size at MR imaging (HR = 1.158, p = 0.006), multifocal or multicentric disease (HR = 1.676, p = 0.017), and peritumoral edema on T2WI (HR = 2.166, p = 0.001) were identified as independent predictors of recurrence, while adjuvant endocrine therapy (HR = 0.624, p = 0.035) was inversely associated with recurrence. The prediction model showed good discrimination ability in predicting 5-year recurrence (C index, 0.707 in the development cohort; 0.686 in the validation cohort) and overall recurrence (C index, 0.699 in the development cohort; 0.678 in the validation cohort). The calibration plot demonstrated an excellent correlation (concordance correlation coefficient, 0.903). CONCLUSION A prediction model based on breast MR imaging and clinicopathological features showed good discrimination to predict recurrence in young women with breast cancer treated with upfront surgery, which could contribute to individualized risk stratification. CLINICAL RELEVANCE STATEMENT Our prediction model, incorporating preoperative breast MR imaging and clinicopathological features, predicts recurrence in young women with breast cancer undergoing upfront surgery, facilitating personalized risk stratification and informing tailored management strategies. KEY POINTS Younger women with breast cancer have worse outcomes than those diagnosed at more typical ages. The described prediction model showed good discrimination performance in predicting 5-year and overall recurrence. Incorporating better risk stratification tools in this population may help improve outcomes.
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Affiliation(s)
- Eun Young Chae
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
| | - Mi Ran Jung
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Joo Hee Cha
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hee Jung Shin
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Woo Jung Choi
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
| | - Hak Hee Kim
- Department of Radiology, Research Institute of Radiology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea
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2
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Ghareeb GA, Nass ZA, Abu-Grain S, Alnaji A, Almohanna H, Nasser HAS, Al Shahrani S. Genetic Testing Among Breast Cancer Patients in the Eastern Region of Saudi Arabia: Single-Center Experience. J Epidemiol Glob Health 2024; 14:1351-1357. [PMID: 39256315 PMCID: PMC11442735 DOI: 10.1007/s44197-024-00296-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2023] [Accepted: 09/01/2024] [Indexed: 09/12/2024] Open
Abstract
BACKGROUND Genetic testing for persons with a heightened likelihood of harboring a germline mutation permits early identification and appropriate management. This study aimed to identify the proportion of breast cancer (BC) patients who were offered genetic testing and the prevalence of BRCA mutations among them. Additionally, we assessed the demographic and clinical features of BC patients in the Eastern Region of Saudi Arabia. MATERIALS AND METHODS Data from 2535 patients with BC were retrieved from the registry between 2017 and 2021. The data were analyzed and presented using univariate and bivariate statistics. Odds ratios and 95% confidence intervals using logistic regression analysis were computed to identify the predictors of BRCA testing. RESULTS Patients with BC ranged in age from 18 to 103 years, and the mean age was 49.60 ± 12.14 years. BC was detected in men in 29 (1.1%) cases. Among diagnosed patients with BC, a total of 96 (3.7%) patients underwent testing for BRCA gene mutations. Of them, 36 (37.5%) patients had a BRCA gene mutation. The likelihood of undergoing BRCA testing was higher for those who were diagnosed with the condition before the age of 50, patients who were referred from private institutions, and patients with a history of previously diagnosed cancer. The likelihood of conducting BRCA testing was significantly lower among those with distant metastases. CONCLUSION The proportion of BRCA testing among BC patients was found to be relatively low. The development of a cost-effective, locally developed risk assessment tool that incorporates genetic counseling and testing for those with a familial predisposition to BC is imperative.
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Affiliation(s)
- Ghadeer Al Ghareeb
- Qatif Health Network, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia.
| | - Zainab Al Nass
- Qatif Health Network, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia
| | - Salma Abu-Grain
- Qatif Health Network, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia
| | - Alia Alnaji
- Qatif Health Network, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia
| | - Hani Almohanna
- Research Centre- KKMC, King Fahad Specialist Hospital-Dammam, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia
| | | | - Saad Al Shahrani
- King Fahad Specialist Hospital- Dammam, Eastern Health Cluster, Dammam, Kingdom of Saudi Arabia
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3
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Tinterri C, Gentile D, Caruso F, Cortesi L, De Laurentiis M, Fortunato L, Santini D, Turchetti D, Ferrari A, Zambelli A, Senonetwork Italia Breast Centre Responders. BRCA Testing for Patients Treated in Italy: A National Survey of Breast Centers Associated with Senonetwork. Curr Oncol 2024; 31:3815-3825. [PMID: 39057154 PMCID: PMC11276301 DOI: 10.3390/curroncol31070282] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2024] [Revised: 06/25/2024] [Accepted: 06/28/2024] [Indexed: 07/28/2024] Open
Abstract
BACKGROUND Breast units (BUs) provide breast cancer (BC) care, including prevention, treatment, and genetic assessment. Genetic research has highlighted BRCA1/2 mutations as key hereditary BC risk factors. BRCA testing is crucial for personalized treatment and prevention strategies. However, the integration of BRCA testing in Italian BUs faces multiple challenges. This study, by Senonetwork Italia, aimed to evaluate genetic testing practices and identify obstacles within Italian BUs. METHODS Senonetwork Italia conducted a 16-question web-based survey involving 153 BUs. The survey assessed aspects of BRCA testing, including timing, urgency, counseling, patient selection, and multi-gene panels. RESULTS Of the 153 BUs, 109 (71.2%) responded. Testing before surgery was performed by 70.6% of centers, with urgent cases acknowledged by 87.2%. Most centers (56.0%) arranged urgent pre-test counseling within a week. BRCA mutation status influenced treatment decisions in 99.1% of cases. Multi-gene panels were used by 33.0% of centers for all genetic counseling cases, while 56.0% followed standard referral criteria. The main challenges included cost, reimbursement, and reporting timelines. CONCLUSIONS This survey highlights significant variations in BRCA testing practices across Italian BUs and identifies key logistical and financial challenges. There is a need for standardized practices of genetic testing to ensure personalized and effective BC management in Italy.
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Affiliation(s)
- Corrado Tinterri
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy;
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Milan, Italy;
| | - Damiano Gentile
- Breast Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy;
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Milan, Italy;
| | - Francesco Caruso
- HICC Humanitas Istituto Clinico Catanese, 95045 Misterbianco, Italy;
| | - Laura Cortesi
- Azienda Ospedaliera-Universitaria di Modena, Università degli Studi di Modena e Reggio Emilia, 41121 Modena, Italy;
| | - Michelino De Laurentiis
- Dipartimento di Oncologia Senologica, Istituto Nazionale Tumori “Fondazione PASCALE”, 80131 Napoli, Italy;
| | - Lucio Fortunato
- Breast Centre, Azienda Ospedaliera San Giovanni-Addolorata, 00184 Rome, Italy;
| | - Donatella Santini
- IRCCS Azienda Ospedaliero, Universitaria di Bologna Policlinico di Sant’Orsola, 40138 Bologna, Italy;
| | - Daniela Turchetti
- Department of Medical and Surgical Sciences, University of Bologna, 40138 Bologna, Italy;
- Medical Genetics Unit, IRCCS Azienda Ospedaliero-Universitaria di Bologna, 40138 Bologna, Italy
| | - Alberta Ferrari
- Fondazione IRCCS Policlinico San Matteo di Pavia, 27100 Pavia, Italy;
| | - Alberto Zambelli
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Milan, Italy;
- Medical Oncology and Hematology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089 Milan, Italy
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4
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Chang CM, Chang CC, Lam HYP, Peng SY, Lai YH, Hsiang BD, Liao YY, Hsu HJ, Jiang SJ. Therapeutic Peptide RF16 Derived from CXCL8 Inhibits MDA-MB-231 Cell Invasion and Metastasis. Int J Mol Sci 2023; 24:14029. [PMID: 37762330 PMCID: PMC10531501 DOI: 10.3390/ijms241814029] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Revised: 09/08/2023] [Accepted: 09/11/2023] [Indexed: 09/29/2023] Open
Abstract
Interleukin (IL)-8 plays a vital role in regulating inflammation and breast cancer formation by activating CXCR1/2. We previously designed an antagonist peptide, (RF16), to inhibits the activation of downstream signaling pathways by competing with IL-8 in binding to CXCR1/2, thereby inhibiting IL-8-induced chemoattractant monocyte binding. To evaluate the effect of the RF16 peptide on breast cancer progression, triple-negative MDA-MB-231 and ER-positive MCF-7 breast cancer cells were used to investigate whether RF16 can inhibit the IL-8-induced breast cancer metastasis. Using growth, proliferation, and invasiveness assays, the results revealed that RF16 reduced cell proliferation, migration, and invasiveness in MDA-MB-231 cells. The RF16 peptide also regulated the protein and mRNA expressions of epithelial-mesenchymal transition (EMT) markers in IL-8-stimulated MDA-MB-231 cells. It also inhibited downstream IL-8 signaling and the IL-8-induced inflammatory response via the mitogen-activated protein kinase (MAPK) and Phosphoinositide 3-kinase (PI3K) pathways. In the xenograft tumor mouse model, RF16 synergistically reinforces the antitumor efficacy of docetaxel by improving mouse survival and retarding tumor growth. Our results indicate that RF16 significantly inhibited IL-8-stimulated cell growth, migration, and invasion in MDA-MB-231 breast cancer cells by blocking the activation of p38 and AKT cascades. It indicated that the RF16 peptide may serve as a new supplementary drug for breast cancer.
