1
|
Sun X, Reiner AS, Tran AP, Watt GP, Oh JH, Mellemkjær L, Lynch CF, Knight JA, John EM, Malone KE, Liang X, Woods M, Derkach A, Concannon P, Bernstein JL, Shu X. A genome-wide association study of contralateral breast cancer in the Women's Environmental Cancer and Radiation Epidemiology Study. Breast Cancer Res 2024; 26:16. [PMID: 38263039 PMCID: PMC10807183 DOI: 10.1186/s13058-024-01765-1] [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: 09/30/2023] [Accepted: 01/06/2024] [Indexed: 01/25/2024] Open
Abstract
BACKGROUND Contralateral breast cancer (CBC) is the most common second primary cancer diagnosed in breast cancer survivors, yet the understanding of the genetic susceptibility of CBC, particularly with respect to common variants, remains incomplete. This study aimed to investigate the genetic basis of CBC to better understand this malignancy. FINDINGS We performed a genome-wide association analysis in the Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study of women with first breast cancer diagnosed at age < 55 years including 1161 with CBC who served as cases and 1668 with unilateral breast cancer (UBC) who served as controls. We observed two loci (rs59657211, 9q32, SLC31A2/FAM225A and rs3815096, 6p22.1, TRIM31) with suggestive genome-wide significant associations (P < 1 × 10-6). We also found an increased risk of CBC associated with a breast cancer-specific polygenic risk score (PRS) comprised of 239 known breast cancer susceptibility single nucleotide polymorphisms (SNPs) (rate ratio per 1-SD change: 1.25; 95% confidence interval 1.14-1.36, P < 0.0001). The protective effect of chemotherapy on CBC risk was statistically significant only among patients with an elevated PRS (Pheterogeneity = 0.04). The AUC that included the PRS and known breast cancer risk factors was significantly elevated. CONCLUSIONS The present GWAS identified two previously unreported loci with suggestive genome-wide significance. We also confirm that an elevated risk of CBC is associated with a comprehensive breast cancer susceptibility PRS that is independent of known breast cancer risk factors. These findings advance our understanding of genetic risk factors involved in CBC etiology.
Collapse
Affiliation(s)
- Xiaohui Sun
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
- Department of Epidemiology, Zhejiang Chinese Medical University, Zhejiang, China
| | - Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Anh Phong Tran
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Gordon P Watt
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Lene Mellemkjær
- Diet, Cancer and Health, Danish Cancer Institute, Strandboulevarden 49, 2100, Copenhagen, Denmark
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa College of Public Health, Iowa City, IA, 52242, USA
| | - Julia A Knight
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA, USA
- Department of Medicine, Division of Oncology, Stanford University School of Medicine, Stanford, CA, USA
| | - Kathleen E Malone
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Xiaolin Liang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Meghan Woods
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Andriy Derkach
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Patrick Concannon
- Department of Pathology, Immunology and Laboratory Medicine, Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA
| | - Xiang Shu
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, 10017, USA.
| |
Collapse
|
2
|
Watt GP, Smith SA, Howell RM, Pérez-Andújar A, Reiner AS, Cerviño L, McCormick B, Hess D, Knight JA, Malone KE, John EM, Bernstein L, Lynch CF, Mellemkjær L, Shore RE, Liang X, Woods M, Boice JD, Dauer LT, Bernstein JL. Trends in Radiation Dose to the Contralateral Breast During Breast Cancer Radiation Therapy. Radiat Res 2023; 200:331-339. [PMID: 37590492 PMCID: PMC10684055 DOI: 10.1667/rade-23-00014.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/31/2023] [Indexed: 08/19/2023]
Abstract
Over 4 million survivors of breast cancer live in the United States, 35% of whom were treated before 2009. Approximately half of patients with breast cancer receive radiation therapy, which exposes the untreated contralateral breast to radiation and increases the risk of a subsequent contralateral breast cancer (CBC). Radiation oncology has strived to reduce unwanted radiation dose, but it is unknown whether a corresponding decline in actual dose received to the untreated contralateral breast has occurred. The purpose of this study was to evaluate trends in unwanted contralateral breast radiation dose to inform risk assessment of second primary cancer in the contralateral breast for long-term survivors of breast cancer. Individually estimated radiation absorbed doses to the four quadrants and areola central area of the contralateral breast were estimated for 2,132 women treated with radiation therapy for local/regional breast cancers at age <55 years diagnosed between 1985 and 2008. The two inner quadrant doses and two outer quadrant doses were averaged. Trends in dose to each of the three areas of the contralateral breast were evaluated in multivariable models. The population impact of reducing contralateral breast dose on the incidence of radiation-associated CBC was assessed by estimating population attributable risk fraction (PAR) in a multivariable model. The median dose to the inner quadrants of the contralateral breast was 1.70 Gy; to the areola, 1.20 Gy; and to the outer quadrants, 0.72 Gy. Ninety-two percent of patients received ≥1 Gy to the inner quadrants. For each calendar year of diagnosis, dose declined significantly for each location, most rapidly for the inner quadrants (0.04 Gy/year). Declines in dose were similar across subgroups defined by age at diagnosis and body mass index. The PAR for CBC due to radiation exposure >1 Gy for women <40 years of age was 17%. Radiation dose-reduction measures have reduced dose to the contralateral breast during breast radiation therapy. Reducing the dose to the contralateral breast to <1 Gy could prevent an estimated 17% of subsequent radiation-associated CBCs for women treated under 40 years of age. These dose estimates inform CBC surveillance for the growing number of breast cancer survivors who received radiation therapy as young women in recent decades. Continued reductions in dose to the contralateral breast could further reduce the incidence of radiation-associated CBC.
Collapse
Affiliation(s)
- Gordon P. Watt
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan A. Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Rebecca M. Howell
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | - Anne S. Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Beryl McCormick
- Department of Radiation Oncology, Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health, University of Toronto, Ontario, Canada
| | - Kathleen E. Malone
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, Washington
| | - Esther M. John
- Departments of Epidemiology & Population Health and of Medicine, Stanford University School of Medicine, Stanford, California
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, California
| | | | | | - Roy E. Shore
- Department of Population Health, New York University Grossman School of Medicine, New York, New York
| | - Xiaolin Liang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Meghan Woods
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| | - John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, Maryland
- Department of Medicine, Vanderbilt University, Nashville, Tennessee
| | | | - Jonine L. Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York
| |
Collapse
|
3
|
Boutry S, Helaers R, Lenaerts T, Vikkula M. Rare variant association on unrelated individuals in case-control studies using aggregation tests: existing methods and current limitations. Brief Bioinform 2023; 24:bbad412. [PMID: 37974506 DOI: 10.1093/bib/bbad412] [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: 02/14/2023] [Revised: 10/14/2023] [Accepted: 10/28/2023] [Indexed: 11/19/2023] Open
Abstract
Over the past years, progress made in next-generation sequencing technologies and bioinformatics have sparked a surge in association studies. Especially, genome-wide association studies (GWASs) have demonstrated their effectiveness in identifying disease associations with common genetic variants. Yet, rare variants can contribute to additional disease risk or trait heterogeneity. Because GWASs are underpowered for detecting association with such variants, numerous statistical methods have been recently proposed. Aggregation tests collapse multiple rare variants within a genetic region (e.g. gene, gene set, genomic loci) to test for association. An increasing number of studies using such methods successfully identified trait-associated rare variants and led to a better understanding of the underlying disease mechanism. In this review, we compare existing aggregation tests, their statistical features and scope of application, splitting them into the five classical classes: burden, adaptive burden, variance-component, omnibus and other. Finally, we describe some limitations of current aggregation tests, highlighting potential direction for further investigations.
Collapse
Affiliation(s)
- Simon Boutry
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74 (+5) bte B1.74.06, 1200 Brussels, Belgium
- Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles-Vrije Universiteit Brussels, 1050 Brussels, Belgium
| | - Raphaël Helaers
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74 (+5) bte B1.74.06, 1200 Brussels, Belgium
| | - Tom Lenaerts
- Interuniversity Institute of Bioinformatics in Brussels, Université Libre de Bruxelles-Vrije Universiteit Brussels, 1050 Brussels, Belgium
- Machine Learning Group, Université Libre de Bruxelles, 1050 Brussels, Belgium
- Artificial Intelligence laboratory, Vrije Universiteit Brussel, 1050 Brussels, Belgium
| | - Miikka Vikkula
- Human Molecular Genetics, de Duve Institute, University of Louvain, Avenue Hippocrate 74 (+5) bte B1.74.06, 1200 Brussels, Belgium
- WELBIO department, WEL Research Institute, avenue Pasteur, 6, 1300 Wavre, Belgium
| |
Collapse
|
4
|
Larionov A, Fewings E, Redman J, Goldgraben M, Clark G, Boice J, Concannon P, Bernstein J, Conti DV, Tischkowitz M. The Contribution of Germline Pathogenic Variants in Breast Cancer Genes to Contralateral Breast Cancer Risk in BRCA1/BRCA2/PALB2-Negative Women. Cancers (Basel) 2023; 15:cancers15020415. [PMID: 36672364 PMCID: PMC9856968 DOI: 10.3390/cancers15020415] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 12/27/2022] [Accepted: 01/03/2023] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Contralateral breast cancer (CBC) is associated with younger age at first diagnosis, family history and pathogenic germline variants (PGVs) in genes such as BRCA1, BRCA2 and PALB2. However, data regarding genetic factors predisposing to CBC among younger women who are BRCA1/2/PALB2-negative remain limited. METHODS In this nested case-control study, participants negative for BRCA1/2/PALB2 PGVs were selected from the WECARE Study. The burden of PGVs in established breast cancer risk genes was compared in 357 cases with CBC and 366 matched controls with unilateral breast cancer (UBC). The samples were sequenced in two phases. Whole exome sequencing was used in Group 1, 162 CBC and 172 UBC (mean age at diagnosis: 42 years). A targeted panel of genes was used in Group 2, 195 CBC and 194 UBC (mean age at diagnosis: 50 years). Comparisons of PGVs burdens between CBC and UBC were made in these groups, and additional stratified sub-analysis was performed within each group according to the age at diagnosis and the time from first breast cancer (BC). RESULTS The PGVs burden in Group 1 was significantly higher in CBC than in UBC (p = 0.002, OR = 2.5, 95CI: 1.2-5.6), driven mainly by variants in CHEK2 and ATM. The proportions of PGVs carriers in CBC and UBC in this group were 14.8% and 5.8%, respectively. There was no significant difference in PGVs burden between CBC and UBC in Group 2 (p = 0.4, OR = 1.4, 95CI: 0.7-2.8), with proportions of carriers being 8.7% and 8.2%, respectively. There was a significant association of PGVs in CBC with younger age. Metanalysis combining both groups confirmed the significant association between the burden of PGVs and the risk of CBC (p = 0.006) with the significance driven by the younger cases (Group 1). CONCLUSION In younger BRCA1/BRCA2/PALB2-negative women, the aggregated burden of PGVs in breast cancer risk genes was associated with the increased risk of CBC and was inversely proportional to the age at onset.
Collapse
Affiliation(s)
- Alexey Larionov
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
- School of Water, Energy and Environment, Cranfield University, Cranfield, Bedford MK43 0AL, UK
- Correspondence: (A.L.); (M.T.)
| | - Eleanor Fewings
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
| | - James Redman
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
| | - Mae Goldgraben
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
| | - Graeme Clark
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
| | - John Boice
- Division of Epidemiology, Department of Medicine, Vanderbilt University Medical Center, Nashville, TN 37232, USA
| | - Patrick Concannon
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL 32610, USA
| | - Jonine Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA
| | - David V. Conti
- Division of Biostatistics, Department of Population and Public Health Sciences, University of Southern California, Los Angeles, CA 90032, USA
| | | | - Marc Tischkowitz
- Department of Medical Genetics, National Institute for Health Research Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, Cambridge CB2 0QQ, UK
- Correspondence: (A.L.); (M.T.)
| |
Collapse
|
5
|
Watt GP, Knight JA, Nguyen TL, Reiner AS, Malone KE, John EM, Lynch CF, Brooks JD, Woods M, Liang X, Bernstein L, Pike MC, Hopper JL, Bernstein JL. Association of contralateral breast cancer risk with mammographic density defined at higher-than-conventional intensity thresholds. Int J Cancer 2022; 151:1304-1309. [PMID: 35315524 PMCID: PMC9420749 DOI: 10.1002/ijc.34001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/25/2022] [Accepted: 03/04/2022] [Indexed: 11/06/2022]
Abstract
Mammographic dense area (MDA) is an established predictor of future breast cancer risk. Recent studies have found that risk prediction might be improved by redefining MDA in effect at higher-than-conventional intensity thresholds. We assessed whether such higher-intensity MDA measures gave stronger prediction of subsequent contralateral breast cancer (CBC) risk using the Women's Environment, Cancer, and Radiation Epidemiology (WECARE) Study, a population-based CBC case-control study of ≥1 year survivors of unilateral breast cancer diagnosed between 1990 and 2008. Three measures of MDA for the unaffected contralateral breast were made at the conventional intensity threshold ("Cumulus") and at two sequentially higher-intensity thresholds ("Altocumulus" and "Cirrocumulus") using the CUMULUS software and mammograms taken up to 3 years prior to the first breast cancer diagnosis. The measures were fitted separately and together in multivariable-adjusted logistic regression models of CBC (252 CBC cases and 271 unilateral breast cancer controls). The strongest association with CBC was MDA defined using the highest intensity threshold, Cirrocumulus (odds ratio per adjusted SD [OPERA] 1.40, 95% CI 1.13-1.73); and the weakest association was MDA defined at the conventional threshold, Cumulus (1.32, 95% CI 1.05-1.66). In a model fitting the three measures together, the association of CBC with Cirrocumulus was unchanged (1.40, 95% CI 0.97-2.05), and the lower brightness measures did not contribute to the CBC model fit. These results suggest that MDA defined at a high-intensity threshold is a better predictor of CBC risk and has the potential to improve CBC risk stratification beyond conventional MDA measures.
Collapse
Affiliation(s)
- Gordon P. Watt
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, Ontario, Canada
- Dalla Lana School of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Tuong L. Nguyen
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Anne S. Reiner
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Kathleen E. Malone
- Fred Hutchinson Cancer Research Center, Seattle, Washington, United States of America
| | - Esther M. John
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California, United States of America
| | | | - Jennifer D. Brooks
- Dalla Lana School of Public Health Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope Comprehensive Cancer Center, Duarte, California, United States of America
| | - Malcolm C. Pike
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| | - John L. Hopper
- Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia
| | - Jonine L. Bernstein
- Memorial Sloan Kettering Cancer Center, New York, New York, United States of America
| |
Collapse
|
6
|
Watt GP, Knight JA, Lin C, Lynch CF, Malone KE, John EM, Bernstein L, Brooks JD, Reiner AS, Liang X, Woods M, Nguyen TL, Hopper JL, Pike MC, Bernstein JL. Mammographic texture features associated with contralateral breast cancer in the WECARE Study. NPJ Breast Cancer 2021; 7:146. [PMID: 34845211 PMCID: PMC8630158 DOI: 10.1038/s41523-021-00354-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2021] [Accepted: 11/01/2021] [Indexed: 01/12/2023] Open
Abstract
To evaluate whether mammographic texture features were associated with second primary contralateral breast cancer (CBC) risk, we created a "texture risk score" using pre-treatment mammograms in a case-control study of 212 women with CBC and 223 controls with unilateral breast cancer. The texture risk score was associated with CBC (odds per adjusted standard deviation = 1.25, 95% CI 1.01-1.56) after adjustment for mammographic percent density and confounders. These results support the potential of texture features for CBC risk assessment of breast cancer survivors.