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Affiliation(s)
- Chun-Ming Chang
- Department of General Surgery, Hualien Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, Hualien 97004, Taiwan;
- Institute of Medical Sciences, Tzu Chi University, Hualien 97004, Taiwan
| | - Chun-Chun Chang
- Department of Laboratory Medicine, Hualien Tzu Chi Hospital, Hualien 97004, Taiwan;
- Department of Laboratory Medicine and Biotechnology, College of Medicine, Tzu Chi University, Hualien 97004, Taiwan
| | - Ho Yin Pekkle Lam
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (H.Y.P.L.); (S.-Y.P.); (Y.-H.L.)
- Master Program in Biomedical Sciences, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
| | - Shih-Yi Peng
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (H.Y.P.L.); (S.-Y.P.); (Y.-H.L.)
- Master Program in Biomedical Sciences, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
| | - Yi-Hsuan Lai
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (H.Y.P.L.); (S.-Y.P.); (Y.-H.L.)
| | - Bi-Da Hsiang
- Department of Molecular Biology and Human Genetics, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
| | - Yu-Yi Liao
- Master Program in Biomedical Sciences, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
| | - Hao-Jen Hsu
- Department of Biomedical Sciences and Engineering, College of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
| | - Shinn-Jong Jiang
- Department of Biochemistry, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan; (H.Y.P.L.); (S.-Y.P.); (Y.-H.L.)
- Master Program in Biomedical Sciences, School of Medicine, Tzu Chi University, Hualien 97004, Taiwan;
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5
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Fiziev PP, McRae J, Ulirsch JC, Dron JS, Hamp T, Yang Y, Wainschtein P, Ni Z, Schraiber JG, Gao H, Cable D, Field Y, Aguet F, Fasnacht M, Metwally A, Rogers J, Marques-Bonet T, Rehm HL, O'Donnell-Luria A, Khera AV, Farh KKH. Rare penetrant mutations confer severe risk of common diseases. Science 2023; 380:eabo1131. [PMID: 37262146 DOI: 10.1126/science.abo1131] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2022] [Accepted: 03/16/2023] [Indexed: 06/03/2023]
Abstract
We examined 454,712 exomes for genes associated with a wide spectrum of complex traits and common diseases and observed that rare, penetrant mutations in genes implicated by genome-wide association studies confer ~10-fold larger effects than common variants in the same genes. Consequently, an individual at the phenotypic extreme and at the greatest risk for severe, early-onset disease is better identified by a few rare penetrant variants than by the collective action of many common variants with weak effects. By combining rare variants across phenotype-associated genes into a unified genetic risk model, we demonstrate superior portability across diverse global populations compared with common-variant polygenic risk scores, greatly improving the clinical utility of genetic-based risk prediction.
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Affiliation(s)
- Petko P Fiziev
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Jeremy McRae
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Jacob C Ulirsch
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Jacqueline S Dron
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - Tobias Hamp
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Yanshen Yang
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Pierrick Wainschtein
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Queensland, Australia
| | - Zijian Ni
- Department of Statistics, University of Wisconsin-Madison, Madison, WI 53706, USA
| | - Joshua G Schraiber
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Hong Gao
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Dylan Cable
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology (MIT), Cambridge, MA 02142, USA
| | - Yair Field
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Francois Aguet
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Marc Fasnacht
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Ahmed Metwally
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
| | - Jeffrey Rogers
- Human Genome Sequencing Center and Department of Molecular and Human Genetics, Baylor College of Medicine, Houston, TX 77030, USA
- Wisconsin National Primate Research Center, University of Wisconsin-Madison, Madison, WI 53715, USA
| | - Tomas Marques-Bonet
- Institute of Evolutionary Biology (UPF-CSIC), 08003 Barcelona, Spain
- Catalan Institution of Research and Advanced Studies (ICREA), 08010 Barcelona, Spain
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST), 08003 Barcelona, Spain
- Institut Català de Paleontologia Miquel Crusafont, Universitat Autònoma de Barcelona, 08193 Barcelona, Spain
| | - Heidi L Rehm
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
| | - Anne O'Donnell-Luria
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Division of Genetics and Genomics, Boston Children's Hospital, Boston, MA 02115, USA
| | - Amit V Khera
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
- Verve Therapeutics, Cambridge, MA 02215, USA
| | - Kyle Kai-How Farh
- Artificial Intelligence Laboratory, Illumina, Inc., San Diego, CA 92122, USA
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6
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Fiziev P, McRae J, Ulirsch JC, Dron JS, Hamp T, Yang Y, Wainschtein P, Ni Z, Schraiber JG, Gao H, Cable D, Field Y, Aguet F, Fasnacht M, Metwally A, Rogers J, Marques-Bonet T, Rehm HL, O’Donnell-Luria A, Khera AV, Kai-How Farh K. Rare penetrant mutations confer severe risk of common diseases. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.01.23289356. [PMID: 37205493 PMCID: PMC10187340 DOI: 10.1101/2023.05.01.23289356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/21/2023]
Abstract
We examined 454,712 exomes for genes associated with a wide spectrum of complex traits and common diseases and observed that rare, penetrant mutations in genes implicated by genome-wide association studies confer ∼10-fold larger effects than common variants in the same genes. Consequently, an individual at the phenotypic extreme and at the greatest risk for severe, early-onset disease is better identified by a few rare penetrant variants than by the collective action of many common variants with weak effects. By combining rare variants across phenotype-associated genes into a unified genetic risk model, we demonstrate superior portability across diverse global populations compared to common variant polygenic risk scores, greatly improving the clinical utility of genetic-based risk prediction. One sentence summary Rare variant polygenic risk scores identify individuals with outlier phenotypes in common human diseases and complex traits.
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Affiliation(s)
- Petko Fiziev
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Jeremy McRae
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Jacob C. Ulirsch
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Jacqueline S. Dron
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard; Cambridge, Massachusetts 02142, USA
| | - Tobias Hamp
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Yanshen Yang
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Pierrick Wainschtein
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Zijian Ni
- Department of Statistics, UW Madison; Madison, Wisconsin 53706, USA
| | - Joshua G. Schraiber
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Hong Gao
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Dylan Cable
- Department of Electrical Engineering and Computer Science, MIT; Cambridge, Massachusetts 02142, USA
| | - Yair Field
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Francois Aguet
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Marc Fasnacht
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Ahmed Metwally
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
| | - Jeffrey Rogers
- Human Genome Sequencing Center and Department of Molecular and Human Genetics, Baylor College of Medicine; Houston, Texas 77030, USA
- Wisconsin National Primate Research Center, University of Wisconsin; Madison 53715, USA
| | - Tomas Marques-Bonet
- Institute of Evolutionary Biology (UPF-CSIC); 08003 Barcelona, Spain
- Catalan Institution of Research and Advanced Studies (ICREA); 08010 Barcelona, Spain
- CNAG-CRG, Centre for Genomic Regulation (CRG), Barcelona Institute of Science and Technology (BIST); 08003 Barcelona, Spain
- Institut Català de Paleontologia Miquel Crusafont, Universitat Autònoma de Barcelona; 08193 Barcelona, Spain
| | - Heidi L. Rehm
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard; Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital; Boston, Massachusetts 02114, USA
| | - Anne O’Donnell-Luria
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard; Cambridge, Massachusetts 02142, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital; Boston, Massachusetts 02114, USA
- Division of Genetics and Genomics, Boston Children’s Hospital; Boston, Massachusetts 02115, USA
| | - Amit V. Khera
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard; Cambridge, Massachusetts 02142, USA
- Verve Therapeutics, Cambridge, Massachusetts 02215, USA
| | - Kyle Kai-How Farh
- Artificial Intelligence Laboratory, Illumina, Inc.; San Diego, California 92122, USA
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7
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Mehta P, Bothra SJ. PARP inhibitors in hereditary breast and ovarian cancer and other cancers: A review. ADVANCES IN GENETICS 2021; 108:35-80. [PMID: 34844716 DOI: 10.1016/bs.adgen.2021.08.002] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
There has been a paradigm shift in the management of cancer, with the immense progress in cancer genomics. More and more targeted therapies are becoming available by the day and personalized medicine is becoming popular with specific drugs being designed for selected subgroups of patients. One such new class of targeted drugs in the armamentarium is Poly ADP Ribose Polymerase (PARP) inhibitors (PARPi), which inhibit the enzyme PARP, thus interfering with DNA repair. This strategy utilizes a pre-existing genomic lesion in tumors with homologous recombination repair defects (including BRCA mutations), weakening tumor cells further by blocking the alternate pathway of DNA repair. In this review, we discuss in detail, the evolution, genetics, mechanism of action, mechanism of resistance, indications of use of PARP inhibitors, as well as combination with other agents and future directions.
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Affiliation(s)
- Prashant Mehta
- Department of Medical Oncology, Hematology and BMT, Asian Institute of Medical Sciences, Faridabad, India.
| | - Sneha J Bothra
- Department of Medical Oncology, Action Cancer Institute, New Delhi, India
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8
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Rippinger N, Fischer C, Sinn HP, Dikow N, Sutter C, Rhiem K, Grill S, Cremer FW, Nguyen HP, Ditsch N, Kast K, Hettmer S, Kratz CP, Schott S. Breast cancer characteristics and surgery among women with Li-Fraumeni syndrome in Germany-A retrospective cohort study. Cancer Med 2021; 10:7747-7758. [PMID: 34569185 PMCID: PMC8559485 DOI: 10.1002/cam4.4300] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Revised: 08/16/2021] [Accepted: 08/30/2021] [Indexed: 12/26/2022] Open
Abstract
Background Women with Li‐Fraumeni syndrome (LFS) have elevated breast cancer (BC) risk. Optimal BC treatment strategies in this population are yet unknown. Methods BC subtypes and treatment were retrospectively investigated between December 2016 and January 2019 in a multicentre study. BC risks were evaluated according to the type of surgery. Results Thirty‐five women of our study population (35/44; 79.5%) had developed 36 breast lesions at first diagnosis at a mean age of 34 years. Those breast lesions comprised 32 invasive BCs (89%), three ductal carcinoma in situ alone (8%) and one malignant phyllodes tumour (3%). BCs were mainly high‐grade (18/32), of no special type (NST; 31/32), HER2‐enriched (11/32) or luminal‐B‐(like)‐type (10/32). Affected women (n = 35) received breast‐conserving surgery (BCS, n = 17) or a mastectomy (ME, n = 18) including seven women with simultaneous contralateral prophylactic mastectomy (CPM) at first diagnosis. Nineteen women suffered 20 breast or locoregional axillary lesions at second diagnosis with mean age of 36. Median time between first and second diagnosis was 57 months; median time to contra‐ and ipsilateral recurrence depended on surgical strategies (BCS: 46 vs. unilateral ME: 93 vs. bilateral ME > 140 months). Women with a primary treatment of solitaire therapeutic ME suffered from contralateral BC earlier compared to those with therapeutic ME and CPM (median: 93 vs. >140 months). Conclusion Aggressive BC subtypes occur among women with LFS. Surgical treatment, i.e. ME and CPM, may prolong time to a second BC diagnosis. Conclusion on long‐term survival benefit is pending. Individual competing tumour risks and long‐term outcomes need to be taken into consideration.
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Affiliation(s)
- Nathalie Rippinger
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christine Fischer
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Hans-Peter Sinn
- Department of Pathology, University Hospital Heidelberg, Heidelberg, Germany
| | - Nicola Dikow
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Christian Sutter
- Institute of Human Genetics, University Hospital Heidelberg, Heidelberg, Germany
| | - Kerstin Rhiem
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany
| | - Sabine Grill
- Department of Gynecology and Centre for Hereditary Breast and Ovarian Cancer, Comprehensive Cancer Center (CCC TUM), University Hospital Rechts der Isar, Technical University of Munich (TUM), Munich, Germany
| | | | - Huu P Nguyen
- Institute of Medical Genetics and Applied Genomics, University Hospital of Tuebingen, Tuebingen, Germany.,Department of Human Genetics, University of Bochum, Bochum, Germany
| | - Nina Ditsch
- Department of Gynecology and Obstetrics, Ludwig-Maximilians University (LMU), University Hospital of Munich, Munich, Germany.,Department of Gynecology and Obstretrics, University Hospital Augsburg, Augsburg, Germany
| | - Karin Kast
- Center for Hereditary Breast and Ovarian Cancer, Center for Integrated Oncology (CIO), Medical Faculty, University Hospital Cologne, Cologne, Germany.,Department of Gynecology and Obstetrics, Medical Faculty, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany.,National Center for Tumour Diseases (NCT), Partner Site Dresden, Dresden, Germany
| | - Simone Hettmer
- Department of Paediatrics and Adolescent Medicine, Division of Paediatric Haematology and Oncology Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Christian P Kratz
- Paediatric Haematology and Oncology and Rare Disease Program, Hannover Medical School, Hannover, Germany
| | - Sarah Schott
- Department of Gynecology and Obstetrics, University Hospital Heidelberg, Heidelberg, Germany
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9
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Kim H, Choi DH, Park W. Germline BRCA Mutation and Clinical Outcomes in Breast Cancer Patients Focusing on Survival and Failure Patterns: A Long-Term Follow-Up Study of Koreans. Medicina (B Aires) 2020; 56:medicina56100514. [PMID: 33019612 PMCID: PMC7601388 DOI: 10.3390/medicina56100514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2020] [Revised: 09/29/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022] Open
Abstract
Background and Objectives: This study aimed to evaluate the effect of a BRCA mutation on survival and failure patterns, focusing on the risk of ipsilateral recurrence and contralateral breast cancer in patients. Materials and Methods: We retrospectively reviewed medical records of 300 patients with breast cancer who underwent genetic screening for BRCA1/2 genes and were treated at Samsung Medical Center between 1 January 2000 and 31 December 2010. Ultimately, clinical outcomes of 273 patients were analyzed. Results: The median follow-up duration was 102 months (range, 1 to 220 months). Patients with BRCA1/2-mutated tumors had a shorter 10-year disease-free survival (DFS) rate compared to those with non-mutated tumors (62.8% vs. 80.0%, p = 0.02). Regarding failure patterns, patients with BRCA1/2-mutated tumors showed a higher incidence of contralateral breast cancer than those with non-mutated tumors (BRCA1/2 non-mutated vs. mutated tumors: 4.9% vs. 26.0%, p < 0.001). BRCA mutation status remained a significant prognostic factor for contralateral breast recurrence-free survival (HR: 4.155; 95% CI: 1.789–9.652; p = 0.001). Korean patients with a BRCA mutation showed inferior DFS compared to those without a BRCA mutation. Conclusions: BRCA mutation status is a strong predictor of recurrence in contralateral breast cancer. Strategies such as prophylactic treatment and active surveillance should be discussed with breast cancer patients who have a BRCA mutation.