Collapse
Affiliation(s)
- Gordon P. Watt
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Julia A. Knight
- grid.250674.20000 0004 0626 6184Lunenfeld-Tanenbaum Research Institute, Sinai Health, Toronto, ON Canada ,grid.17063.330000 0001 2157 2938Division of Epidemiology, Dalla Lana School of Public Health, Toronto, ON Canada
| | - Christine Lin
- grid.240473.60000 0004 0543 9901Penn State College of Medicine, Hershey, PA USA
| | - Charles F. Lynch
- grid.214572.70000 0004 1936 8294 Department of Epidemiology, University of Iowa, Iowa City, IA USA
| | - Kathleen E. Malone
- grid.270240.30000 0001 2180 1622Fred Hutchinson Cancer Research Center, Seattle, WA USA
| | - Esther M. John
- grid.168010.e0000000419368956Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, CA USA ,grid.168010.e0000000419368956Department of Medicine, Stanford University School of Medicine, Stanford, CA USA
| | - Leslie Bernstein
- grid.410425.60000 0004 0421 8357Beckman Research Institute, City of Hope National Medical Center, Duarte, CA USA
| | - Jennifer D. Brooks
- grid.17063.330000 0001 2157 2938Division of Epidemiology, Dalla Lana School of Public Health, Toronto, ON Canada
| | - Anne S. Reiner
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Xiaolin Liang
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Meghan Woods
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Tuong L. Nguyen
- grid.1008.90000 0001 2179 088XMelbourne School of Population and Global Health, University of Melbourne, Parkville, VIC Australia
| | - John L. Hopper
- grid.1008.90000 0001 2179 088XMelbourne School of Population and Global Health, University of Melbourne, Parkville, VIC Australia
| | - Malcolm C. Pike
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Jonine L. Bernstein
- grid.51462.340000 0001 2171 9952Memorial Sloan Kettering Cancer Center, New York, NY USA
| |
Collapse
|
7
|
Carlson LE, Watt GP, Tonorezos ES, Chow EJ, Yu AF, Woods M, Lynch CF, John EM, Mellemkjӕr L, Brooks JD, Knight JA, Reiner AS, Liang X, Smith SA, Bernstein L, Dauer LT, Cerviño LI, Howell RM, Shore RE, Boice JD, Bernstein JL. Coronary Artery Disease in Young Women After Radiation Therapy for Breast Cancer: The WECARE Study. JACC: CARDIOONCOLOGY 2021; 3:381-392. [PMID: 34604798 PMCID: PMC8463731 DOI: 10.1016/j.jaccao.2021.07.008] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/04/2021] [Revised: 07/14/2021] [Accepted: 07/18/2021] [Indexed: 01/23/2023]
Abstract
Background Radiation therapy (RT) for breast cancer increases risk of coronary artery disease (CAD). Women treated for left- vs right-sided breast cancer receive greater heart radiation exposure, which may further increase this risk. The risk of radiation-associated CAD specifically among younger breast cancer survivors is not well defined. Objectives The purpose of this study was to report CAD risk among participants in the Women's Environmental Cancer and Radiation Epidemiology Study. Methods A total of 1,583 women who were <55 years of age when diagnosed with breast cancer between 1985 and 2008 completed a cardiovascular health questionnaire. Risk of radiation-associated CAD was evaluated by comparing women treated with left-sided RT with women treated with right-sided RT using multivariable Cox proportional hazards models. Effect modification by treatment and cardiovascular risk factors was examined. Results In total, 517 women who did not receive RT and 94 women who had a pre-existing cardiovascular disease diagnosis were excluded, leaving 972 women eligible for analysis. Their median follow-up time was 14 years (range 1-29 years). The 27.5-year cumulative incidences of CAD for women receiving left- vs right-sided RT were 10.5% and 5.8%, respectively (P = 0.010). The corresponding HR of CAD for left- vs right-sided RT in the multivariable Cox model was 2.5 (95% CI: 1.3-4.7). There was no statistically significant effect modification by any factor evaluated. Conclusions Young women treated with RT for left-sided breast cancer had over twice the risk of CAD compared with women treated with RT for right-sided breast cancer. Laterality of RT is independently associated with an increased risk of CAD and should be considered in survivorship care of younger breast cancer patients.
Collapse
Affiliation(s)
| | - Gordon P. Watt
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
- Address for correspondence: Dr Gordon P. Watt, Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, Second Floor, New York, New York 10017. @gp_watt
| | - Emily S. Tonorezos
- National Cancer Institute, Division of Cancer Control and Population Sciences, Rockville, Maryland, USA
| | - Eric J. Chow
- Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Anthony F. Yu
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | | | | | | | - Jennifer D. Brooks
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Ontario, Canada
| | - Julia A. Knight
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Ontario, Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Anne S. Reiner
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Susan A. Smith
- University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, California, USA
| | | | | | - Rebecca M. Howell
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Roy E. Shore
- New York University Grossman School of Medicine, New York, New York, USA
| | - John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, Maryland, USA
- Vanderbilt University, Nashville, Tennessee, USA
| | | | | |
Collapse
|
8
|
Reiner AS, Robson ME, Mellemkjær L, Tischkowitz M, John EM, Lynch CF, Brooks JD, Boice JD, Knight JA, Teraoka SN, Liang X, Woods M, Shen R, Shore RE, Stram DO, Thomas DC, Malone KE, Bernstein L, Riaz N, Woodward W, Powell S, Goldgar D, Concannon P, Bernstein JL. Radiation Treatment, ATM, BRCA1/2, and CHEK2*1100delC Pathogenic Variants and Risk of Contralateral Breast Cancer. J Natl Cancer Inst 2021; 112:1275-1279. [PMID: 32119081 DOI: 10.1093/jnci/djaa031] [Citation(s) in RCA: 18] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 02/10/2020] [Accepted: 02/26/2020] [Indexed: 11/14/2022] Open
Abstract
Whether radiation therapy (RT) affects contralateral breast cancer (CBC) risk in women with pathogenic germline variants in moderate- to high-penetrance breast cancer-associated genes is unknown. In a population-based case-control study, we examined the association between RT; variants in ATM, BRCA1/2, or CHEK2*1100delC; and CBC risk. We analyzed 708 cases of women with CBC and 1399 controls with unilateral breast cancer, all diagnosed with first invasive breast cancer between 1985 and 2000 and aged younger than 55 years at diagnosis and screened for variants in breast cancer-associated genes. Rate ratios (RR) and 95% confidence intervals (CIs) were estimated using multivariable conditional logistic regression. RT did not modify the association between known pathogenic variants and CBC risk (eg, BRCA1/2 pathogenic variant carriers without RT: RR = 3.52, 95% CI = 1.76 to 7.01; BRCA1/2 pathogenic variant carriers with RT: RR = 4.46, 95% CI = 2.96 to 6.71), suggesting that modifying RT plans for young women with breast cancer is unwarranted. Rare ATM missense variants, not currently identified as pathogenic, were associated with increased risk of RT-associated CBC (carriers of ATM rare missense variants of uncertain significance without RT: RR = 0.38, 95% CI = 0.09 to 1.55; carriers of ATM rare missense variants of uncertain significance with RT: RR = 2.98, 95% CI = 1.31 to 6.80). Further mechanistic studies will aid clinical decision-making related to RT.
Collapse
Affiliation(s)
- Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Mark E Robson
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Weill Cornell Medical College, Cornell University, New York, NY, USA
| | | | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - Esther M John
- Stanford University, School of Medicine, Stanford, CA, USA
| | | | - Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health Science, Toronto, ON, Canada
| | - John D Boice
- Vanderbilt University Medical Center, Vanderbilt-Ingram Cancer Center, Bethesda, MD, USA
| | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health Science, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Sharon N Teraoka
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Ronglai Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | | | | | | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Nadeem Riaz
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Wendy Woodward
- MD Anderson Cancer Center, The University of Texas, Houston, TX, USA
| | - Simon Powell
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - David Goldgar
- University of Utah, School of Medicine, Salt Lake City, UT, USA
| | - Patrick Concannon
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | | | | |
Collapse
|
9
|
Reiner AS, Watt GP, John EM, Lynch CF, Brooks JD, Mellemkjær L, Boice JD, Knight JA, Concannon P, Smith SA, Liang X, Woods M, Shore R, Malone KE, Bernstein L, Bernstein JL. Smoking, Radiation Therapy, and Contralateral Breast Cancer Risk in Young Women. J Natl Cancer Inst 2021; 114:631-634. [PMID: 33779721 DOI: 10.1093/jnci/djab047] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 02/01/2021] [Accepted: 03/19/2021] [Indexed: 12/19/2022] Open
Abstract
Evidence is mounting that cigarette smoking contributes to second primary contralateral breast cancer (CBC) risk. Whether radiation therapy (RT) interacts with smoking to modify this risk is unknown. In this multicenter, individually-matched case-control study, we examined the association between RT, smoking, and CBC risk. The study included 1,521 CBC cases and 2,212 controls with unilateral breast cancer, all diagnosed with first invasive breast cancer between 1985-2008 at age <55 years. Absorbed radiation doses to contralateral breast regions were estimated with thermoluminescent dosimeters in tissue-equivalent anthropomorphic phantoms and smoking history was collected by interview. Rate ratios (RRs) and 95% confidence intervals (CIs) for CBC risk were estimated by multivariable conditional logistic regression. There was no interaction between any measure of smoking with RT to increase CBC risk (eg, the interaction of continuous RT dose with smoking at first breast cancer diagnosis [ever/never]: RR = 1.00, 95% CI = 0.89-1.14; continuous RT dose with years smoked: RR = 1.00, 95% CI = 0.99-1.01; and continuous RT dose with lifetime pack-years: RR = 1.00, 95% CI = 0.99-1.01). There was no evidence that RT further increased CBC risk in young women with first primary breast cancer who were current smokers or had smoking history.
Collapse
Affiliation(s)
- Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Gordon P Watt
- Memorial Sloan Kettering Cancer Center, New York, NY
| | | | | | - Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health Science, Toronto, Canada
| | | | - John D Boice
- Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN
| | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health Science, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Patrick Concannon
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL
| | - Susan A Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston, TX
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, NY
| | - Roy Shore
- NYU School of Medicine, New York, NY
| | | | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, CA
| | | | | |
Collapse
|
10
|
Watt GP, John EM, Bandera EV, Malone KE, Lynch CF, Palmer JR, Knight JA, Troester MA, Bernstein JL. Race, ethnicity and risk of second primary contralateral breast cancer in the United States. Int J Cancer 2021; 148:2748-2758. [PMID: 33544892 DOI: 10.1002/ijc.33501] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2020] [Revised: 01/12/2021] [Accepted: 01/14/2021] [Indexed: 01/19/2023]
Abstract
Breast cancer survivors have a high risk of a second primary contralateral breast cancer (CBC), but there are few studies of CBC risk in racial/ethnic minority populations. We examined whether the incidence and risk factors for CBC differed by race/ethnicity in the United States. Women with a first invasive Stage I-IIB breast cancer diagnosis at ages 20-74 years between 2000 and 2015 in the Surveillance, Epidemiology, and End Results Program (SEER) 18 registries were followed through 2016 for a diagnosis of invasive CBC ≥1 year after the first breast cancer diagnosis. We used cause-specific Cox proportional hazards models to test the association between race/ethnicity and CBC, adjusting for age, hormone receptor status, radiation therapy, chemotherapy and stage at first diagnosis, and evaluated the impact of contralateral prophylactic mastectomy, socioeconomic status, and insurance status on the association. After a median follow-up of 5.9 years, 9247 women (2.0%) were diagnosed with CBC. Relative to non-Hispanic (NH) White women, CBC risk was increased in NH Black women (hazard ratio = 1.44, 95% CI 1.35-1.54) and Hispanic women (1.11, 95% CI 1.02-1.20), with the largest differences among women diagnosed at younger ages. Adjustment for contralateral prophylactic mastectomy, socioeconomic status and health insurance did not explain the associations. Therefore, non-Hispanic Black and Hispanic women have an increased risk of CBC that is not explained by clinical or socioeconomic factors collected in SEER. Large studies of diverse breast cancer survivors with detailed data on treatment delivery and adherence are needed to inform interventions to reduce this disparity.
Collapse
Affiliation(s)
- Gordon P Watt
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| | - Esther M John
- Department of Epidemiology and Population Health, Stanford University School of Medicine, Stanford, California, USA
| | - Elisa V Bandera
- Cancer Epidemiology and Health Outcomes, Rutgers Cancer Institute of New Jersey, New Brunswick, New Jersey, USA
| | - Kathleen E Malone
- Epidemiology Program, Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, Washington, USA
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, Iowa, USA
| | - Julie R Palmer
- Department of Medicine, Boston University School of Medicine, Boston, Massachusetts, USA
| | - Julia A Knight
- Prosserman Centre for Population Health Research, Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Ontario, Canada
| | - Melissa A Troester
- Department of Epidemiology, University of North Carolina Gillings School of Global Public Health, Chapel Hill, North Carolina, USA
| | - Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, New York, USA
| |
Collapse
|
11
|
A case-control study of the joint effect of reproductive factors and radiation treatment for first breast cancer and risk of contralateral breast cancer in the WECARE study. Breast 2020; 54:62-69. [PMID: 32927238 PMCID: PMC7494790 DOI: 10.1016/j.breast.2020.07.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2020] [Revised: 06/27/2020] [Accepted: 07/24/2020] [Indexed: 11/23/2022] Open
Abstract
Objective To examined the impact of reproductive factors on the relationship between radiation treatment (RT) for a first breast cancer and risk of contralateral breast cancer (CBC). Methods The Women’s Environmental Cancer and Radiation Epidemiology (WECARE) Study is a multi-center, population-based case-control study where cases are women with asynchronous CBC (N = 1521) and controls are women with unilateral breast cancer (N = 2211). Rate ratios (RR) and 95% confidence intervals (CI) were estimated using conditional logistic regression to assess the independent and joint effects of RT (ever/never and location-specific stray radiation dose to the contralateral breast [0, >0-<1Gy, ≥1Gy]) and reproductive factors (e.g., parity). Results Nulliparous women treated with RT (≥1Gy dose) were at increased risk of CBC compared with nulliparous women not treated with RT, although this relationship did not reach statistical significance (RR = 1.34, 95% CI 0.87, 2.07). Women treated with RT who had an interval pregnancy (i.e., pregnancy after first diagnosis and before second diagnosis [in cases]/reference date [in controls]) had an increased risk of CBC compared with those who had an interval pregnancy with no RT (RR = 4.60, 95% CI 1.16, 18.28). This was most apparent for women with higher radiation doses to the contralateral breast. Conclusion Among young female survivors of breast cancer, we found some evidence suggesting that having an interval pregnancy could increase a woman’s risk of CBC following RT for a first breast cancer. While sampling variability precludes strong interpretations, these findings suggest a role for pregnancy and hormonal factors in radiation-associated CBC. Radiation treatment is associated with increased contralateral breast cancer risk in some women. Reproductive status at the time of treatment may modify this relationship. Some evidence that pregnancy after radiation treatment increases contralateral breast cancer risk.