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Affiliation(s)
- Hakyoung Kim
- Department of Radiation Oncology, Korea University Guro Hospital, Korea University College of Medicine, Seoul 02841, Korea;
| | - Doo Ho Choi
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
- Correspondence: ; Tel.: +82-2-3410-2600; Fax: +82-2-3410-2619
| | - Won Park
- Department of Radiation Oncology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul 06351, Korea;
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10
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Aldawsari HM, Singh S. Rapid Microwave-Assisted Cisplatin-Loaded Solid Lipid Nanoparticles: Synthesis, Characterization and Anticancer Study. NANOMATERIALS 2020; 10:nano10030510. [PMID: 32168934 PMCID: PMC7153468 DOI: 10.3390/nano10030510] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/03/2020] [Revised: 02/24/2020] [Accepted: 03/01/2020] [Indexed: 11/16/2022]
Abstract
Cisplatin is one of the most leading potent chemotherapy drugs prescribed for the treatment of most solid tumors. However, the induction of toxicities and the development of resistance restricts its applications. Efforts are made in the proposed study to control the delivery of cisplatin to tumor sites by incorporating it into solid lipid nanoparticle (SLNs) drug carriers. By considering this fact, in the current research work, a single-step, one-pot, microwave-assisted technology was used to produce cisplatin-loaded SLNs. The shape of the SLNs was observed to be spherical, with a uniform size distribution of 74.85 nm, polydispersity index (PDI) of 0.311, and zeta potential of -20.8 mV. The percentage of encapsulation efficiency was found to be 71.85%. In vitro drug release study was calculated to be 80% in 24 h. The formulation in blood was found to be safe; a study of hemolysis confirmed this. Breast cancer cell line MCF-7 was used to test cytotoxicity and cellular interaction of cisplatin-loaded SLNs with an IC50 value of 6.51 ± 0.39 μg/mL. Overall, the results of our findings show that the approach of SLNs-based, cisplatin-based, drug delivery has led to increased sustainability in breast cancer therapy with superior biocompatibility.
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Affiliation(s)
- Hibah M. Aldawsari
- Department of Pharmaceutics, Faculty of Pharmacy, King Abdulaziz University, Jeddah 21589, Saudi Arabia
- Correspondence:
| | - Sima Singh
- Discipline of Pharmaceutical Sciences, College of Health Sciences, University of KwaZulu Natal, Durban 4000, South Africa;
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11
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Julien L, Genet J, Leymarie N, Honart JF, Rimareix F, Mazouni C, Kolb F, De Frémicourt K, Conversano A, Marchal F, Simon E, Brix M, Sarfati B. [Comparing outcomes of Immediate Breast reconstruction with and without use of radiotherapy]. ANN CHIR PLAST ESTH 2020; 65:181-197. [PMID: 32007227 DOI: 10.1016/j.anplas.2019.12.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2019] [Accepted: 12/05/2019] [Indexed: 10/25/2022]
Abstract
BACKGROUND Breast cancer and its treatment remains a public health problem. There is still a lack of epidemiological data concerning complications and aesthetic results bound to radiotherapy after an immediate breast reconstruction. The objective of this study was to compare outcomes of immediate breast reconstruction regardless to the use of radiotherapy (history of radiotherapy or adjuvant radiation therapy), in order to determine risk factor of complications and bad aesthetic results. METHODS We conducted a retrospective study between January 2014 and December 2016 at the hospital "Gustave Roussy" in Paris, concerning breast cancer patients who needed immediate breast reconstruction after total mastectomy. The primary endpoint was to assess the failure rate of reconstruction and the aesthetic result, the secondary endpoint assessed the early and late rate of complications. We realized a multivariate analysis in order to identify risks factors that may predict complications. RESULTS Three hundred and thirty three patients have been included: 157 in the "radiotherapy group" compared to 176 in the "no radiotherapy group". Preoperative characteristics were comparable. Average follow-up was between 1 and 3years without missing. Patients who benefited from radiotherapy had an equal risk failure of reconstruction. The subgroup analysis revealed non-significant differences: 12.7% failure rate reconstruction in the "radiotherapy group" vs. 12.5%. We could notify a better rate of "excellent results" in the "no radiotherapy group": 35% vs. 8.2%. Secondary outcomes were comparable. CONCLUSIONS Radiotherapy related to immediate breast reconstruction didn't increase the failure rate of reconstruction or aesthetic results, comparatively to non-irradiated patients. It is therefore permissible to suggest an immediate breast reconstruction to any patients which would benefit from a total mastectomy followed by radiotherapy; in order to prevent them from a secondary breast reconstruction, who could be physically and psychologically more impactful.
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Affiliation(s)
- L Julien
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France.
| | - J Genet
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - N Leymarie
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - J-F Honart
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Rimareix
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - C Mazouni
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Kolb
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - K De Frémicourt
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - A Conversano
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
| | - F Marchal
- Department of cancer surgery, institut de cancérologie de Lorraine, 54000 Vandoeuvre-les-Nancy, France
| | - E Simon
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - M Brix
- Department of plastic and maxillofacial surgery, hôpital Cenral, CHRU Nancy, 54000 Nancy, France
| | - B Sarfati
- Department of cancer surgery, institut de cancérologie Gustave-Roussy, 75000 Villejuif, France
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12
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Genetic Testing for Breast Cancer Susceptibility Should Be Offered before Unilateral Abdominally Based Free Flap Breast Reconstruction. Plast Reconstr Surg 2019; 144:12-20. [PMID: 31246791 DOI: 10.1097/prs.0000000000005693] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Pathogenic mutations have been identified in approximately 10 percent of patients who present with breast cancer. Notably, failure to identify deleterious genetic mutations has particular implications for patients undergoing abdominally based breast reconstruction, as the donor site can be used only once. The authors sought to determine: (1) how many patients underwent genetic testing before unilateral abdominally based free flap breast reconstruction; (2) how often deleterious mutations were detected after abdominally based free flap breast reconstruction; and (3) the cost-effectiveness of expanding genetic testing in this patient population. METHODS The authors retrospectively identified all patients who underwent unilateral abdominally based free flap breast reconstruction at Brigham and Women's Hospital/Dana-Farber Cancer Institute between 2007 and 2016. Chart review was performed to collect relevant demographic and clinical data. Relevant hospital financial data were obtained. RESULTS Of the 713 who underwent free flap breast reconstruction, 160 patients met inclusion criteria, and mean follow-up was 5.8 years. Three patients (1.9 percent of 160) underwent contralateral surgery after completing reconstruction, two of whom had BRCA2 and one with ATM mutation. One hundred eleven patients met National Comprehensive Cancer Network guidelines for genetic testing, but of those only 55.9 percent (62 patients) were tested. Financial data revealed that testing every patient in the cohort would result in a net savings of $262,000. CONCLUSIONS During a relatively short follow-up period, a small percentage of patients were diagnosed with pathogenic mutations and underwent contralateral mastectomy and reconstruction. However, because of the costliness of surgery and the decreased cost of genetic testing, it is cost-effective to test every patient before unilateral abdominally based free flap breast reconstruction.
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13
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Park S, Lim W, Song G. Chrysophanol selectively represses breast cancer cell growth by inducing reactive oxygen species production and endoplasmic reticulum stress via AKT and mitogen-activated protein kinase signal pathways. Toxicol Appl Pharmacol 2018; 360:201-211. [DOI: 10.1016/j.taap.2018.10.010] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2018] [Revised: 10/02/2018] [Accepted: 10/05/2018] [Indexed: 02/06/2023]
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14
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Song CV, Teo SH, Taib NA, Yip CH. Surgery for BRCA, TP53 and PALB2: a literature review. Ecancermedicalscience 2018; 12:863. [PMID: 30174725 PMCID: PMC6113980 DOI: 10.3332/ecancer.2018.863] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2018] [Indexed: 12/22/2022] Open
Abstract
Introduction The presence of a deleterious mutation, most commonly a BRCA mutation, has a tremendous impact on the management of breast cancer. We review the surgical management of BRCA mutation carriers, and two other potentially high-risk mutations, TP53 and PALB2. Methodology A search was done on PubMed, limited to reviews and the English language only. The search terms used were ‘BRCA’ or ‘PALB2’ or ‘TP53’ and ‘surgery’. Fifteen articles were identified by searching and one article was obtained from other sources. Results Breast-conserving surgery has equivalent survival, but may have an increased risk of local recurrence, compared to mastectomy among BRCA mutation carriers. Contralateral prophylactic mastectomy may not improve overall survival, despite reducing the risk of developing contralateral breast cancer. The use of preoperative genetic testing allows patients to have combined curative and prophylactic surgery. However, preoperative genetic testing may influence patients to make rash decisions. In healthy BRCA mutation carriers, bilateral prophylactic mastectomy is done to prevent breast cancer from occurring. Bilateral prophylactic mastectomy is highly effective in reducing the risk of breast cancer in healthy BRCA mutation-positive women and may have a survival benefit. Prophylactic oophorectomy reduces the risk of ovarian cancer, but may not have an effect on the risk of breast cancer. There is a lack of studies on surgery for non-BRCA mutations. TP53 and PALB2 are potentially high-risk mutations for breast cancer, which may justify the use of prophylactic surgery. Advice should be given on a case-by-case basis. Conclusion A comprehensive approach is needed to provide optimum treatment for breast cancer patients with deleterious mutations.
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Affiliation(s)
| | - Soo-Hwang Teo
- Cancer Research Malaysia, Subang Jaya 47500, Malaysia
| | | | - Cheng-Har Yip
- Ramsay Sime Darby Health Care, Subang Jaya 47500, Malaysia
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15
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Substantial evidence for the clinical significance of missense variant BRCA1 c.5309G>T p.(Gly1770Val). Breast Cancer Res Treat 2018; 172:497-503. [PMID: 30105462 DOI: 10.1007/s10549-018-4903-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2018] [Accepted: 07/24/2018] [Indexed: 02/07/2023]
Abstract
PURPOSE Classification of rare BRCA1 missense variants presents a major challenge for the counseling and treatment of patients. Variant classification can be complicated by conflicting lines of evidence. BRCA1 c.5309G>T p.(Gly1770Val) has been shown to abrogate BRCA1 protein homologous DNA repair; however, multiple sequence alignment demonstrates a lack of sequence conservation at this position, suggesting that glycine at position 1770 may not be essential for cellular maintenance in humans. We analyzed clinical information to resolve the classification of BRCA1 c.5309G>T p.(Gly1770Val). METHODS We performed multifactorial likelihood analysis combining segregation data for 14 informative families, and breast tumor histopathological data for 17 variant carriers, ascertained through the ENIGMA consortium. RESULTS Bayes segregation analysis gave a likelihood ratio of 101:1 in favor of pathogenicity. The vast majority of breast tumors showed features indicative of pathogenic variant carrier status, resulting in a likelihood ratio of 15800794:1 towards pathogenicity. Despite a low prior probability of pathogenicity (0.03) based on bioinformatic prediction, multifactorial likelihood analysis including segregation and histopathology analysis gave a posterior probability of > 0.99 and final classification of Pathogenic. CONCLUSIONS We provide evidence that BRCA1 c.5309G>T p.(Gly1770Val), previously described as a Moroccan founder variant, should be treated as a disease-causing variant despite a lack of evolutionary conservation at this amino acid position. Additionally, we stress that bioinformatic information should be used in combination with other data, either direct clinical evidence or some form of clinical calibration, to arrive at a final clinical classification.
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16
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Gemignani F, Mayhew PD, Giuffrida MA, Palaigos J, Runge JJ, Holt DE, Robertson NA, Seguin B, Walker M, Singh A, Liptak JM, Romanelli G, Martano M, Boston SE, Lux C, Busetto R, Culp WTN, Skorupski KA, Burton JH. Association of surgical approach with complication rate, progression-free survival time, and disease-specific survival time in cats with mammary adenocarcinoma: 107 cases (1991–2014). J Am Vet Med Assoc 2018; 252:1393-1402. [DOI: 10.2460/javma.252.11.1393] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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17
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Wang YA, Jian JW, Hung CF, Peng HP, Yang CF, Cheng HCS, Yang AS. Germline breast cancer susceptibility gene mutations and breast cancer outcomes. BMC Cancer 2018; 18:315. [PMID: 29566657 PMCID: PMC5863855 DOI: 10.1186/s12885-018-4229-5] [Citation(s) in RCA: 61] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2017] [Accepted: 03/15/2018] [Indexed: 01/07/2023] Open
Abstract
Background It is unclear whether germline breast cancer susceptibility gene mutations affect breast cancer related outcomes. We wanted to evaluate mutation patterns in 20 breast cancer susceptibility genes and correlate the mutations with clinical characteristics to determine the effects of these germline mutations on breast cancer prognosis. Methods The study cohort included 480 ethnic Chinese individuals in Taiwan with at least one of the six clinical risk factors for hereditary breast cancer: family history of breast or ovarian cancer, young age of onset for breast cancer, bilateral breast cancer, triple negative breast cancer, both breast and ovarian cancer, and male breast cancer. PCR-enriched amplicon-sequencing on a next generation sequencing platform was used to determine the germline DNA sequences of all exons and exon-flanking regions of the 20 genes. Protein-truncating variants were identified as pathogenic. Results We detected a 13.5% carrier rate of pathogenic germline mutations, with BRCA2 being the most prevalent and the non-BRCA genes accounting for 38.5% of the mutation carriers. BRCA mutation carriers were more likely to be diagnosed of breast cancer with lymph node involvement (66.7% vs 42.6%; P = 0.011), and had significantly worse breast cancer specific outcomes. The 5-year disease-free survival was 73.3% for BRCA mutation carriers and 91.1% for non-carriers (hazard ratio for recurrence or death 2.42, 95% CI 1.29–4.53; P = 0.013). After adjusting for clinical prognostic factors, BRCA mutation remained an independent poor prognostic factor for cancer recurrence or death (adjusted hazard ratio 3.04, 95% CI 1.40–6.58; P = 0.005). Non-BRCA gene mutation carriers did not exhibit any significant difference in cancer characteristics or outcomes compared to those without detected mutations. Among the risk factors for hereditary breast cancer, the odds of detecting a germline mutation increased significantly with having bilateral breast cancer (adjusted odds ratio 3.27, 95% CI 1.64–6.51; P = 0.0008) or having more than one risk factor (odds ratio 2.07, 95% CI 1.22–3.51; P = 0.007). Conclusions Without prior knowledge of the mutation status, BRCA mutation carriers had more advanced breast cancer on initial diagnosis and worse cancer-related outcomes. Optimal approach to breast cancer treatment for BRCA mutation carriers warrants further investigation. Electronic supplementary material The online version of this article (10.1186/s12885-018-4229-5) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Yong Alison Wang
- Department of Internal Medicine, Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan.
| | - Jhih-Wei Jian
- Genomic Research Center, Academia Sinica, Taipei, Taiwan.,Institute of Biomedical Informatics, National Yang-Ming University, Taipei, Taiwan.,Bioinformatics Program, Taiwan International Graduate Program, Institute of Information Science, Academia Sinica, Taipei, Taiwan
| | - Chen-Fang Hung
- Department of Research, Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan
| | - Hung-Pin Peng
- Genomic Research Center, Academia Sinica, Taipei, Taiwan
| | - Chi-Fan Yang
- Institute of Biomedical Sciences, Academia Sinica, Taipei, Taiwan
| | - Hung-Chun Skye Cheng
- Department of Research, Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan.,Department of Radiation Oncology, Koo Foundation Sun-Yat Sen Cancer Center, Taipei, Taiwan
| | - An-Suei Yang
- Genomic Research Center, Academia Sinica, Taipei, Taiwan.
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18
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Szymonowicz K, Oeck S, Malewicz NM, Jendrossek V. New Insights into Protein Kinase B/Akt Signaling: Role of Localized Akt Activation and Compartment-Specific Target Proteins for the Cellular Radiation Response. Cancers (Basel) 2018; 10:cancers10030078. [PMID: 29562639 PMCID: PMC5876653 DOI: 10.3390/cancers10030078] [Citation(s) in RCA: 91] [Impact Index Per Article: 13.0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2018] [Revised: 03/15/2018] [Accepted: 03/16/2018] [Indexed: 12/19/2022] Open
Abstract
Genetic alterations driving aberrant activation of the survival kinase Protein Kinase B (Akt) are observed with high frequency during malignant transformation and cancer progression. Oncogenic gene mutations coding for the upstream regulators or Akt, e.g., growth factor receptors, RAS and phosphatidylinositol-3-kinase (PI3K), or for one of the three Akt isoforms as well as loss of the tumor suppressor Phosphatase and Tensin Homolog on Chromosome Ten (PTEN) lead to constitutive activation of Akt. By activating Akt, these genetic alterations not only promote growth, proliferation and malignant behavior of cancer cells by phosphorylation of various downstream signaling molecules and signaling nodes but can also contribute to chemo- and radioresistance in many types of tumors. Here we review current knowledge on the mechanisms dictating Akt’s activation and target selection including the involvement of miRNAs and with focus on compartmentalization of the signaling network. Moreover, we discuss recent advances in the cross-talk with DNA damage response highlighting nuclear Akt target proteins with potential involvement in the regulation of DNA double strand break repair.