Collapse
|
12
|
Lee S, Liang X, Woods M, Reiner AS, Concannon P, Bernstein L, Lynch CF, Boice JD, Deasy JO, Bernstein JL, Oh JH. Machine learning on genome-wide association studies to predict the risk of radiation-associated contralateral breast cancer in the WECARE Study. PLoS One 2020; 15:e0226157. [PMID: 32106268 PMCID: PMC7046218 DOI: 10.1371/journal.pone.0226157] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2019] [Accepted: 11/20/2019] [Indexed: 01/13/2023] Open
Abstract
The purpose of this study was to identify germline single nucleotide polymorphisms (SNPs) that optimally predict radiation-associated contralateral breast cancer (RCBC) and to provide new biological insights into the carcinogenic process. Fifty-two women with contralateral breast cancer and 153 women with unilateral breast cancer were identified within the Women’s Environmental Cancer and Radiation Epidemiology (WECARE) Study who were at increased risk of RCBC because they were ≤ 40 years of age at first diagnosis of breast cancer and received a scatter radiation dose > 1 Gy to the contralateral breast. A previously reported algorithm, preconditioned random forest regression, was applied to predict the risk of developing RCBC. The resulting model produced an area under the curve (AUC) of 0.62 (p = 0.04) on hold-out validation data. The biological analysis identified the cyclic AMP-mediated signaling and Ephrin-A as significant biological correlates, which were previously shown to influence cell survival after radiation in an ATM-dependent manner. The key connected genes and proteins that are identified in this analysis were previously identified as relevant to breast cancer, radiation response, or both. In summary, machine learning/bioinformatics methods applied to genome-wide genotyping data have great potential to reveal plausible biological correlates associated with the risk of RCBC.
Collapse
Affiliation(s)
- Sangkyu Lee
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Xiaolin Liang
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Meghan Woods
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Anne S. Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Patrick Concannon
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, United States of America
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute of the City of Hope, Duarte, CA, United States of America
| | - Charles F. Lynch
- Department of Epidemiology, The University of Iowa, Iowa City, IA, United States of America
| | - John D. Boice
- Department of Medicine, Vanderbilt University Medical Center, Nashville, TN, United States of America
| | - Joseph O. Deasy
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Jonine L. Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
| | - Jung Hun Oh
- Department of Medical Physics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America
- * E-mail:
| |
Collapse
|
13
|
Watt GP, Reiner AS, Smith SA, Stram DO, Capanu M, Malone KE, Lynch CF, John EM, Knight JA, Mellemkjær L, Bernstein L, Brooks JD, Woods M, Liang X, Haile RW, Riaz N, Conti DV, Robson M, Duggan D, Boice JD, Shore RE, Tischkowitz M, Orlow I, Thomas DC, Concannon P, Bernstein JL. Association of a Pathway-Specific Genetic Risk Score With Risk of Radiation-Associated Contralateral Breast Cancer. JAMA Netw Open 2019; 2:e1912259. [PMID: 31560388 PMCID: PMC6777239 DOI: 10.1001/jamanetworkopen.2019.12259] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
IMPORTANCE Radiation therapy for breast cancer is associated with increased risk of a second primary contralateral breast cancer, but the genetic factors modifying this association are not well understood. OBJECTIVE To determine whether a genetic risk score comprising single nucleotide polymorphisms in the nonhomologous end-joining DNA repair pathway is associated with radiation-associated contralateral breast cancer. DESIGN, SETTING, AND PARTICIPANTS This case-control study included a case group of women with contralateral breast cancer that was diagnosed at least 1 year after a first primary breast cancer who were individually matched to a control group of women with unilateral breast cancer. Inclusion criteria were receiving a first invasive breast cancer diagnosis prior to age 55 years between 1985 and 2008. Women were recruited through 8 population-based cancer registries in the United States, Canada, and Denmark as part of the Women's Environment, Cancer, and Radiation Epidemiology Studies I (November 2000 to August 2004) and II (March 2010 to December 2012). Data analysis was conducted from July 2017 to August 2019. EXPOSURES Stray radiation dose to the contralateral breast during radiation therapy for the first breast cancer. A novel genetic risk score comprised of genetic variants in the nonhomologous end-joining DNA repair pathway was considered the potential effect modifier, dichotomized as high risk if the score was above the median of 74 and low risk if the score was at or below the median. MAIN OUTCOMES AND MEASURES The main outcome was risk of contralateral breast cancer associated with stray radiation dose stratified by genetic risk score, age, and latency. RESULTS A total of 5953 women were approached for study participation, and 3732 women (62.7%) agreed to participate. The median (range) age at first diagnosis was 46 (23-54) years. After 5 years of latency or more, among women who received the first diagnosis when they were younger than 40 years, exposure to 1.0 Gy (to convert to rad, multiply by 100) or more of stray radiation was associated with a 2-fold increased risk of contralateral breast cancer compared with women who were not exposed (rate ratio, 2.0 [95% CI, 1.1-3.6]). The risk was higher among women with a genetic risk score above the median (rate ratio, 3.0 [95% CI, 1.1-8.1]), and there was no association among women with a genetic risk score below the median (rate ratio, 1.3 [95% CI, 0.5-3.7]). Among younger women with a high genetic risk score, the attributable increased risk for contralateral breast cancer associated with stray radiation dose was 28%. CONCLUSIONS AND RELEVANCE This study found an increased risk of contralateral breast cancer that was attributable to stray radiation exposure among women with a high genetic risk score and who received a first breast cancer diagnosis when they were younger than 40 years after 5 years or more of latency. This genetic risk score may help guide treatment and surveillance for women with breast cancer.
Collapse
Affiliation(s)
- Gordon P. Watt
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Anne S. Reiner
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Susan A. Smith
- Department of Radiation Physics, The University of Texas MD Anderson Cancer Center, Houston
| | - Daniel O. Stram
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | | | | | | | - Esther M. John
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, California
| | - Julia A. Knight
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | | | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, California
| | - Jennifer D. Brooks
- Epidemiology Division, Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, New York
| | | | - Nadeem Riaz
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - David V. Conti
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | - Mark Robson
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - David Duggan
- Translational Genomics Research Institute, An Affiliate of City of Hope, Phoenix, Arizona
| | - John D. Boice
- National Council on Radiation Protection and Measurements, Bethesda, Maryland
- Vanderbilt University, Nashville, Tennessee
| | - Roy E. Shore
- New York University School of Medicine, New York
| | | | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Duncan C. Thomas
- Department of Preventive Medicine, University of Southern California, Los Angeles
| | | | | |
Collapse
|
14
|
Brooks JD, Comen EA, Reiner AS, Orlow I, Leong SF, Liang X, Mellemkjær L, Knight JA, Lynch CF, John EM, Bernstein L, Woods M, Doody DR, Malone KE, Bernstein JL. CYP2D6 phenotype, tamoxifen, and risk of contralateral breast cancer in the WECARE Study. Breast Cancer Res 2018; 20:149. [PMID: 30526633 PMCID: PMC6288916 DOI: 10.1186/s13058-018-1083-y] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/19/2018] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Tamoxifen treatment greatly reduces a woman's risk of developing a second primary breast cancer. There is, however, substantial variability in treatment response, some of which may be attributed to germline genetic variation. CYP2D6 is a key enzyme in the metabolism of tamoxifen to its active metabolites, and variants in this gene have been associated with reduced tamoxifen metabolism. The impact of variation on risk of contralateral breast cancer (CBC) is unknown. METHODS Germline DNA from 1514 CBC cases and 2203 unilateral breast cancer controls was genotyped for seven single nucleotide polymorphisms, one three-nucleotide insertion-deletion, and a full gene deletion. Each variant has an expected impact on enzyme activity, which in combination allows for the classification of women as extensive, intermediate, and poor metabolizers (EM, IM, and PM respectively). Each woman was assigned one of six possible diplotypes and a corresponding CYP2D6 activity score (AS): EM/EM (AS = 2), EM/IM (AS = 1.5), EM/PM (AS = 1), IM/IM (AS = 0.75), IM/PM (AS = 0.5), and PM/PM (AS = 0). We also collapsed categories of the AS to generate an overall phenotype (EM, AS ≥ 1; IM, AS = 0.5-0.75; PM, AS = 0). Rate ratios (RRs) and 95% confidence intervals (CIs) for the association between tamoxifen treatment and risk of CBC in our study population were estimated using conditional logistic regression, stratified by AS. RESULTS Among women with AS ≥ 1 (i.e., EM), tamoxifen treatment was associated with a 20-55% reduced RR of CBC (AS = 2, RR = - 0.81, 95% CI 0.62-1.06; AS = 1.5, RR = 0.45, 95% CI 0.30-0.68; and AS = 1, RR = 0.55, 95% CI 0.40-0.74). Among women with no EM alleles and at least one PM allele (i.e., IM and PM), tamoxifen did not appear to impact the RR of CBC in this population (AS = 0.5, RR = 1.08, 95% CI 0.59-1.96; and AS = 0, RR = 1.17, 95% CI 0.58-2.35) (p for homogeneity = - 0.02). CONCLUSION This study suggests that the CYP2D6 phenotype may contribute to some of the observed variability in the impact of tamoxifen treatment for a first breast cancer on risk of developing CBC.
Collapse
Affiliation(s)
- Jennifer D. Brooks
- University of Toronto, Dalla Lana School of Public Health Sciences, 155 College St. HSB 676, Toronto, ON M5T 3M7 Canada
| | | | - Anne S. Reiner
- Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Irene Orlow
- Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Siok F. Leong
- Memorial Sloan Kettering Cancer Center, New York, NY USA
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, NY USA
| | | | - Julia A. Knight
- University of Toronto, Dalla Lana School of Public Health Sciences, 155 College St. HSB 676, Toronto, ON M5T 3M7 Canada
- Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | | | - Esther M. John
- Department of Medicine and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Centre, Duarte, CA USA
| | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, NY USA
| | | | | | | |
Collapse
|
15
|
Morton LM, Kerns SL, Dolan ME. Role of Germline Genetics in Identifying Survivors at Risk for Adverse Effects of Cancer Treatment. Am Soc Clin Oncol Educ Book 2018; 38:775-786. [PMID: 30231410 DOI: 10.1200/edbk_201391] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The growing population of cancer survivors often faces adverse effects of treatment, which have a substantial impact on morbidity and mortality. Although certain adverse effects are thought to have a significant heritable component, much work remains to be done to understand the role of germline genetic factors in the development of treatment-related toxicities. In this article, we review current understanding of genetic susceptibility to a range of adverse outcomes among cancer survivors (e.g., fibrosis, urinary and rectal toxicities, ototoxicity, chemotherapy-induced peripheral neuropathy, subsequent malignancies). Most previous research has been narrowly focused, investigating variation in candidate genes and pathways such as drug metabolism, DNA damage and repair, and inflammation. Few of the findings from these earlier candidate gene studies have been replicated in independent populations. Advances in understanding of the genome, improvements in technology, and reduction in laboratory costs have led to recent genome-wide studies, which agnostically interrogate common and/or rare variants across the entire genome. Larger cohorts of patients with homogeneous treatment exposures and systematic ascertainment of well-defined outcomes as well as replication in independent study populations are essential aspects of the study design and are increasingly leading to the discovery of variants associated with each of the adverse outcomes considered in this review. In the long-term, validated germline genetic associations hold tremendous promise for more precisely identifying patients at highest risk for developing adverse treatment effects, with implications for frontline therapy decision-making, personalization of long-term follow-up guidelines, and potential identification of targets for prevention or treatment of the toxicity.
Collapse
Affiliation(s)
- Lindsay M Morton
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
| | - Sarah L Kerns
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
| | - M Eileen Dolan
- From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL
| |
Collapse
|
16
|
Morton LM, Ricks-Santi L, West CML, Rosenstein BS. Radiogenomic Predictors of Adverse Effects following Charged Particle Therapy. Int J Part Ther 2018; 5:103-113. [PMID: 30505881 PMCID: PMC6261418 DOI: 10.14338/ijpt-18-00009.1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2018] [Accepted: 06/16/2018] [Indexed: 12/31/2022] Open
Abstract
Radiogenomics is the study of genomic factors that are associated with response to radiation therapy. In recent years, progress has been made toward identifying genetic risk factors linked with late radiation-induced adverse effects. These advances have been underpinned by the establishment of an international Radiogenomics Consortium with collaborative studies that expand cohort sizes to increase statistical power and efforts to improve methodologic approaches for radiogenomic research. Published studies have predominantly reported the results of research involving patients treated with photons using external beam radiation therapy. These studies demonstrate our ability to pool international cohorts to identify common single nucleotide polymorphisms associated with risk for developing normal tissue toxicities. Progress has also been achieved toward the discovery of genetic variants associated with radiation therapy-related subsequent malignancies. With the increasing use of charged particle therapy (CPT), there is a need to establish cohorts for patients treated with these advanced technology forms of radiation therapy and to create biorepositories with linked clinical data. While some genetic variants are likely to impact toxicity and second malignancy risks for both photons and charged particles, it is plausible that others may be specific to the radiation modality due to differences in their biological effects, including the complexity of DNA damage produced. In recognition that the formation of patient cohorts treated with CPT for radiogenomic studies is a high priority, efforts are underway to establish collaborations involving institutions treating cancer patients with protons and/or carbon ions as well as consortia, including the Proton Collaborative Group, the Particle Therapy Cooperative Group, and the Pediatric Proton Consortium Registry. These important radiogenomic CPT initiatives need to be expanded internationally to build on experience gained from the Radiogenomics Consortium and epidemiologists investigating normal tissue toxicities and second cancer risk.
Collapse
Affiliation(s)
- Lindsay M. Morton
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, National Institutes of Health, Bethesda, MD, USA
| | | | - Catharine M. L. West
- Division of Cancer Sciences, The University of Manchester, Manchester Academic Health Science Centre, Christie Hospital, Manchester, United Kingdom
| | - Barry S. Rosenstein
- Department of Radiation Oncology and Department of Genetics & Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| |
Collapse
|
17
|
Reiner AS, Sisti J, John EM, Lynch CF, Brooks JD, Mellemkjær L, Boice JD, Knight JA, Concannon P, Capanu M, Tischkowitz M, Robson M, Liang X, Woods M, Conti DV, Duggan D, Shore R, Stram DO, Thomas DC, Malone KE, Bernstein L, Bernstein JL. Breast Cancer Family History and Contralateral Breast Cancer Risk in Young Women: An Update From the Women's Environmental Cancer and Radiation Epidemiology Study. J Clin Oncol 2018; 36:1513-1520. [PMID: 29620998 DOI: 10.1200/jco.2017.77.3424] [Citation(s) in RCA: 38] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose The Women's Environmental Cancer and Radiation Epidemiology (WECARE) study demonstrated the importance of breast cancer family history on contralateral breast cancer (CBC) risk, even for noncarriers of deleterious BRCA1/2 mutations. With the completion of WECARE II, updated risk estimates are reported. Additional analyses that exclude women negative for deleterious mutations in ATM, CHEK2*1100delC, and PALB2 were performed. Patients and Methods The WECARE Study is a population-based case-control study that compared 1,521 CBC cases with 2,212 individually matched unilateral breast cancer (UBC) controls. Participants were younger than age 55 years when diagnosed with a first invasive breast cancer between 1985 and 2008. Women were interviewed about breast cancer risk factors, including family history. A subset of women was screened for deleterious mutations in BRCA1/2, ATM, CHEK2*1100delC, and PALB2. Rate ratios (RRs) were estimated using multivariable conditional logistic regression. Cumulative absolute risks (ARs) were estimated by combining RRs from the WECARE Study and population-based SEER*Stat cancer incidence data. Results Women with any first-degree relative with breast cancer had a 10-year AR of 8.1% for CBC (95% CI, 6.7% to 9.8%). Risks also were increased if the relative was diagnosed at an age younger than 40 years (10-year AR, 13.5%; 95% CI, 8.8% to 20.8%) or with CBC (10-year AR, 14.1%; 95% CI, 9.5% to 20.7%). These risks are comparable with those seen in BRCA1/2 deleterious mutation carriers (10-year AR, 18.4%; 95% CI, 16.0% to 21.3%). In the subset of women who tested negative for deleterious mutations in BRCA1/2, ATM, CHEK2*1100delC, and PALB2, estimates were unchanged. Adjustment for known breast cancer single-nucleotide polymorphisms did not affect estimates. Conclusion Breast cancer family history confers a high CBC risk, even after excluding women with deleterious mutations. Clinicians are urged to use detailed family histories to guide treatment and future screening decisions for young women with breast cancer.
Collapse
Affiliation(s)
- Anne S Reiner
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julia Sisti
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Esther M John
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Charles F Lynch
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Jennifer D Brooks
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Lene Mellemkjær
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - John D Boice
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Julia A Knight
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Patrick Concannon
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Marinela Capanu
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Marc Tischkowitz
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Mark Robson
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Xiaolin Liang
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Meghan Woods
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - David V Conti
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - David Duggan
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Roy Shore
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Daniel O Stram
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Duncan C Thomas
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Kathleen E Malone
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | - Leslie Bernstein
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| | | | - Jonine L Bernstein
- Anne S. Reiner, Julia Sisti, Marinela Capanu, Mark Robson, Xiaolin Liang, Meghan Woods, and Jonine L. Bernstein, Memorial Sloan Kettering Cancer Center; Mark Robson, Cornell University; Roy Shore, New York University School of Medicine, New York, NY; Esther M. John, Cancer Prevention Institute of California, Fremont, and Stanford School of Medicine, Stanford; David V. Conti, Daniel O. Stram, and Duncan C. Thomas, University of Southern California, Los Angeles; Leslie Bernstein, City of Hope National Medical Center, Duarte, CA; Charles F. Lynch, University of Iowa, Iowa City, IA; Jennifer D. Brooks and Julia A. Knight, University of Toronto; Julia A. Knight, Sinai Health System, Toronto, Ontario, Canada; Lene Mellemkjær, Danish Cancer Society Research Center, Copenhagen, Denmark; John D. Boice, Vanderbilt University Medical Center and the Vanderbilt-Ingram Cancer Center, Nashville, TN; Patrick Concannon, University of Florida, Gainesville, FL; Marc Tischkowitz, University of Cambridge, Cambridge, United Kingdom; David Duggan, Translational Genomics Research Institute, Phoenix, AZ; and Kathleen E. Malone, Fred Hutchinson Cancer Research Center, Seattle, WA
| |
Collapse
|
18
|
Abstract
PURPOSE It was first suggested more than 40 years ago that heterozygous carriers for the human autosomal recessive disorder Ataxia-Telangiectasia (A-T) might also be at increased risk for cancer. Subsequent studies have identified the responsible gene, Ataxia-Telangiectasia Mutated (ATM), characterized genetic variation at this locus in A-T and a variety of different cancers, and described the functions of the ATM protein with regard to cellular DNA damage responses. However, an overall model of how ATM contributes to cancer risk, and in particular, the role of DNA damage in this process, remains lacking. This review considers these questions in the context of contralateral breast cancer (CBC). CONCLUSIONS Heterozygous carriers of loss of function mutations in ATM that are A-T causing, are at increased risk of breast cancer. However, examination of a range of genetic variants, both rare and common, across multiple cancers, suggests that ATM may have additional effects on cancer risk that are allele-dependent. In the case of CBC, selected common alleles at ATM are associated with a reduced incidence of CBC, while other rare and predicted deleterious variants may act jointly with radiation exposure to increase risk. Further studies that characterize germline and somatic ATM mutations in breast cancer and relate the detected genetic changes to functional outcomes, particularly with regard to radiation responses, are needed to gain a complete picture of the complex relationship between ATM, radiation and breast cancer.
Collapse
Affiliation(s)
- Jonine L Bernstein
- a Department of Epidemiology and Biostatistics , Memorial Sloan Kettering Cancer Center , New York , NY , U.S.A
| | | | - Patrick Concannon
- b Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine , University of Florida , Gainesville , FL , U.S.A
| |
Collapse
|
19
|
Luan H, Zhang H, Li Y, Wang P, Cao L, Ma H, Cui Q, Tian G. Association of two obesity-related gene polymorphisms LEPG2548A rs7799039 and LEPRQ223R rs1137101 with the risk of breast cancer. Oncotarget 2017; 8:59333-59344. [PMID: 28938640 PMCID: PMC5601736 DOI: 10.18632/oncotarget.19580] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Accepted: 06/28/2017] [Indexed: 12/18/2022] Open
Abstract
Many studies have been performed to investigate the correlation of leptin (LEP) and leptin receptor (LEPR) polymorphisms with breast cancer (BC) risk, however the results are inconclusive. To obtain a more precise estimation, we conducted this meta-analysis. We searched PubMed, EMBASE, and Web of Science databases to identify qualified studies. Pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the association. Eight eligible studies (2,124 cases and 5,476 controls) for LEP G2548A (rs7799039) polymorphism, and thirteen studies (5,282 cases and 6,140 controls) for LEPR Q223R (rs1137101) polymorphism were included in our study. In general, no significant association between LEP G2548A polymorphism and BC susceptibility was found among five genetic models. In the stratified analysis by ethnicity and sources of controls, significant associations were still not detected in all genetic models. For LEPR Q223R polymorphism, we observed that the association was only statistically significant in Asians (G versus A: OR = 0.532, P = 0.009; GG versus AA: OR = 0.233, P = 0.002; GA versus AA: OR =0.294, P = 0.006; GG versus AA+AG: OR =0.635, P = 0; GA+GG versus AA: OR = 0.242, P = 0.003), but not in general populations and Caucasians. In conclusion, LEP G2548A polymorphism has no relationship with BC susceptibility, while LEPR Q223R polymorphism could decrease BC risk in Asians, but not in overall individuals and Caucasians. More multicenter studies with larger sample sizes are required for further investigation.
Collapse
Affiliation(s)
- Hui Luan
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Hong Zhang
- Department of Oncology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ying Li
- Department of Neurology, Second Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Ping Wang
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Lifei Cao
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Honglan Ma
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qing Cui
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Gang Tian
- Department of Cardiovasology, First Affiliated Hospital, School of Medicine, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| |
Collapse
|
20
|
Reiner AS, Lynch CF, Sisti JS, John EM, Brooks JD, Bernstein L, Knight JA, Hsu L, Concannon P, Mellemkjær L, Tischkowitz M, Haile RW, Shen R, Malone KE, Woods M, Liang X, Morrow M, Bernstein JL. Hormone receptor status of a first primary breast cancer predicts contralateral breast cancer risk in the WECARE study population. Breast Cancer Res 2017; 19:83. [PMID: 28724391 PMCID: PMC5517810 DOI: 10.1186/s13058-017-0874-x] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2017] [Accepted: 06/23/2017] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Previous population-based studies have described first primary breast cancer tumor characteristics and their association with contralateral breast cancer (CBC) risk. However, information on influential covariates such as treatment, family history of breast cancer, and BRCA1/2 mutation carrier status was not available. In a large, population-based, case-control study, we evaluated whether tumor characteristics of the first primary breast cancer are associated with risk of developing second primary asynchronous CBC, overall and in subgroups of interest, including among BRCA1/2 mutation non-carriers, women who are not treated with tamoxifen, and women without a breast cancer family history. METHODS The Women's Environmental Cancer and Radiation Epidemiology Study is a population-based case-control study of 1521 CBC cases and 2212 individually-matched controls with unilateral breast cancer. Detailed information about breast cancer risk factors, treatment for and characteristics of first tumors, including estrogen receptor (ER) and progesterone receptor (PR) status, was obtained by telephone interview and medical record abstraction. Multivariable risk ratios (RRs) and 95% confidence intervals (CIs) were estimated in conditional logistic regression models, adjusting for demographics, treatment, and personal medical and family history. A subset of women was screened for BRCA1/2 mutations. RESULTS Lobular histology of the first tumor was associated with a 30% increase in CBC risk (95% CI 1.0-1.6). Compared to women with ER+/PR+ first tumors, those with ER-/PR- tumors had increased risk of CBC (RR = 1.4, 95% CI 1.1-1.7). Notably, women with ER-/PR- first tumors were more likely to develop CBC with the ER-/PR- phenotype (RR = 5.4, 95% CI 3.0-9.5), and risk remained elevated in multiple subgroups: BRCA1/2 mutation non-carriers, women younger than 45 years of age, women without a breast cancer family history, and women who were not treated with tamoxifen. CONCLUSIONS Having a hormone receptor negative first primary breast cancer is associated with increased risk of CBC. Women with ER-/PR- primary tumors were more likely to develop ER-/PR- CBC, even after excluding BRCA1/2 mutation carriers. Hormone receptor status, which is routinely evaluated in breast tumors, may be used clinically to determine treatment protocols and identify patients who may benefit from increased surveillance for CBC.
Collapse
Affiliation(s)
- Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, NY, USA. .,MPH, 485 Lexington Avenue, 2nd Floor, New York, NY, 10017, USA.
| | | | - Julia S Sisti
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA, USA.,Stanford Department of Medicine, Division of Oncology, and the Stanford Cancer Institute, Stanford, CA, USA
| | - Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, Canada
| | - Li Hsu
- Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Patrick Concannon
- Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of Florida, Gainesville, FL, USA
| | | | - Marc Tischkowitz
- Department of Medical Genetics, University of Cambridge, Cambridge, UK
| | - Robert W Haile
- Stanford Department of Medicine, Division of Oncology, and the Stanford Cancer Institute, Stanford, CA, USA
| | - Ronglai Shen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Monica Morrow
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | | | |
Collapse
|
21
|
Robson ME, Reiner AS, Brooks JD, Concannon PJ, John EM, Mellemkjaer L, Bernstein L, Malone KE, Knight JA, Lynch CF, Woods M, Liang X, Haile RW, Duggan DJ, Shore RE, Smith SA, Thomas DC, Stram DO, Bernstein JL. Association of Common Genetic Variants With Contralateral Breast Cancer Risk in the WECARE Study. J Natl Cancer Inst 2017; 109:3611466. [PMID: 28521362 DOI: 10.1093/jnci/djx051] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2016] [Accepted: 02/27/2017] [Indexed: 12/17/2022] Open
Abstract
Background Women with unilateral breast cancer (UBC) are at risk of developing a subsequent contralateral breast cancer (CBC). Common variants are associated with breast cancer risk. Whether these influence CBC risk is unknown. Methods Participants were breast cancer cases from the population-based Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study. Sixty-seven established breast cancer risk loci were genotyped directly or by imputation in 1459 case subjects with CBC and 2126 UBC control subjects. An unweighted polygenic risk score (PRS) was created by summing the number of risk alleles for each directly genotyped single nucleotide polymorphism (SNP), or for imputed loci, the imputed dosage. A weighted PRS was calculated similarly, but where each SNP's contribution was weighted by the published per-allele log odds ratio. Unweighted and weighted polygenic risk scores and CBC risk were modeled using conditional logistic regression. Cumulative CBC risk was estimated and benchmarked using Surveillance, Epidemiology, and End Results population incidence rates. Results Both unweighted and weighted PRS were statistically significantly associated with CBC risk. The adjusted risk ratio of CBC in women in the upper quartile of unweighted PRS compared with the lowest quartile was 1.63 (95% confidence interval [CI] = 1.33 to 2.00). The estimated 10-year cumulative risk for women in the upper quartile of the unweighted PRS was 7.4% (95% CI = 6.0% to 9.1%). For women in the upper quartile of the weighted PRS, the risk ratio for CBC was 1.75 (95% CI = 1.41 to 2.18) compared with women in the lowest quartile. There was no statistically significant heterogeneity by age, treatment (radiation therapy dose, tamoxifen, chemotherapy), estrogen receptor status of the first primary, histology of the first primary, length of at-risk period for CBC, or breast cancer family history. Conclusions Common genomic variants associated with the development of first primary breast cancer are also associated with the development of CBC; the risk is strongest among those who carry more risk alleles.