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Affiliation(s)
- Klaudia Szymonowicz
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen Medical School, 45122 Essen, Germany.
| | - Sebastian Oeck
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen Medical School, 45122 Essen, Germany.
- Department of Therapeutic Radiology, Yale University School of Medicine, New Haven, CT 06520, USA.
| | - Nathalie M Malewicz
- Department of Anesthesiology, Yale University School of Medicine, New Haven, CT 06520, USA.
| | - Verena Jendrossek
- Institute of Cell Biology (Cancer Research), University of Duisburg-Essen Medical School, 45122 Essen, Germany.
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Thibodeau ML, Reisle C, Zhao E, Martin LA, Alwelaie Y, Mungall KL, Ch'ng C, Thomas R, Ng T, Yip S, J Lim H, Sun S, Young SS, Karsan A, Zhao Y, Mungall AJ, Moore RA, J Renouf D, Gelmon K, Ma YP, Hayes M, Laskin J, Marra MA, Schrader KA, Jones SJM. Genomic profiling of pelvic genital type leiomyosarcoma in a woman with a germline CHEK2:c.1100delC mutation and a concomitant diagnosis of metastatic invasive ductal breast carcinoma. Cold Spring Harb Mol Case Stud 2017; 3:mcs.a001628. [PMID: 28514723 PMCID: PMC5593158 DOI: 10.1101/mcs.a001628] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2016] [Accepted: 04/14/2017] [Indexed: 12/19/2022] Open
Abstract
We describe a woman with the known pathogenic germline variant CHEK2:c.1100delC and synchronous diagnoses of both pelvic genital type leiomyosarcoma (LMS) and metastatic invasive ductal breast carcinoma. CHEK2 (checkpoint kinase 2) is a tumor-suppressor gene encoding a serine/threonine-protein kinase (CHEK2) involved in double-strand DNA break repair and cell cycle arrest. The CHEK2:c.1100delC variant is a moderate penetrance allele resulting in an approximately twofold increase in breast cancer risk. Whole-genome and whole-transcriptome sequencing were performed on the leiomyosarcoma and matched blood-derived DNA. Despite the presence of several genomic hits within the double-strand DNA damage pathway (CHEK2 germline variant and multiple RAD51B somatic structural variants), tumor profiling did not show an obvious DNA repair deficiency signature. However, even though the LMS displayed clear malignant features, its genomic profiling revealed several characteristics classically associated with leiomyomas including a translocation, t(12;14), with one breakpoint disrupting RAD51B and the other breakpoint upstream of HMGA2 with very high expression of HMGA2 and PLAG1. This is the first report of LMS genomic profiling in a patient with the germline CHEK2:c.1100delC variant and an additional diagnosis of metastatic invasive ductal breast carcinoma. We also describe a possible mechanistic relationship between leiomyoma and LMS based on genomic and transcriptome data. Our findings suggest that RAD51B translocation and HMGA2 overexpression may play an important role in LMS oncogenesis.
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Affiliation(s)
- My Linh Thibodeau
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada
| | - Caralyn Reisle
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Eric Zhao
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Lee Ann Martin
- Fraser Valley Cancer Centre, British Columbia Cancer Agency, Surrey, British Columbia V3V 1Z2, Canada
| | - Yazeed Alwelaie
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Karen L Mungall
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Carolyn Ch'ng
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Ruth Thomas
- Hereditary Cancer Program, British Columbia Cancer Agency-Abbotsford, Abbotsford, British Columbia V2S 0C2, Canada
| | - Tony Ng
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Stephen Yip
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada
| | - Howard J Lim
- British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Sophie Sun
- British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Sean S Young
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada.,Cancer Genetics Laboratory, Department of Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Aly Karsan
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada.,Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada.,Cancer Genetics Laboratory, Department of Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Yongjun Zhao
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Andrew J Mungall
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Richard A Moore
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Daniel J Renouf
- British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Karen Gelmon
- British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Yussanne P Ma
- Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Malcolm Hayes
- Department of Pathology and Laboratory Medicine, University of British Columbia, Vancouver, British Columbia V5Z 1M9, Canada.,Cancer Genetics Laboratory, Department of Pathology and Laboratory Medicine, British Columbia Cancer Agency, Vancouver, British Columbia V5Z 4E6, Canada
| | - Janessa Laskin
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada.,Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Marco A Marra
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada.,Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
| | - Kasmintan A Schrader
- Hereditary Cancer Program, Department of Medical Genetics, British Columbia Cancer Agency, 614-750 West Broadway, Vancouver British Columbia V5Z 1H5, Canada
| | - Steven J M Jones
- Department of Medical Genetics, University of British Columbia, Vancouver, British Columbia V6H 3N1, Canada.,Canada's Michael Smith Genome Sciences Centre, British Columbia Cancer Agency, British Columbia V5Z 4S6, Canada
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20
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Plöthner M, Frank M, Graf von der Schulenburg JM. [Whole-genome sequencing in German clinical practice : Economic impacts of its use in selected areas of application]. Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 2017; 60:143-150. [PMID: 27999872 DOI: 10.1007/s00103-016-2492-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
BACKGROUND The diagnostic use of whole-genome sequencing (WGS) is a growing issue in medical care. Due to limited resources in public health service, budget-impact analyses are necessary prior to implementation. OBJECTIVE A budget-impact analysis for WGS of all newborns and diagnostic investigation of tumor patients in different oncologic indications were evaluated. METHODS A cost analysis of WGS based on a quality-assured process chart for WGS at the German Cancer Research Center (DKFZ), Heidelberg, constitutes the basis for this evaluation. Data from the National Association of Statutory Health Insurance Funds and the Robert-Koch-Institute, Berlin, were used for calculations of specific clinical applications. RESULTS AND DISCUSSION WGS in newborn screening leads to costs of € 2.85 bn and to an increase of total expenditure by 1.41%. Sequencing of all tumor patients would cost approximately € 0.84 bn, which corresponds to 0.42% of total expenditures. In all scenarios, the sole consideration of procedure costs results in increasing costs. However, in cost discussions potential savings (reduction of disease-related follow-up-costs, improved cost-effectiveness of medical measures etc.) should be considered. Such considerations are the subject of economic indication-specific evaluations. WGS has the potential to generate a large number of deterministic findings for which treatment options are limited. Hence, it is necessary to limit indications, in which WGS has proven medical evidence.
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Affiliation(s)
- Marika Plöthner
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Deutschland.
| | - Martin Frank
- Center for Health Economics Research Hannover (CHERH), Leibniz University Hannover, Otto-Brenner-Straße 1, 30159, Hannover, Deutschland
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21
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Abstract
Identifying germline BRCA pathogenic mutations in patients with ovarian or breast cancer is a crucial component in the medical management of affected patients. Furthermore, the relatives of affected patients can be offered genetic testing. Relatives who test positive for a germline BRCA pathogenic mutation can take appropriate action to prevent cancer or have cancer diagnosed as early as possible for better treatment options. The recent discovery that BRCA pathogenic mutation status can inform treatment decisions in patients with ovarian cancer has led to an increased demand for BRCA testing, with testing taking place earlier in the patient care pathway. New approaches to genetic counselling may be required to meet this greater demand for BRCA testing. This review discusses the need for best practices for genetic counselling and BRCA testing; it examines the challenges facing current practice and looks at adapted models of genetic counselling.
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Makris GM, Marinelis A, Battista MJ, Chrelias C, Papantoniou N. An ovarian mass after breast cancer: Metachronous carcinoma or metastasis? A case report. Int J Surg Case Rep 2016; 31:106-108. [PMID: 28129608 PMCID: PMC5266487 DOI: 10.1016/j.ijscr.2016.12.022] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2016] [Accepted: 12/28/2016] [Indexed: 01/02/2023] Open
Abstract
In the presence of an ovarian mass after breast cancer, differentiating between primary and secondary lesions can be a difficult task. This case report presents a 45-year-old patient with an ovarian mass two years after the diagnosis of breast cancer. Imaging, histology and predominantly immunohistochemistry may provide valuable tools in the assessment of ambiguous cases. Differences in the immunohistochemical profile of primary tumor and metastases should be anticipated.