Collapse
Affiliation(s)
- Mark E Robson
- Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Medicine, Weill Cornell Medical College, Cornell University, New York, NY, USA
| | - Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, NY, USA.,Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York,NY, USA
| | - Jennifer D Brooks
- Epidemiology Division, University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, ON, Canada
| | | | - Esther M John
- Division of Epidemiology, Department of Health Research and Policy, Cancer Prevention Institute of California, Fremont, CA, USA.,Stanford School of Medicine, Stanford, CA, USA
| | | | - Leslie Bernstein
- Division of Cancer Etiology, Department of Population Sciences, Beckman Research Institute, City of Hope National Medical Center, Duarte, CA, USA
| | - Kathleen E Malone
- Division of Public Health Sciences, Fred Hutchinson Cancer Research Center, Seattle, WA, USA
| | - Julia A Knight
- Epidemiology Division, University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, ON, Canada.,Lunenfeld-Tanenbaum Research Institute, Sinai Health System, Toronto, ON, Canada
| | - Charles F Lynch
- Department of Epidemiology, University of Iowa, Iowa City, IA, USA
| | - Meghan Woods
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York,NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Xiaolin Liang
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York,NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Robert W Haile
- Stanford School of Medicine, Stanford, CA, USA.,Department of Medicine, Division of Oncology, Stanford Cancer Institute, Stanford University, California
| | - David J Duggan
- Integrated Cancer Genomics Division, Translational Genomics Research Institute (TGen), Phoenix, AZ, USA
| | - Roy E Shore
- Department of Population Health, New York University, New York, NY, USA
| | - Susan A Smith
- Department of Radiation Physics, University of Texas, MD Anderson Cancer Center, Houston, TX, USA
| | - Duncan C Thomas
- Division of Biostatistics, Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, California, USA.,Division of Biostatistics and Genetic Epidemiology, University of Southern California, Los Angeles, CA, USA
| | - Daniel O Stram
- Division of Biostatistics and Genetic Epidemiology, University of Southern California, Los Angeles, CA, USA.,Department of Preventive Medicine, University of Southern California Keck School of Medicine, Los Angeles, CA, USA
| | - Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York,NY, USA.,Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | | |
Collapse
|
22
|
Brooks JD, John EM, Mellemkjaer L, Lynch CF, Knight JA, Malone KE, Reiner AS, Bernstein L, Liang X, Shore RE, Stovall M, Bernstein JL. Body mass index, weight change, and risk of second primary breast cancer in the WECARE study: influence of estrogen receptor status of the first breast cancer. Cancer Med 2016; 5:3282-3291. [PMID: 27700016 PMCID: PMC5119984 DOI: 10.1002/cam4.890] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Revised: 07/12/2016] [Accepted: 08/10/2016] [Indexed: 12/03/2022] Open
Abstract
Studies examining the relationship between body mass index (BMI) and risk of contralateral breast cancer (CBC) have reported mixed findings. We previously showed that obese postmenopausal women with estrogen receptor (ER)‐negative breast cancer have a fivefold higher risk of CBC compared with normal weight women. In the current analysis, we reexamined this relationship in the expanded Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study, focusing on the impact of menopausal status and ER status of the first breast cancer. The WECARE Study is a population‐based case–control study of young women with CBC (cases, N = 1386) and with unilateral breast cancer (controls, N = 2045). Rate ratios (RR) and 95% confidence intervals (CI) were calculated to assess the relationship between BMI and risk of CBC stratified by menopausal and ER status. Positive associations with obesity and weight gain were limited to women who became postmenopausal following their first primary breast cancer. Among those with an ER‐negative first breast cancer, obesity (vs. normal weight) at first diagnosis was associated with an increased risk of CBC (RR = 1.9, 95% CI: 1.02, 3.4). Also, weight gain of ≥10 kg after first diagnosis was associated with an almost twofold increased risk of CBC (RR = 1.9, 95% CI: 0.99, 3.8). These results suggest that women with an ER‐negative first primary cancer who are obese at first primary diagnosis or who experience a large weight gain afterward may benefit from heightened surveillance. Future studies are needed to address the impact of weight loss interventions on risk of CBC.
Collapse
Affiliation(s)
- Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, California.,Department of Health Research and Policy (Epidemiology), Stanford University School of Medicine, Stanford, California
| | | | | | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health Sciences, Toronto, Canada.,Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | | | - Anne S Reiner
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, California
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, New York, New York
| | - Roy E Shore
- Department of Population Health, New York University School of Medicine, New York, New York
| | - Marilyn Stovall
- The University of Texas MD Anderson Cancer Center, Houston, Texas
| | | | | |
Collapse
|
23
|
Rakovski C, Langholz B. A post-hoc Unweighted Analysis of Counter-Matched Case-Control Data. Int J Biostat 2016; 11:223-32. [PMID: 26351961 DOI: 10.1515/ijb-2014-0018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Informative sampling based on counter-matching risk set subjects on exposure correlated with a variable of interest has been shown to be an efficient alternative to simple random sampling; however, the opposite is true when correlation between the two covariates is absent. Thus, the counter-matching design will entail substantial gains in statistical efficiency compared to simple random sampling at a first stage of analyses focused by design on variables correlated with the counter-matching variable but will lose efficiency at a second stage of analyses aimed at variables independent of the counter-matching variable and not conceived as a part of the initial study. In an effort to recover efficiency in such second stage of analyses scenarios, we considered a naive analysis of the effect of a dichotomous covariate on the disease rates in the population that ignores the underlying counter-matching sampling design. We derive analytical expressions for the bias and variance and show that when the counter-matching and the new dichotomous variable of interest are uncorrelated and a multiplicative main effects model holds, such an analysis is advantageous over the standard "weighted" approach, especially when the counter-matching variable is rare and in such scenarios the efficiency gains exceeds 80%. Moreover, we consider all possible conceptual violations of the required assumptions and show that moderate departures from the above-mentioned requirements lead to negligible levels of bias; numerical values for the bias under common scenarios are provided. The method is illustrated via an analysis of BRCA1/2 deleterious mutations in the radiation treatment counter-matched WECARE study of second breast cancer.
Collapse
|
24
|
Salomon MP, Li WLS, Edlund CK, Morrison J, Fortini BK, Win AK, Conti DV, Thomas DC, Duggan D, Buchanan DD, Jenkins MA, Hopper JL, Gallinger S, Le Marchand L, Newcomb PA, Casey G, Marjoram P. GWASeq: targeted re-sequencing follow up to GWAS. BMC Genomics 2016; 17:176. [PMID: 26940994 PMCID: PMC4776370 DOI: 10.1186/s12864-016-2459-y] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2015] [Accepted: 02/09/2016] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND For the last decade the conceptual framework of the Genome-Wide Association Study (GWAS) has dominated the investigation of human disease and other complex traits. While GWAS have been successful in identifying a large number of variants associated with various phenotypes, the overall amount of heritability explained by these variants remains small. This raises the question of how best to follow up on a GWAS, localize causal variants accounting for GWAS hits, and as a consequence explain more of the so-called "missing" heritability. Advances in high throughput sequencing technologies now allow for the efficient and cost-effective collection of vast amounts of fine-scale genomic data to complement GWAS. RESULTS We investigate these issues using a colon cancer dataset. After QC, our data consisted of 1993 cases, 899 controls. Using marginal tests of associations, we identify 10 variants distributed among six targeted regions that are significantly associated with colorectal cancer, with eight of the variants being novel to this study. Additionally, we perform so-called 'SNP-set' tests of association and identify two sets of variants that implicate both common and rare variants in the etiology of colorectal cancer. CONCLUSIONS Here we present a large-scale targeted re-sequencing resource focusing on genomic regions implicated in colorectal cancer susceptibility previously identified in several GWAS, which aims to 1) provide fine-scale targeted sequencing data for fine-mapping and 2) provide data resources to address methodological questions regarding the design of sequencing-based follow-up studies to GWAS. Additionally, we show that this strategy successfully identifies novel variants associated with colorectal cancer susceptibility and can implicate both common and rare variants.
Collapse
Affiliation(s)
- Matthew P Salomon
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA. .,Department of Molecular Oncology, John Wayne Cancer Institute at Providence Saint John's Health Center, Santa Monica, CA, USA.
| | - Wai Lok Sibon Li
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Christopher K Edlund
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - John Morrison
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Barbara K Fortini
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Aung Ko Win
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - David V Conti
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Duncan C Thomas
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - David Duggan
- Translational Genomics Research Institute, Phoenix, AZ, USA.
| | - Daniel D Buchanan
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, VIC, Australia. .,Oncogenomics Group, Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - Mark A Jenkins
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - John L Hopper
- Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Parkville, Melbourne, VIC, Australia.
| | - Steven Gallinger
- Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada.
| | | | - Polly A Newcomb
- Public Health Sciences Division, Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
| | - Graham Casey
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| | - Paul Marjoram
- Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA.
| |
Collapse
|
25
|
Kitahara CM, Linet MS, Rajaraman P, Ntowe E, Berrington de González A. A New Era of Low-Dose Radiation Epidemiology. Curr Environ Health Rep 2016; 2:236-49. [PMID: 26231501 DOI: 10.1007/s40572-015-0055-y] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
Abstract
The last decade has introduced a new era of epidemiologic studies of low-dose radiation facilitated by electronic record linkage and pooling of cohorts that allow for more direct and powerful assessments of cancer and other stochastic effects at doses below 100 mGy. Such studies have provided additional evidence regarding the risks of cancer, particularly leukemia, associated with lower-dose radiation exposures from medical, environmental, and occupational radiation sources, and have questioned the previous findings with regard to possible thresholds for cardiovascular disease and cataracts. Integrated analysis of next generation genomic and epigenetic sequencing of germline and somatic tissues could soon propel our understanding further regarding disease risk thresholds, radiosensitivity of population subgroups and individuals, and the mechanisms of radiation carcinogenesis. These advances in low-dose radiation epidemiology are critical to our understanding of chronic disease risks from the burgeoning use of newer and emerging medical imaging technologies, and the continued potential threat of nuclear power plant accidents or other radiological emergencies.
Collapse
Affiliation(s)
- Cari M Kitahara
- Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, 9609 Medical Center Drive, Rm 7E566, Rockville, MD, 20850, USA,
| | | | | | | | | |
Collapse
|
26
|
Sisti JS, Bernstein JL, Lynch CF, Reiner AS, Mellemkjaer L, Brooks JD, Knight JA, Bernstein L, Malone KE, Woods M, Liang X, John EM. Reproductive factors, tumor estrogen receptor status and contralateral breast cancer risk: results from the WECARE study. SPRINGERPLUS 2015; 4:825. [PMID: 26751177 PMCID: PMC4695460 DOI: 10.1186/s40064-015-1642-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/08/2015] [Accepted: 12/20/2015] [Indexed: 01/02/2023]
Abstract
Several reproductive factors are known to be associated with risk of breast cancer; however, relationships between these factors with risk of second primary asynchronous contralateral breast cancer (CBC) have not been widely studied. The Women’s Environmental, Cancer, and Radiation Epidemiology (WECARE) Study is a population-based case-control study of 1521 CBC cases and 2212 individually matched controls with unilateral breast cancer. Using multivariable conditional logistic regression models, we examined associations between reproductive factors and CBC risk, and whether associations differed by estrogen receptor (ER) status and menopausal status of the first breast cancer. Older age at menarche was inversely associated with CBC risk (≥14 vs. ≤11 years risk ratio (RR) = 0.82, 95 % confidence interval (CI) 0.65–1.03, Ptrend = 0.02). Among parous women, an increasing number of full-term pregnancies (FTP) was inversely associated with risk (≥4 vs. 1 FTP RR = 0.60, 95 % CI 0.41–0.88, Ptrend = 0.005). Ever breast-feeding was inversely associated with CBC risk only among women with ER-negative first tumors (ever vs. never breast-fed RR = 0.69, 95 % CI 0.48–1.00, Pheterogeneity = 0.05). Older age at first FTP was inversely associated with CBC risk among women with ER-negative first tumors (≥30 vs. <20 years old RR = 0.66, 95 % CI 0.35–1.27, Ptrend = 0.03), but suggestively positively associated with risk among women with ER-positive first tumors (Pheterogeneity = 0.03). Young age at menarche and low parity, both risk factors for first primary breast cancer, were also associated with overall CBC risk. Reductions in risk associated with breast-feeding were limited to women with ER-negative first tumors, who are at higher CBC risk than women with ER-positive primaries.
Collapse
Affiliation(s)
- Julia S Sisti
- Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017 USA
| | - Jonine L Bernstein
- Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017 USA
| | | | - Anne S Reiner
- Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017 USA
| | | | - Jennifer D Brooks
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada
| | - Julia A Knight
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada ; Lunenfeld-Tanenbaum Research Institute, Mount Sinai Hospital, Toronto, Canada
| | - Leslie Bernstein
- Beckman Research Institute, City of Hope National Medical Center, Duarte, CA USA
| | | | - Meghan Woods
- Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017 USA
| | - Xiaolin Liang
- Memorial Sloan Kettering Cancer Center, 485 Lexington Avenue, 2nd Floor, New York, NY 10017 USA
| | - Esther M John
- Cancer Prevention Institute of California, Fremont, CA USA ; Department of Health Research and Policy (Epidemiology) and Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA USA
| | | |
Collapse
|
27
|
Leff DR, Ho C, Thomas H, Daniels R, Side L, Lambert F, Knight J, Griffiths M, Banwell M, Aitken J, Clayton G, Dua S, Shaw A, Smith S, Ramakrishnan V. A multidisciplinary team approach minimises prophylactic mastectomy rates. Eur J Surg Oncol 2015; 41:1005-12. [PMID: 25986853 DOI: 10.1016/j.ejso.2015.02.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2014] [Revised: 01/22/2015] [Accepted: 02/12/2015] [Indexed: 01/11/2023] Open
Abstract
BACKGROUND Prophylactic mastectomy (PM) has become increasingly common but is not without complications especially if accompanied by reconstructive surgery. In patients with sporadic unilateral breast cancer, contralateral PM offers no survival advantage. Multidisciplinary team (MDT) communication and interaction may facilitate shared decision-making and curtail PM rates. The aim of this study was investigate the effect of a regional MDT meeting on PM decision-making. METHODS We conducted an observational study involving retrospective review of prospectively recorded MDT meeting records for a 151 patient requests for PM from 2011 to 2014. Final MDT decisions were recorded as PM 'accepted', 'declined' or 'pending'. For MDT sanctioned requests, the factors justifying PM were recorded. Where PM was declined, justification for MDT refusal was sought and recorded. RESULTS Approximately half of all requests for PM have been upheld (53.0%) and 1/3 of requests have been declined (32.5%). Of those declined, low risk of contralateral breast cancer versus relatively high risk of systemic relapse were commonly cited as justification for PM refusal (45.7%). A proportion of patients who initiated PM discussion subsequently changed their minds (19.6%), or failed to attend clinic appointments (6.5%). Some patients were deemed medically unfit for complex reconstructive surgery (13%), or were declined on the basis of an apparent cosmetic drive for surgery (6.5%), concerns regarding depression or anxiety (2.2%) and/or if family history could not be substantiated (6.5%). DISCUSSION MDT meetings facilitate cross-specialty interrogation of requests for PM, minimise unnecessary surgery and restrict PM to those likely to derive maximum benefit.
Collapse
Affiliation(s)
- D R Leff
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - C Ho
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - H Thomas
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - R Daniels
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - L Side
- Institute for Women's Health, University College Hospitals, London, United Kingdom
| | - F Lambert
- Psychological Therapies Department, Mid Essex Hospitals Services NHS Trust, Essex, United Kingdom
| | - J Knight
- Breast Reconstruction Awareness Group, United Kingdom
| | - M Griffiths
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - M Banwell
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - J Aitken
- West Suffolk NHS Foundation Trust, Bury St Edmunds, Suffolk, United Kingdom
| | - G Clayton
- The Breast Unit, Mid Essex Hospitals NHS Trust, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - S Dua
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - A Shaw
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom
| | - S Smith
- The Breast Unit, Broomfield Hospital, Chelmsford, Essex, United Kingdom
| | - V Ramakrishnan
- St Andrew's Centre for Burns and Plastic Surgery, Chelmsford, Essex, United Kingdom.
| |
Collapse
|
28
|
Drubay D, Caër-Lorho S, Laroche P, Laurier D, Rage E. Mortality from Circulatory System Diseases among French Uranium Miners: A Nested Case-Control Study. Radiat Res 2015; 183:550-62. [PMID: 25807316 DOI: 10.1667/rr13834.1] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
A significant association has been observed between radon exposure and cerebrovascular disease (CeVD) mortality among French uranium miners, but risk factors for circulatory system diseases (CSD) have not been previously considered. We conducted new analyses in the recently updated (through 2007) French cohort of uranium miners (n = 5,086), which included 442 deaths from CSD, 167 of them from ischemic heart disease (IHD) and 105 from CeVD. A nested case-control study was then set up to collect and investigate the influence of these risk factors on the relationships between mortality from CSD and occupational external gamma ray and internal ionizing radiation exposure (radon and long-lived radionuclides) in this updated cohort. The nested case-control study included miners first employed after 1955, still employed in 1976 and followed up through 2007. Individual information about CSD risk factors was collected from medical files for the 76 deaths from CSD (including 26 from IHD and 16 from CeVD) and 237 miners who had not died of CSD by the end of follow-up. The exposure-risk relationships were assessed with a Cox proportional hazard model weighted by the inverse sampling probability. A significant increase in all CSD and CeVD mortality risks associated with radon exposure was observed in the total cohort [hazard ratios: HRCSD/100 working level months (WLM) = 1.11, 95% confidence interval (1.01; 1.22) and HRCeVD/100 WLM = 1.25 (1.09; 1.43), respectively]. A nonsignificant exposure-risk relationship was observed for every type of cumulative ionizing radiation exposure and every end point [e.g., HRCSD/100WLM = 1.43 (0.71; 2.87)]. The adjustment for each CSD risk factor did not substantially change the exposure-risk relationships. When the model was adjusted for overweight, hypertension, diabetes, hypercholesterolemia and smoking status, the HR/100WLM for CSD, for example, was equal to 1.21 (0.54; 2.75); and when it was adjusted for risk factors selected with the Akaike information criterion, it was equal to 1.44 (0.66; 3.14). To our knowledge, this is the first study to use a uranium miner cohort to consider the major standard CSD risk factors in assessing the relationships between ionizing radiation exposure and the risk of death from these diseases. These results suggest that the significant relationship between CeVD risk and radon exposure observed in the total French cohort is probably not affected by the CSD risk factors. Extending the collection of information about CSD risk factors to a larger subsample would be useful to confirm this result.
Collapse
Affiliation(s)
- Damien Drubay
- a Institut de Radioprotection et de Sûreté Nucléaire (IRSN), PRP-HOM, SRBE, LEPID, Fontenay-aux-Roses, France
| | | | | | | | | |
Collapse
|
29
|
Capanu M, Seshan VE. False discovery rates for rare variants from sequenced data. Genet Epidemiol 2015; 39:65-76. [PMID: 25556339 PMCID: PMC4711769 DOI: 10.1002/gepi.21880] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2014] [Revised: 10/23/2014] [Accepted: 11/11/2014] [Indexed: 01/22/2023]
Abstract
The detection of rare deleterious variants is the preeminent current technical challenge in statistical genetics. Sorting the deleterious from neutral variants at a disease locus is challenging because of the sparseness of the evidence for each individual variant. Hierarchical modeling and Bayesian model uncertainty are two techniques that have been shown to be promising in pinpointing individual rare variants that may be driving the association. Interpreting the results from these techniques from the perspective of multiple testing is a challenge and the goal of this article is to better understand their false discovery properties. Using simulations, we conclude that accurate false discovery control cannot be achieved in this framework unless the magnitude of the variants' risk is large and the hierarchical characteristics have high accuracy in distinguishing deleterious from neutral variants.
Collapse
Affiliation(s)
- Marinela Capanu
- Memorial Sloan-Kettering Cancer Center, 307 E 63rd St, 3rd Floor, New York, NY 10021
| | - Venkatraman E. Seshan
- Memorial Sloan-Kettering Cancer Center, 307 E 63rd St, 3rd Floor, New York, NY 10021
| |
Collapse
|
30
|
Marjoram P, Thomas DC. Next-Generation Sequencing Studies: Optimal Design and Analysis, Missing Heritability and Rare Variants. CURR EPIDEMIOL REP 2014. [DOI: 10.1007/s40471-014-0022-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
|
31
|
Moskowitz CS, Chou JF, Wolden SL, Bernstein JL, Malhotra J, Novetsky Friedman D, Mubdi NZ, Leisenring WM, Stovall M, Hammond S, Smith SA, Henderson TO, Boice JD, Hudson MM, Diller LR, Bhatia S, Kenney LB, Neglia JP, Begg CB, Robison LL, Oeffinger KC. Breast cancer after chest radiation therapy for childhood cancer. J Clin Oncol 2014; 32:2217-23. [PMID: 24752044 PMCID: PMC4100937 DOI: 10.1200/jco.2013.54.4601] [Citation(s) in RCA: 180] [Impact Index Per Article: 18.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
PURPOSE The risk of breast cancer is high in women treated for a childhood cancer with chest irradiation. We sought to examine variations in risk resulting from irradiation field and radiation dose. PATIENTS AND METHODS We evaluated cumulative breast cancer risk in 1,230 female childhood cancer survivors treated with chest irradiation who were participants in the CCSS (Childhood Cancer Survivor Study). RESULTS Childhood cancer survivors treated with lower delivered doses of radiation (median, 14 Gy; range, 2 to 20 Gy) to a large volume (whole-lung field) had a high risk of breast cancer (standardized incidence ratio [SIR], 43.6; 95% CI, 27.2 to 70.3), as did survivors treated with high doses of delivered radiation (median, 40 Gy) to the mantle field (SIR, 24.2; 95% CI, 20.7 to 28.3). The cumulative incidence of breast cancer by age 50 years was 30% (95% CI, 25 to 34), with a 35% incidence among Hodgkin lymphoma survivors (95% CI, 29 to 40). Breast cancer-specific mortality at 5 and 10 years was 12% (95% CI, 8 to 18) and 19% (95% CI, 13 to 25), respectively. CONCLUSION Among women treated for childhood cancer with chest radiation therapy, those treated with whole-lung irradiation have a greater risk of breast cancer than previously recognized, demonstrating the importance of radiation volume. Importantly, mortality associated with breast cancer after childhood cancer is substantial.
Collapse
Affiliation(s)
- Chaya S Moskowitz
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN.
| | - Joanne F Chou
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Suzanne L Wolden
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Jonine L Bernstein
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Jyoti Malhotra
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Danielle Novetsky Friedman
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Nidha Z Mubdi
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Wendy M Leisenring
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Marilyn Stovall
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Sue Hammond
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Susan A Smith
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Tara O Henderson
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - John D Boice
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Melissa M Hudson
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Lisa R Diller
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Smita Bhatia
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Lisa B Kenney
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Joseph P Neglia
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Colin B Begg
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Leslie L Robison
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| | - Kevin C Oeffinger
- Chaya S. Moskowitz, Joanne F. Chou, Suzanne L. Wolden, Jonine L. Bernstein, Danielle Novetsky Friedman, Nidha Z. Mubdi, Colin B. Begg, and Kevin C. Oeffinger, Memorial Sloan Kettering Cancer Center; Jyoti Malhotra, Mount Sinai Medical Center, New York, NY; Wendy M. Leisenring, Fred Hutchinson Cancer Research Center, Seattle, WA; Marilyn Stovall and Susan A. Smith, University of Texas MD Anderson Cancer Center, Houston, TX; Sue Hammond, Nationwide Children's Hospital, Columbus, OH; Tara O. Henderson, University of Chicago Medicine Comer Children's Hospital, Chicago, IL; John D. Boice, Vanderbilt-Ingram Cancer Center, Nashville; Melissa M. Hudson and Leslie L. Robison, St Jude Children's Research Hospital, Memphis, TN; Lisa R. Diller and Lisa B. Kenney, Dana-Farber Cancer Institute, Boston, MA; Smita Bhatia, City of Hope National Medical Center, Duarte, CA; and Joseph P. Neglia, University of Minnesota Masonic Cancer Center, Minneapolis, MN
| |
Collapse
|
32
|
Emond JA, Pierce JP, Natarajan L, Gapuz LR, Nguyen J, Parker BA, Varki NM, Patterson RE. Risk of breast cancer recurrence associated with carbohydrate intake and tissue expression of IGFI receptor. Cancer Epidemiol Biomarkers Prev 2014; 23:1273-9. [PMID: 24755714 DOI: 10.1158/1055-9965.epi-13-1218] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND The insulin-like growth factor-I (IGFI) receptor is a potential target for breast cancer treatment and may be influenced by dietary intake. METHODS Nested, case-control study of 265 postmenopausal breast cancer survivors; primary breast cancer tissue was stained to determine IGFI receptor status. Change in carbohydrate intake from baseline to year 1 of study was estimated from 24-hour dietary recalls. Breast cancer recurrence cases (91) were matched to two controls (n = 174) on disease and study characteristics and counter matched on change in carbohydrate intake. Weighted conditional logistic regression models fit the risk of recurrence on IGFI receptor status and dietary change. RESULTS Half of the tumors were IGFI receptor positive. Increased risk of recurrence was associated with IGFI receptor-positive status [HR 1.7; 95% confidence interval (CI), 1.2-2.5] and, separately, with a stable/increased intake of carbohydrates (HR 2.0; 95% CI, 1.3-5.0). There was a borderline significant interaction between those two variables (P = 0.11). Specifically, carbohydrate intake had no significant impact on risk of recurrence among women who were receptor negative, yet increased the risk of recurrence by more than 5-fold among women who were receptor positive (HR 5.5; 95% CI, 1.8-16.3). CONCLUSIONS Among women whose tumor tissue is positive for the IGFI receptor, reducing carbohydrate intake after diagnosis could reduce the risk of breast cancer recurrence. These findings need replication in a larger sample. IMPACT This is the first study to suggest that it may be possible to personalize dietary recommendations for breast cancer survivors based on molecular characteristics of their primary tumor tissue. .
Collapse
Affiliation(s)
- Jennifer A Emond
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - John P Pierce
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - Loki Natarajan
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - Laarni R Gapuz
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - John Nguyen
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - Barbara A Parker
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| | - Nissi M Varki
- Department of Pathology, University of California, San Diego, La Jolla, California
| | - Ruth E Patterson
- Authors' Affiliations: Cancer Prevention and Control Program, Moores UCSD Cancer Center, Department of Family and Preventive Medicine; and
| |
Collapse
|
33
|
Duan L, Thomas DC. A Bayesian Hierarchical Model for Relating Multiple SNPs within Multiple Genes to Disease Risk. Int J Genomics 2013; 2013:406217. [PMID: 24490143 PMCID: PMC3892936 DOI: 10.1155/2013/406217] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2013] [Revised: 09/03/2013] [Accepted: 09/09/2013] [Indexed: 11/18/2022] Open
Abstract
A variety of methods have been proposed for studying the association of multiple genes thought to be involved in a common pathway for a particular disease. Here, we present an extension of a Bayesian hierarchical modeling strategy that allows for multiple SNPs within each gene, with external prior information at either the SNP or gene level. The model involves variable selection at the SNP level through latent indicator variables and Bayesian shrinkage at the gene level towards a prior mean vector and covariance matrix that depend on external information. The entire model is fitted using Markov chain Monte Carlo methods. Simulation studies show that the approach is capable of recovering many of the truly causal SNPs and genes, depending upon their frequency and size of their effects. The method is applied to data on 504 SNPs in 38 candidate genes involved in DNA damage response in the WECARE study of second breast cancers in relation to radiotherapy exposure.
Collapse
Affiliation(s)
- Lewei Duan
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California (USC), 2001 N. Soto Street, Los Angeles, CA, USA
| | - Duncan C. Thomas
- Division of Biostatistics, Department of Preventive Medicine, University of Southern California (USC), 2001 N. Soto Street, Los Angeles, CA, USA
| |
Collapse
|
34
|
Thomas DC, Yang Z, Yang F. Two-phase and family-based designs for next-generation sequencing studies. Front Genet 2013; 4:276. [PMID: 24379824 PMCID: PMC3861783 DOI: 10.3389/fgene.2013.00276] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2013] [Accepted: 11/19/2013] [Indexed: 12/21/2022] Open
Abstract
The cost of next-generation sequencing is now approaching that of early GWAS panels, but is still out of reach for large epidemiologic studies and the millions of rare variants expected poses challenges for distinguishing causal from non-causal variants. We review two types of designs for sequencing studies: two-phase designs for targeted follow-up of genomewide association studies using unrelated individuals; and family-based designs exploiting co-segregation for prioritizing variants and genes. Two-phase designs subsample subjects for sequencing from a larger case-control study jointly on the basis of their disease and carrier status; the discovered variants are then tested for association in the parent study. The analysis combines the full sequence data from the substudy with the more limited SNP data from the main study. We discuss various methods for selecting this subset of variants and describe the expected yield of true positive associations in the context of an on-going study of second breast cancers following radiotherapy. While the sharing of variants within families means that family-based designs are less efficient for discovery than sequencing unrelated individuals, the ability to exploit co-segregation of variants with disease within families helps distinguish causal from non-causal ones. Furthermore, by enriching for family history, the yield of causal variants can be improved and use of identity-by-descent information improves imputation of genotypes for other family members. We compare the relative efficiency of these designs with those using unrelated individuals for discovering and prioritizing variants or genes for testing association in larger studies. While associations can be tested with single variants, power is low for rare ones. Recent generalizations of burden or kernel tests for gene-level associations to family-based data are appealing. These approaches are illustrated in the context of a family-based study of colorectal cancer.
Collapse
Affiliation(s)
- Duncan C Thomas
- Department of Preventive Medicine, University of Southern California Los Angeles, CA, USA
| | - Zhao Yang
- Department of Preventive Medicine, University of Southern California Los Angeles, CA, USA
| | - Fan Yang
- Department of Preventive Medicine, University of Southern California Los Angeles, CA, USA
| |
Collapse
|
35
|
Marcu LG, Santos A, Bezak E. Risk of second primary cancer after breast cancer treatment. Eur J Cancer Care (Engl) 2013; 23:51-64. [PMID: 23947545 DOI: 10.1111/ecc.12109] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/10/2013] [Indexed: 12/26/2022]
Abstract
Technological advances in both diagnosis and treatment of breast cancer lead to early detection and better treatment management. Consequently, the population of long-term survivors is on the rise. The risk of developing second cancers among breast cancer survivors was shown to be higher than that for the general population. The aim of this work was to review the literature on the risk of second primary cancer (SPC) after breast irradiation. Pubmed search of population-based studies on SPC after breast irradiation was conducted and the findings (in terms of Standardised Incidence Ratio) were collated and discussed. Several studies confirmed the link between breast tumour irradiation and risk of SPC, showing a small, but valid risk. There are, however, confounding factors that can either underestimate or overestimate risks: misclassification of tumour status, genetic inheritance, smoking, environmental factors, and the lack of accurate data in cancer registries. While isolating these potential triggers might be difficult, this approach would allow better discernability between radiotherapy-related risks and those generated by other factors. It is also important to evaluate the current status of treatment-related late effects and to lower such risks by minimising the dose delivered to normal tissues.