Introduction Differentiating between primary and secondary ovarian cancer can be a difficult task. In hereditary conditions breast malignancies and primary ovarian cancer often coexist. Presentation of case We present a 45-year-old patient with an ovarian mass two years after the diagnosis of a lobular, triple negative breast carcinoma. There was concern whether the lesion represented a metachronous ovarian cancer or a metastasis of the lobular carcinoma. The final histological examination showed a metastatic lesion, deriving from the lobular breast carcinoma, as evidenced by the immunohistochemical profile; nevertheless, there were changes in hormonal receptor expression in the metastatic lesion compared to the primary, triple negative tumor. The patient underwent genetic testing for BRCA1 and BRCA2 mutations and was negative. In the adjuvant setting the patient received 6 cycles of chemotherapy with carboplatin and paclitaxel; eighteen months later, the patient remains without disease recurrence. Discussion and conclusion This case report highlights the role of imaging, histology and predominantly immunohistochemistry as valuable tools in the assessment of ambiguous ovarian lesions after breast cancer.
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Affiliation(s)
- Georgios-Marios Makris
- Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece; Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece.
| | - Alexandros Marinelis
- Department of Obstetrics and Gynecology, Athens Euroclinic Hospital, Athens Greece
| | | | - Charalampos Chrelias
- Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece
| | - Nikolaos Papantoniou
- Gynecological Oncology Unit, Third Department of Obstetrics and Gynecology, General University Hospital "Attikon", University of Athens, Athens, Greece
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23
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Sedghi M, Esfandiari E, Fazel-Najafabadi E, Salehi M, Salavaty A, Fattahpour S, Dehghani L, Nouri N, Mokarian F. Genomic rearrangement screening of the BRCA1 from seventy Iranian high-risk breast cancer families. JOURNAL OF RESEARCH IN MEDICAL SCIENCES 2016; 21:95. [PMID: 28163741 PMCID: PMC5244654 DOI: 10.4103/1735-1995.193167] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/04/2016] [Revised: 06/01/2016] [Accepted: 07/01/2016] [Indexed: 01/23/2023]
Abstract
Background: The second leading cause of cancer deaths in women is breast cancer. Germline mutations in susceptibility breast cancer gene BRCA1 increase the lifetime risk of breast cancer. Eighty-one large genomic rearrangements (LGRs) have been reported up to date in BRCA1 gene, and evaluation of these rearrangements helps with precise risk assessment in high-risk individuals. In this study, we have investigated LGRs in BRCA1 among Iranian high-risk breast cancer families. Materials and Methods: Seventy patients with breast cancer who were identified negative for point mutations or small deletions/insertions of BRCA1 gene were selected. Deletions and duplications of BRCA1 gene were evaluated using multiplex ligation-dependent probe amplification (MLPA). Results: Two deletions, deletion of exons 1A/1B-2 and exon 24, were detected in two patients with breast cancer. The former alteration was found in a woman with a strong family history of breast cancer while the latter one was detected in a woman with early onset of breast cancer. Conclusion: Although our data confirm that LGRs in BRCA1 comprise a relatively small proportion of mutations in hereditary breast cancer in the Iranian population, MLPA analysis might be considered for screening of LGRs in high-risk individuals. It is worth to note that our results are consistent with previous studies in various Asian and European countries.
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Affiliation(s)
- Maryam Sedghi
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elham Esfandiari
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Esmat Fazel-Najafabadi
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mansoor Salehi
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Division of Genetics and Molecular Biology, Medical School, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbas Salavaty
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Shirin Fattahpour
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Leila Dehghani
- Department of Advanced Technologies in Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran; Isfahan Neurosciences Research Center, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nayerossadat Nouri
- Medical Genetics Laboratory, Alzahra University Hospital, Isfahan University of Medical Sciences, Isfahan, Iran; Pediatric Inherited Diseases Research Center, Research Institute for Primordial Prevention of Non-communicable Disease, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fariborz Mokarian
- Department of Oncology, Isfahan University of Medical Sciences, Isfahan, Iran
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24
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Hurtado-de-Mendoza A, Jackson MC, Anderson L, Sheppard VB. The Role of Knowledge on Genetic Counseling and Testing in Black Cancer Survivors at Increased Risk of Carrying a BRCA1/2 Mutation. J Genet Couns 2016; 26:113-121. [PMID: 27402168 DOI: 10.1007/s10897-016-9986-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2015] [Accepted: 06/02/2016] [Indexed: 10/21/2022]
Abstract
Genetic counseling and testing (GCT) for hereditary breast and ovarian cancers (HBOC) can inform treatment decisions in survivors. Black women at risk of HBOC have lower GCT engagement. There is limited data about Black survivors' experiences. The goals of this study were to: 1) examine the factors associated with HBOC knowledge and 2) assess the impact of knowledge on GCT engagement in a sample of Black survivors at risk of HBOC. Fifty Black at-risk breast/ovarian cancer survivors participated in a telephone-based survey. GCT use was measured across a continuum (awareness, referral, and use). The primary predictor variable was HBOC knowledge. Other clinical, socio-demographic, and psychosocial variables were included. Multiple linear and ordinal regression models (knowledge as the outcome and GCT as the outcome) assessed the predictors of knowledge and GCT engagement. Less than half (48 %) of survivors were referred to or used GCT services. Knowledge was moderate (M = 7.78, SD = 1.61). In the multivariable analysis, lower age (β = -.34, p = .01) and lower stage (β = -.318, p = .017) were associated with higher knowledge. Higher knowledge (β = .567, p = .006) and higher self-efficacy (β = .406, p = .001) were significantly associated with GCT engagement. Future interventions directed at increasing knowledge, self-efficacy, and improving the referral process are warranted.
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Affiliation(s)
- Alejandra Hurtado-de-Mendoza
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven St. NW, Suite 4100, Washington, DC, 20007, USA.
| | - Monica C Jackson
- Department of Mathematics and Statistics, American University, Washington, DC, USA
| | - Lyndsay Anderson
- Capital Breast Care Center, MedStar Georgetown University Hospital/Lombardi Comprehensive Cancer Center, Washington, DC, USA
| | - Vanessa B Sheppard
- Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, 3300 Whitehaven St. NW, Suite 4100, Washington, DC, 20007, USA
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25
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Chiang HC, Elledge R, Larson P, Jatoi I, Li R, Hu Y. Effects of Radiation Therapy on Breast Epithelial Cells in BRCA1/2 Mutation Carriers. BREAST CANCER-BASIC AND CLINICAL RESEARCH 2015; 9:25-9. [PMID: 26052229 PMCID: PMC4454133 DOI: 10.4137/bcbcr.s26774] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/31/2015] [Revised: 04/27/2015] [Accepted: 04/29/2015] [Indexed: 12/12/2022]
Abstract
Women carrying BRCA1 and BRCA2 mutations have significantly elevated risk of developing breast and ovarian cancers. BRCA1-associated breast cancer likely originates from progenitors of the luminal epithelial lineage. Recent studies indicate that radiation therapy (RT) for BRCA1 cancer patients is associated with lower incidence of developing subsequent ipsilateral breast cancer. In the current study, we analyzed tumor-free breast tissue procured via prophylactic bilateral mastectomy from three BRCA1 and one BRCA2 mutation carriers, who had been previously treated with RT for unilateral breast cancers. Freshly isolated breast cells from the irradiated and nonirradiated breast tissue of the same individuals were subjected to flow cytometry, using established cell-surface markers. Two out of the three BRCA1 carriers and one BRCA2 carrier exhibited significantly diminished luminal cell population in the irradiated breast versus the nonirradiated side. There was also RT-associated reduction in the colony-forming ability of the breast epithelial cells. Our finding suggests that prior RT could result in the depletion of the luminal epithelial compartment and thus reduced incidence of BRCA1/2-associated breast cancer.