Collapse
Affiliation(s)
- L G Marcu
- Department of Medical Physics, Royal Adelaide Hospital, Adelaide, SA, Australia; School of Chemistry and Physics, University of Adelaide, Adelaide, SA, Australia; Faculty of Science, University of Oradea, Oradea, Romania
| | | | | |
Collapse
|
36
|
Southey MC, Teo ZL, Winship I. PALB2 and breast cancer: ready for clinical translation! APPLICATION OF CLINICAL GENETICS 2013; 6:43-52. [PMID: 23935381 PMCID: PMC3735037 DOI: 10.2147/tacg.s34116] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
For almost two decades, breast cancer clinical genetics has operated in an environment where a heritable cause of breast cancer susceptibility is identified in the vast minority of women seeking advice about their personal and/or family history of breast and/or ovarian cancer. A new wave of genetic information is upon us that promises to provide an explanation for the greater proportion of current missing heritability of breast cancer. Whilst researchers refine bioinformatic and analytic methodology necessary to interpret the new genetic data, attention needs to be paid to defining appropriate and coordinated pathways for the translation of this information so that it can be applied in clinical genetic services for the benefit of the majority of women who currently have no explanation for their breast cancer susceptibility. The search for additional breast cancer susceptibility genes remains a very active area of research. Exhausting the power of linkage studies that identified BRCA1 and BRCA2, the research community moved to candidate gene studies that led to the identification of ATM, BRIP1, CHEK2, and PALB2 as so-called "moderate-risk" breast cancer susceptibility genes. Mutations in these genes are rare and although early reports suggested that, on average, they are associated with moderate risks of breast cancer; population-based studies have demonstrated that at least some mutations in these genes are associated with breast cancer risks that are comparable to the average risk associated with BRCA2 mutations. The search for additional breast cancer susceptibility genes has now moved onto research platforms applying massively parallel sequencing capable of sequencing whole human exomes and genomes in single instrument runs. These programs are identifying a large number of additional putative breast cancer susceptibility genes, many of which are currently undergoing validation. It is highly anticipated that the remaining missing heritability of breast cancer will be due to mutations in many different genes, each explaining a small proportion of the currently unexplained heritable breast cancer susceptibility. The characterization of PALB2 as a breast cancer susceptibility gene and subsequent research that has refined our understanding of the prevalence and penetrance of heritable mutations in PALB2 offers a precious opportunity to use the data as a model and develop modes of translation that would be appropriate for the anticipated volume of imminent new information.
Collapse
Affiliation(s)
- Melissa C Southey
- Genetic Epidemiology Laboratory, Department of Pathology, The University of Melbourne, Victoria, Australia
| | | | | |
Collapse
|
37
|
Brooks JD, Teraoka SN, Bernstein L, Mellemkjær L, Malone KE, Lynch CF, Haile RW, Concannon P, Reiner AS, Duggan DJ, Schiermeyer K, Bernstein JL, Figueiredo JC. Common variants in genes coding for chemotherapy metabolizing enzymes, transporters, and targets: a case-control study of contralateral breast cancer risk in the WECARE Study. Cancer Causes Control 2013; 24:1605-14. [PMID: 23775025 PMCID: PMC3709075 DOI: 10.1007/s10552-013-0237-6] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2012] [Accepted: 05/21/2013] [Indexed: 11/27/2022]
Abstract
Purpose Women who receive chemotherapy for a first primary breast cancer have been observed to have a reduced risk of contralateral breast cancer (CBC), however, whether the genetic profile of a patient modifies this protective effect is currently not understood. The purpose of this study is to investigate the impact of germline genetic variation in genes coding for drug metabolizing enzymes, transporters, and targets on the association between chemotherapy and risk of CBC. Methods From the population-based Women’s Environment Cancer and Radiation Epidemiology (WECARE) Study, we included 636 Caucasian women with CBC (cases) and 1,224 women with unilateral breast cancer (controls). The association between common chemotherapeutic regimens, CMF and FAC/FEC, and risk of CBC stratified by genotype of 180 single nucleotide polymorphisms in 14 genes selected for their known involvement in metabolism, action, and transport of breast cancer chemotherapeutic agents, were determined using conditional logistic regression. Results CMF (RR = 0.5, 95 % CI 0.4, 0.7) and FAC/FEC (RR = 0.7, 95 % CI 0.4, 1.0) are associated with lower CBC risk relative to no chemotherapy in multivariable-adjusted models. Here we show that genotype of selected genes involved in the metabolism and uptake of these therapeutic agents does not significantly alter the protective effect of either CMF or FAC/FEC on risk of CBC. Conclusion The results of this study show that germline genetic variation in selected gene does not significantly alter the protective effect of CMF, FAC, and FEC on risk of CBC. Electronic supplementary material The online version of this article (doi:10.1007/s10552-013-0237-6) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, 3rd Floor, New York, NY, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
38
|
Bernstein JL, Thomas DC, Shore RE, Robson M, Boice JD, Stovall M, Andersson M, Bernstein L, Malone KE, Reiner AS, Lynch CF, Capanu M, Smith SA, Tellhed L, Teraoka SN, Begg CB, Olsen JH, Mellemkjaer L, Liang X, Diep AT, Borg A, Concannon P, Haile RW. Contralateral breast cancer after radiotherapy among BRCA1 and BRCA2 mutation carriers: a WECARE study report. Eur J Cancer 2013; 49:2979-85. [PMID: 23706288 DOI: 10.1016/j.ejca.2013.04.028] [Citation(s) in RCA: 59] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2013] [Revised: 03/04/2013] [Accepted: 04/27/2013] [Indexed: 01/29/2023]
Abstract
BACKGROUND Women with germline BRCA1 or BRCA2 (BRCA1/BRCA2) mutations are at very high risk of developing breast cancer, including asynchronous contralateral breast cancer (CBC). BRCA1/BRCA2 genes help maintain genome stability and assist in DNA repair. We examined whether the risk of CBC associated with radiation treatment was higher among women with germline BRCA1/BRCA2 mutations than among non-carriers. METHODS A population-based, nested case-control study was conducted within a cohort of 52,536 survivors of unilateral breast cancer (UBC). Cases were 603 women with CBC and controls were 1199 women with UBC individually matched on age at diagnosis, race, year of first diagnosis and cancer registry. All women were tested for BRCA1 and BRCA2 mutations. Radiation absorbed dose from the initial radiotherapy (RT) to the CBC location within the contralateral breast was reconstructed from measurements in a tissue-equivalent phantom and details available in the therapy records. FINDINGS Among women treated with radiation, the mean radiation dose was 1.1 Gy (range = 0.02-6.2 Gy). Risk of developing CBC was elevated among women who carried a deleterious BRCA1/BRCA2 mutation (rate ratio, RR = 4.5, confidence interval, CI = 3.0-6.8), and also among those treated with RT (RR = 1.2, CI = 1.0-1.6). However, among mutation carriers, an incremental increase in risk associated with radiation dose was not statistically significant. INTERPRETATION Multiplicative interaction of RT with mutation status would be reflected by a larger association of RT with CBC among carriers than among non-carriers, but this was not apparent. Accordingly, there was no clear indication that carriers of deleterious BRCA/BRCA2 mutations were more susceptible to the carcinogenic effects of radiation than non-carriers. These findings are reassuring and have important clinical implications for treatment decisions and the clinical management of patients harbouring deleterious BRCA1/BRCA2 mutations. FUNDING All work associated with this study was supported by the U.S. National Cancer Institute [R01CA097397, U01CA083178].
Collapse
Affiliation(s)
- Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
39
|
Quintana MA, Schumacher FR, Casey G, Bernstein JL, Li L, Conti DV. Incorporating prior biologic information for high-dimensional rare variant association studies. Hum Hered 2013; 74:184-95. [PMID: 23594496 DOI: 10.1159/000346021] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
BACKGROUND Given the increasing scale of rare variant association studies, we introduce a method for high-dimensional studies that integrates multiple sources of data as well as allows for multiple region-specific risk indices. METHODS Our method builds upon the previous Bayesian risk index by integrating external biological variant-specific covariates to help guide the selection of associated variants and regions. Our extension also incorporates a second level of uncertainty as to which regions are associated with the outcome of interest. RESULTS Using a set of study-based simulations, we show that our approach leads to an increase in power to detect true associations in comparison to several commonly used alternatives. Additionally, the method provides multi-level inference at the pathway, region and variant levels. CONCLUSION To demonstrate the flexibility of the method to incorporate various types of information and the applicability to high-dimensional data, we apply our method to a single region within a candidate gene study of second primary breast cancer and to multiple regions within a candidate pathway study of colon cancer.
Collapse
Affiliation(s)
- Melanie A Quintana
- Department of Preventive Medicine, University of Southern California, Los Angeles, CA 90089, USA
| | | | | | | | | | | |
Collapse
|
40
|
Brooks JD, Teraoka SN, Malone KE, Haile RW, Bernstein L, Lynch CF, Mellemkjær L, Duggan DJ, Reiner AS, Concannon P, Schiermeyer K, Lewinger JP, Bernstein JL, Figueiredo JC. Variants in tamoxifen metabolizing genes: a case-control study of contralateral breast cancer risk in the WECARE study. INTERNATIONAL JOURNAL OF MOLECULAR EPIDEMIOLOGY AND GENETICS 2013; 4:35-48. [PMID: 23565321 PMCID: PMC3612453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 02/11/2013] [Indexed: 06/02/2023]
Abstract
Tamoxifen has been shown to greatly reduce risk of recurrence and contralateral breast cancer (CBC). Still, second primary contralateral breast cancer is the most common malignancy to follow a first primary breast cancer. Genetic variants in CYP2D6 and other drug-metabolizing enzymes that alter the metabolism of tamoxifen may be associated with CBC risk in women who receive the drug. This is the first study to investigate the impact of this variation on risk of CBC in women who receive tamoxifen. From the population-based Women's Environment Cancer and Radiation Epidemiology (WECARE) Study, we included 624 Caucasian women with CBC (cases) and 1,199 women with unilateral breast cancer (controls) with complete information on tumor characteristics and treatment. Conditional logistic regression was used to assess the risk of CBC associated with 112 single nucleotide polymorphisms (SNPs) in 8 genes involved in the metabolism of tamoxifen among tamoxifen users and non-users. After adjustment for multiple testing, no significant association was observed between any of the genotyped variants and CBC risk in either tamoxifen users or non-users. These results suggest that when using a tagSNP approach, common variants in selected genes involved in the metabolism of tamoxifen are not associated with risk of CBC among women treated with the drug.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer CenterUSA
| | - Sharon N Teraoka
- University of Florida Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of FloridaUSA
| | - Kathleen E Malone
- Program in Epidemiology, Division of Public Health Science, Fred Hutchinson Cancer Research CenterUSA
| | - Robert W Haile
- Stanford School of Medicine, Department of Medicine, Division of OncologyUSA
| | - Leslie Bernstein
- Department of Population Sciences, Beckman Research Institute of the City of HopeUSA
| | - Charles F Lynch
- Department of Epidemiology, The University of Iowa College of Public HealthUSA
| | - Lene Mellemkjær
- Research Department II, Institute of Cancer Epidemiology, Danish Cancer SocietyUSA
| | - David J Duggan
- Genetic Basis of Human Disease Division, Translational Genomic Research InstituteUSA
| | - Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer CenterUSA
| | - Patrick Concannon
- University of Florida Genetics Institute and Department of Pathology, Immunology and Laboratory Medicine, University of FloridaUSA
| | | | - Juan Pablo Lewinger
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern CaliforniaUSA
| | | | - Jonine L Bernstein
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer CenterUSA
| | - Jane C Figueiredo
- Department of Preventive Medicine, Norris Comprehensive Cancer Center, Keck School of Medicine, University of Southern CaliforniaUSA
| |
Collapse
|
41
|
Reiner AS, John EM, Brooks JD, Lynch CF, Bernstein L, Mellemkjær L, Malone KE, Knight JA, Capanu M, Teraoka SN, Concannon P, Liang X, Figueiredo JC, Smith SA, Stovall M, Pike MC, Haile RW, Thomas DC, Begg CB, Bernstein JL. Risk of asynchronous contralateral breast cancer in noncarriers of BRCA1 and BRCA2 mutations with a family history of breast cancer: a report from the Women's Environmental Cancer and Radiation Epidemiology Study. J Clin Oncol 2012; 31:433-9. [PMID: 23269995 DOI: 10.1200/jco.2012.43.2013] [Citation(s) in RCA: 86] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
PURPOSE To fully characterize the risk of contralateral breast cancer (CBC) in patients with breast cancer with a family history who test negative for BRCA1 and BRCA2 mutations. PATIENTS AND METHODS From our population-based case-control study comparing women with CBC to women with unilateral breast cancer (UBC), we selected women who tested negative for BRCA1 and BRCA2 mutations (594 patients with CBC/1,119 control patients with UBC). Rate ratios (RRs) and 95% CIs were estimated to examine the association between family history of breast cancer and risk of asynchronous CBC. Age- and family history-specific 10-year cumulative absolute risks of CBC were estimated. RESULTS Family history of breast cancer was associated with increased CBC risk; risk was highest among young women (< 45 years) with first-degree relatives affected at young ages (< 45 years; RR, 2.5; 95% CI, 1.1 to 5.3) or women with first-degree relatives with bilateral disease (RR, 3.6; 95% CI, 2.0 to 6.4). Women diagnosed with UBC before age 55 years with a first-degree family history of CBC had a 10-year risk of CBC of 15.6%. CONCLUSION Young women with breast cancer who have a family history of breast cancer and who test negative for deleterious mutations in BRCA1 and BRCA2 are at significantly greater risk of CBC than other breast cancer survivors. This risk varies with diagnosis age, family history of CBC, and degree of relationship to an affected relative. Women with a first-degree family history of bilateral disease have risks of CBC similar to mutation carriers. This has important implications for the clinical management of patients with breast cancer with family history of the disease.