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Affiliation(s)
- Huai-Chin Chiang
- Department of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Richard Elledge
- Department of Medicine, Cancer Therapy and Research Center, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Paula Larson
- Methodist Healthcare System, San Antonio, TX, USA
| | - Ismail Jatoi
- Division of Surgical Oncology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Rong Li
- Department of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
| | - Yanfen Hu
- Department of Molecular Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA
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26
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Second primary breast cancer in BRCA1 and BRCA2 mutation carriers: 10-year cumulative incidence in the Breast Cancer Family Registry. Breast Cancer Res Treat 2015; 151:653-60. [PMID: 25975955 DOI: 10.1007/s10549-015-3419-y] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2015] [Accepted: 05/06/2015] [Indexed: 10/23/2022]
Abstract
BReast CAncer genes 1 and 2 (BRCA1 and BRCA2) mutation carriers diagnosed with breast cancer are at increased risk of developing a second primary breast cancer. Data from high-risk clinics may be subject to different biases which can cause both over and underestimation of this risk. Using data from a large multi-institutional family registry we estimated the 10-year cumulative risk of second primary breast cancer including more complete testing information on family members. We prospectively followed 800 women diagnosed with breast cancer from the Breast Cancer Family Registry (BCFR) who were carriers of a BRCA1 or BRCA2 pathogenic mutation or a variant of unknown clinical significance. In order to limit survival and ascertainment bias, cases were limited to those diagnosed with a first primary breast cancer from 1994 to 2001 and enrolled in the BCFR within 3 years after their cancer diagnosis. We excluded women enrolled after being diagnosed with a second breast cancer. We calculated 10-year incidence of second primary breast cancers. The 10-year incidence of a second primary breast cancer was highest in BRCA1 mutation carriers (17 %; 95 % CI 11-25 %), with even higher estimates in those first diagnosed under the age of 40 (21 %; 95 % CI 13-34 %). Lower rates were found in BRCA2 mutation carriers (7 %; 95 % CI 3-15 %) and women with a variant of unknown clinical significance (6 %; 95 % CI 4-9 %). Whereas the cumulative 10-year incidence of second primary breast cancer is high in BRCA1 mutation carriers, the estimates in BRCA2 mutation carriers and women with variants of unknown clinical significance are similar to those reported in women with sporadic breast cancer.
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27
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Legislation in the genomic era: the Affordable Care Act and genetic testing for cancer risk assessment. Genet Med 2015; 17:962-4. [PMID: 25741860 DOI: 10.1038/gim.2015.18] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2014] [Accepted: 01/19/2015] [Indexed: 11/08/2022] Open
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Berbers J, van Baardwijk A, Houben R, Heuts E, Smidt M, Keymeulen K, Bessems M, Tuinder S, Boersma LJ. ‘Reconstruction: Before or after postmastectomy radiotherapy?’ A systematic review of the literature. Eur J Cancer 2014; 50:2752-62. [DOI: 10.1016/j.ejca.2014.07.023] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2014] [Revised: 07/10/2014] [Accepted: 07/30/2014] [Indexed: 11/27/2022]
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29
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Darbre PD, Mannello F, Exley C. Aluminium and breast cancer: Sources of exposure, tissue measurements and mechanisms of toxicological actions on breast biology. J Inorg Biochem 2013; 128:257-61. [DOI: 10.1016/j.jinorgbio.2013.07.005] [Citation(s) in RCA: 60] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2013] [Revised: 07/01/2013] [Accepted: 07/07/2013] [Indexed: 12/16/2022]
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30
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Lang KA. Genetic counseling for breast cancer risk: how did we get here and where are we going? Expert Rev Mol Diagn 2013; 13:541-51. [PMID: 23895125 DOI: 10.1586/14737159.2013.811903] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
Genetic counselors have been helping patients navigate hereditary cancer risk for decades. The rapidly changing landscape of genetic testing options means the field is again at a unique time in its history. Fears that arose when BRCA testing first became available are again being voiced in light of next-generation sequencing. The origins of genetic counseling, best practices, and recommendations that have come about since those early days need to be well understood before these new challenges can be met. The role of a proper risk assessment in preventing adverse outcomes is vital as options for testing change. In addition, an understanding of how various countries have incorporated genetic testing and genetic counseling into their healthcare systems can provide lessons in moving forward and capitalizing on the new technology that is again creating a genetics revolution.
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Affiliation(s)
- Katherine Af Lang
- Northside Hospital Cancer Institute, 1000 Johnson Ferry Rd NE, Atlanta, GA 30342, USA.
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31
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Ren J, Jin F, Yu Z, Zhao L, Wang L, Bai X, Zhao H, Yao W, Mi X, Wang E, Olopade OI, Wei M. MYC overexpression and poor prognosis in sporadic breast cancer with BRCA1 deficiency. Tumour Biol 2013; 34:3945-58. [PMID: 23860775 DOI: 10.1007/s13277-013-0983-9] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2013] [Accepted: 06/26/2013] [Indexed: 12/31/2022] Open
Abstract
Breast cancer is a complex disease; the molecular mechanisms involved in sporadic breast carcinogenesis remain to be elucidated. The present study aimed to explore the deficiency of breast cancer susceptibility gene 1 (BRCA1), including protein loss expression, promoter hypermethylation and gene copy deletion, its correlationship with other tumor markers expression (TP53, MYC, etc.), and clinical significance in sporadic breast cancer. BRCA1 protein expression was negative in 226 of 374 (60.4%) cases of this study. Cases negative for BRCA1 protein were more often with pathological tumor-node-metastasis stage III, positive for lymph node metastasis and MYC overexpression than BRCA1-positive tumors. BRCA1 hypermethylation was detected in 16.4% (31 of 189) breast cancers, which correlated with BRCA1 negative, ER negative, MYC overexpression, and triple-negative phenotype. In addition, the percentage of cells with BRCA1 gene copy deletion was significantly increased in BRCA1-methylated tumors. Kaplan-Meier survival analysis showed that patients with BRCA1-negative expression showed a worse overall survival (OS) than those with BRCA1-positive expression, and patients with BRCA1-methylated tumors had a significantly worse disease-free survival than did patients with unmethylated tumors. Furthermore, BRCA1 hypermethylation showed an inverse association with OS in LN-positive or p53-negative subgroup patients. Importantly, uni- and multivariate Cox regression analyses revealed that BRCA1 was an independent prognostic indicator of OS in sporadic breast cancer. Thus, we found MYC overexpression and poor prognosis in sporadic breast cancer with BRCA1 deficiency. The targeting of BRCA1 deficiency in combination with MYC-pathways inhibitors may provide a promising strategy for sporadic breast cancer care, the triple-negative subtype in particular.
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Affiliation(s)
- Jie Ren
- Department of Pharmacology, College of Pharmaceutical Sciences, China Medical University, Shenyang, 110001, Liaoning, People's Republic of China
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Kobayashi H, Ohno S, Sasaki Y, Matsuura M. Hereditary breast and ovarian cancer susceptibility genes (review). Oncol Rep 2013; 30:1019-29. [PMID: 23779253 DOI: 10.3892/or.2013.2541] [Citation(s) in RCA: 108] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2013] [Accepted: 05/20/2013] [Indexed: 11/06/2022] Open
Abstract
Women with hereditary breast and ovarian cancer (HBOC) syndrome represent a unique group who are diagnosed at a younger age and result in an increased lifetime risk for developing breast, ovarian and other cancers. This review integrates recent progress and insights into the molecular basis that underlie the HBOC syndrome. A review of English language literature was performed by searching MEDLINE published between January 1994 and October 2012. Mutations and common sequence variants in the BRCA1 and BRCA2 (BRCA) genes are responsible for the majority of HBOC syndrome. Lifetime cancer risks in BRCA mutation carriers are 60-80% for breast cancer and 20-40% for ovarian cancer. Mutations in BRCA genes cannot account for all cases of HBOC, indicating that the remaining cases can be attributed to the involvement of constitutive epimutations or other cancer susceptibility genes, which include Fanconi anemia (FA) cluster (FANCD2, FANCA and FANCC), mismatch repair (MMR) cluster (MLH1, MSH2, PMS1, PMS2 and MSH6), DNA repair cluster (ATM, ATR and CHK1/2), and tumor suppressor cluster (TP53, SKT11 and PTEN). Sporadic breast cancers with TP53 mutations or epigenetic silencing (hypermethylation), ER- and PgR-negative status, an earlier age of onset and high tumor grade resemble phenotypically BRCA1 mutated cancers termed 'BRCAness', those with no BRCA mutations but with a dysfunction of the DNA repair system. In conclusion, genetic or epigenetic loss-of-function mutations of genes that are known to be involved in the repair of DNA damage may lead to increased risk of developing a broad spectrum of breast and ovarian cancers.
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Affiliation(s)
- Hiroshi Kobayashi
- Department of Obstetrics and Gynecology, Nara Medical University, Kashihara, Nara 634-8522, Japan
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Underestimated survival predictions of the prognostic tools Adjuvant! Online and PREDICT in BRCA1-associated breast cancer patients. Fam Cancer 2013; 12:683-9. [DOI: 10.1007/s10689-013-9646-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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