Collapse
Affiliation(s)
- Anne S Reiner
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
42
|
Brooks JD, Bernstein L, Teraoka SN, Knight JA, Mellemkjær L, John EM, Malone KE, Reiner AS, Lynch CF, Concannon P, Haile RW, Bernstein JL. Variation in genes related to obesity, weight, and weight change and risk of contralateral breast cancer in the WECARE Study population. Cancer Epidemiol Biomarkers Prev 2012; 21:2261-7. [PMID: 23033454 DOI: 10.1158/1055-9965.epi-12-1036] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND Body mass index (BMI), a known breast cancer risk factor, could influence breast risk through mechanistic pathways related to sex hormones, insulin resistance, chronic inflammation, and altered levels of adipose-derived hormones. Results from studies of the relationship between BMI and second primary breast cancer have been mixed. To explore the relationship between BMI and asynchronous contralateral breast cancer (CBC), we examined whether variants in genes related to obesity, weight, and weight change are associated with CBC risk. METHODS Variants in 20 genes [182 single-nucleotide polymorphisms (SNP)] involved in adipose tissue metabolism, energy balance, insulin resistance, and inflammation, as well as those identified through genome-wide association studies (GWAS) of BMI and type II-diabetes were evaluated. We examined the association between variants in these genes and the risk of CBC among Caucasian participants [643 cases with CBC and 1,271 controls with unilateral breast cancer (UBC)] in the population-based Women's Environmental Cancer and Radiation Epidemiology (WECARE) Study using conditional logistic regression. RESULTS After adjustment for multiple comparisons, no statistically significant associations between any variant and CBC risk were seen. Stratification by menopausal or estrogen receptor (ER) status did not alter these findings. CONCLUSION Among women with early-onset disease who survive a first breast cancer diagnosis, there was no association between variation in obesity-related genes and risk of CBC. IMPACT Genetic variants in genes related to obesity are not likely to strongly influence subsequent risk of developing a second primary breast cancer.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, 2nd floor, New York 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
43
|
Fucic A, Gamulin M, Ferencic Z, Katic J, Krayer von Krauss M, Bartonova A, Merlo DF. Environmental exposure to xenoestrogens and oestrogen related cancers: reproductive system, breast, lung, kidney, pancreas, and brain. Environ Health 2012; 11 Suppl 1:S8. [PMID: 22759508 PMCID: PMC3388472 DOI: 10.1186/1476-069x-11-s1-s8] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/02/2023]
Abstract
The role of steroids in carcinogenesis has become a major concern in environmental protection, biomonitoring, and clinical research. Although historically oestrogen has been related to development of reproductive system, research over the last decade has confirmed its crucial role in the development and homeostasis of other organ systems. As a number of anthropogenic agents are xenoestrogens, environmental health research has focused on oestrogen receptor level disturbances and of aromatase polymorphisms. Oestrogen and xenoestrogens mediate critical points in carcinogenesis by binding to oestrogen receptors, whose distribution is age-, gender-, and tissue-specific. This review brings data about cancer types whose eatiology may be found in environmental exposure to xenoestrogens. Cancer types that have been well documented in literature to be related with environmental exposure include the reproductive system, breast, lung, kidney, pancreas, and brain. The results of our data mining show (a) a significant correlation between exposure to xenoestrogens and increased, gender-related, cancer risk and (b) a need to re-evaluate agents so far defined as endocrine disruptors, as they are also key molecules in carcinogenesis. This revision may be used to further research of cancer aetiology and to improvement of related legislation. Investigation of cancers caused by xenoestrogens may elucidate yet unknown mechanisms also valuable for oncology and the development of new therapies.
Collapse
Affiliation(s)
- Aleksandra Fucic
- Institute for Medical Research and Occupational Health, Zagreb, Ksaverska c 2, Croatia
| | - Marija Gamulin
- University Hospital “Zagreb”, Zagreb, Kispaticeva 12, Croatia
| | - Zeljko Ferencic
- Children’s Hospital “Srebrnjak”, Zagreb, Srebrnjak 100, Croatia
| | - Jelena Katic
- Institute for Medical Research and Occupational Health, Zagreb, Ksaverska c 2, Croatia
| | | | - Alena Bartonova
- NILU – Norwegian Institute for Air Research, Kjeller, Norway
| | - Domenico F Merlo
- National Institute for Cancer Research, Genoa, Largo R. Benzi 10, Italy
| |
Collapse
|
44
|
Brooks JD, Boice JD, Stovall M, Reiner AS, Bernstein L, John EM, Lynch CF, Mellemkjær L, Knight JA, Thomas DC, Haile RW, Smith SA, Capanu M, Bernstein JL, Shore RE. Reproductive status at first diagnosis influences risk of radiation-induced second primary contralateral breast cancer in the WECARE study. Int J Radiat Oncol Biol Phys 2012; 84:917-24. [PMID: 22483700 DOI: 10.1016/j.ijrobp.2012.01.047] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2011] [Revised: 01/13/2012] [Accepted: 01/13/2012] [Indexed: 11/16/2022]
Abstract
PURPOSE Our study examined whether reproductive and hormonal factors before, at the time of, or after radiation treatment for a first primary breast cancer modify the risk of radiation-induced second primary breast cancer. METHODS AND MATERIALS The Women's Environmental, Cancer and Radiation Epidemiology (WECARE) Study is a multicenter, population-based study of 708 women (cases) with asynchronous contralateral breast cancer (CBC) and 1399 women (controls) with unilateral breast cancer. Radiotherapy (RT) records, coupled with anthropomorphic phantom simulations, were used to estimate quadrant-specific radiation dose to the contralateral breast for each patient. Rate ratios (RR) and 95% confidence intervals (CI) were computed to assess the relationship between reproductive factors and risk of CBC. RESULTS Women who were nulliparous at diagnosis and exposed to ≥1 Gy to the contralateral breast had a greater risk for CBC than did matched unexposed nulliparous women (RR=2.2; 95% CI, 1.2-4.0). No increased risk was seen in RT-exposed parous women (RR=1.1; 95% CI, 0.8-1.4). Women treated with RT who later became pregnant (8 cases and 9 controls) had a greater risk for CBC (RR=6.0; 95% CI, 1.3-28.4) than unexposed women (4 cases and 7 controls) who also became pregnant. The association of radiation with risk of CBC did not vary by number of pregnancies, history of breastfeeding, or menopausal status at the time of first breast cancer diagnosis. CONCLUSION Nulliparous women treated with RT were at an increased risk for CBC. Although based on small numbers, women who become pregnant after first diagnosis also seem to be at an increased risk for radiation-induced CBC.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
45
|
Kaiser JC, Jacob P, Meckbach R, Cullings HM. Breast cancer risk in atomic bomb survivors from multi-model inference with incidence data 1958-1998. RADIATION AND ENVIRONMENTAL BIOPHYSICS 2012; 51:1-14. [PMID: 21947564 DOI: 10.1007/s00411-011-0387-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Accepted: 09/08/2011] [Indexed: 05/03/2023]
Abstract
Breast cancer risk from radiation exposure has been analyzed in the cohort of Japanese a-bomb survivors using empirical models and mechanistic two-step clonal expansion (TSCE) models with incidence data from 1958 to 1998. TSCE models rely on a phenomenological representation of cell transition processes on the path to cancer. They describe the data as good as empirical models and this fact has been exploited for risk assessment. Adequate models of both types have been selected with a statistical protocol based on parsimonious parameter deployment and their risk estimates have been combined using multi-model inference techniques. TSCE models relate the radiation risk to cell processes which are controlled by age-increasing rates of initiating mutations and by changes in hormone levels due to menopause. For exposure at young age, they predict an enhanced excess relative risk (ERR) whereas the preferred empirical model shows no dependence on age at exposure. At attained age 70, the multi-model median of the ERR at 1 Gy decreases moderately from 1.2 Gy(-1) (90% CI 0.72; 2.1) for exposure at age 25 to a 30% lower value for exposure at age 55. For cohort strata with few cases, where model predictions diverge, uncertainty intervals from multi-model inference are enhanced by up to a factor of 1.6 compared to the preferred empirical model. Multi-model inference provides a joint risk estimate from several plausible models rather than relying on a single model of choice. It produces more reliable point estimates and improves the characterization of uncertainties. The method is recommended for risk assessment in practical radiation protection.
Collapse
Affiliation(s)
- J C Kaiser
- Helmholtz-Zentrum München, German Research Centre for Environmental Health, Institute of Radiation Protection, 85764, Neuherberg, Germany.
| | | | | | | |
Collapse
|
46
|
Tischkowitz M, Capanu M, Sabbaghian N, Li L, Liang X, Vallée MP, Tavtigian SV, Concannon P, Foulkes WD, Bernstein L, Bernstein JL, Begg CB. Rare germline mutations in PALB2 and breast cancer risk: a population-based study. Hum Mutat 2012; 33:674-80. [PMID: 22241545 DOI: 10.1002/humu.22022] [Citation(s) in RCA: 67] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2011] [Accepted: 12/22/2011] [Indexed: 12/12/2022]
Abstract
Germline mutations in the PALB2 gene are associated with an increased risk of developing breast cancer but little is known about the frequencies of rare variants in PALB2 and the nature of the variants that influence risk. We selected participants recruited to the Women's Environment, Cancer, and Radiation Epidemiology (WECARE) Study and screened lymphocyte DNA from cases with contralateral breast cancer (n = 559) and matched controls with unilateral breast cancer (n = 565) for PALB2 mutations. Five pathogenic PALB2 mutations were identified among the cases (0.9%) versus none among the controls (P = 0.04). The first-degree female relatives of these five carriers demonstrated significantly higher incidence of breast cancer than relatives of noncarrier cases, indicating that pathogenic PALB2 mutations confer an estimated 5.3-fold increase in risk (95% CI: 1.8-13.2). The frequency of rare (<1% MAF) missense mutations was similar in both groups (23 vs. 21). Our findings confirm in a population-based study setting of women with breast cancer the strong risk associated with truncating mutations in PALB2 that has been reported in family studies. Conversely, there is no evidence from this study that rare PALB2 missense mutations strongly influence breast cancer risk.
Collapse
Affiliation(s)
- Marc Tischkowitz
- Program in Cancer Genetics, Departments of Oncology and Human Genetics, McGill University, Montreal, Quebec, Canada.
| | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Brooks JD, Teraoka SN, Reiner AS, Satagopan JM, Bernstein L, Thomas DC, Capanu M, Stovall M, Smith SA, Wei S, Shore RE, Boice JD, Lynch CF, Mellemkjaer L, Malone KE, Liang X, Haile RW, Concannon P, Bernstein JL. Variants in activators and downstream targets of ATM, radiation exposure, and contralateral breast cancer risk in the WECARE study. Hum Mutat 2012; 33:158-64. [PMID: 21898661 PMCID: PMC3240722 DOI: 10.1002/humu.21604] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2010] [Accepted: 08/25/2011] [Indexed: 11/07/2022]
Abstract
Ionizing radiation (IR) is a breast carcinogen that induces DNA double-strand breaks (DSBs), and variation in genes involved in the DNA DSB response has been implicated in radiation-induced breast cancer. The Women's Environmental, Cancer, and Radiation Epidemiology (WECARE) study is a population-based study of cases with contralateral breast cancer (CBC) and matched controls with unilateral breast cancer. The location-specific radiation dose received by the contralateral breast was estimated from radiotherapy records and mathematical models. One hundred fifty-two SNPs in six genes (CHEK2, MRE11A, MDC1, NBN, RAD50, TP53BP1) involved in the DNA DSBs response were genotyped. No variants or haplotypes were associated with CBC risk (649 cases and 1,284 controls) and no variants were found to interact with radiation dose. Carriers of a RAD50 haplotype exposed to ≥1 gray (Gy) had an increased risk of CBC compared with unexposed carriers (Rate ratios [RR] = 4.31 [95% confidence intervals [CI] 1.93-9.62]); with an excess relative risk (ERR) per Gy = 2.13 [95% CI 0.61-5.33]). Although the results of this study were largely null, carriers of a haplotype in RAD50 treated with radiation had a greater CBC risk than unexposed carriers. This suggests that carriers of this haplotype may be susceptible to the DNA-damaging effects of radiation therapy associated with radiation-induced breast cancer.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Thomas D. Response to 'Gene-by-environment experiments: a new approach to finding the missing heritability' by van IJzendoorn et al. Nat Rev Genet 2011. [DOI: 10.1038/nrg2764-c2] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
|
49
|
Teraoka SN, Bernstein JL, Reiner AS, Haile RW, Bernstein L, Lynch CF, Malone KE, Stovall M, Capanu M, Liang X, Smith SA, Mychaleckyj J, Hou X, Mellemkjaer L, Boice JD, Siniard A, Duggan D, Thomas DC, Concannon P. Single nucleotide polymorphisms associated with risk for contralateral breast cancer in the Women's Environment, Cancer, and Radiation Epidemiology (WECARE) Study. Breast Cancer Res 2011; 13:R114. [PMID: 22087758 PMCID: PMC3326556 DOI: 10.1186/bcr3057] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2011] [Revised: 11/14/2011] [Accepted: 11/17/2011] [Indexed: 12/19/2022] Open
Abstract
Introduction Genome-wide association studies, focusing primarily on unilateral breast cancer, have identified single nucleotide polymorphisms (SNPs) in a number of genomic regions that have alleles associated with a significantly increased risk of breast cancer. In the current study we evaluate the contributions of these previously identified regions to the risk of developing contralateral breast cancer. The most strongly disease-associated SNPs from prior studies were tested for association with contralateral breast cancer. A subset of these SNPs, selected upon their main effects on contralateral breast cancer risk was further evaluated for interaction with treatment modalities and estrogen receptor (ER) status. Methods We genotyped 21 SNPs in 708 women with contralateral breast cancer and 1394 women with unilateral breast cancer who serve as the cases and controls in the Women's Environment, Cancer and Radiation Epidemiology (WECARE) Study. Records of treatment and ER status were available for most of WECARE Study participants. Associations of SNP genotypes and risk for contralateral breast cancer were calculated with multivariable adjusted conditional logistic regression methods. Results Multiple SNPs in the FGFR2 locus were significantly associated with contralateral breast cancer, including rs1219648 (per allele rate ratio (RR) = 1.25, 95%CI = 1.08-1.45). Statistically significant associations with contralateral breast cancer were also observed at rs7313833, near the PTHLH gene (per allele RR = 1.26, 95%CI = 1.08-1.47), rs13387042 (2q35) (per allele RR = 1.19, 95%CI = 1.02-1.37), rs13281615 (8q24) (per allele RR = 1.21, 95%CI = 1.04-1.40), and rs11235127 near TMEM135 (per allele RR = 1.26, 95%CI = 1.04-1.53). The A allele of rs13387042 (2q35) was significantly associated with contralateral breast cancer in ER negative first tumors while the A allele of rs11235127 (near TMEM135) was significantly associated with contralateral breast cancer in ER positive first tumors. Although some SNP genotypes appeared to modify contralateral breast cancer risk with respect to tamoxifen treatment or particular radiation doses, trend tests for such effects were not significant. Conclusions Our results indicate that some common risk variants associated with primary breast cancer also increase risk for contralateral breast cancer, and that these risks vary with the ER status of the first tumor.
Collapse
Affiliation(s)
- Sharon N Teraoka
- Center for Public Health Genomics, University of Virginia, Charlottesville, VA 22908-0717, USA.
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
50
|
Brooks JD, John EM, Mellemkjær L, Reiner AS, Malone KE, Lynch CF, Figueiredo JC, Haile RW, Shore RE, Bernstein JL, Bernstein L. Body mass index and risk of second primary breast cancer: the WECARE Study. Breast Cancer Res Treat 2011; 131:571-80. [PMID: 21892703 DOI: 10.1007/s10549-011-1743-4] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2011] [Accepted: 08/13/2011] [Indexed: 11/25/2022]
Abstract
The identification of potentially modifiable risk factors, such as body size, could allow for interventions that could help reduce the burden of contralateral breast cancer (CBC) among breast cancer survivors. Studies examining the relationship between body mass index (BMI) and CBC have yielded mixed results. From the population-based, case-control, Women's Environmental, Cancer and Radiation Epidemiology (WECARE) Study, we included 511 women with CBC (cases) and 999 women with unilateral breast cancer (controls) who had never used postmenopausal hormone therapy. Rate ratios (RR) and 95% confidence intervals (CI) were used to assess the relationship between BMI and CBC risk. No associations between BMI at first diagnosis or weight-change between first diagnosis and date of CBC diagnosis (or corresponding date in matched controls) and CBC risk were seen. However, obese (BMI ≥ 30 kg/m(2)) postmenopausal women with estrogen receptor (ER)-negative first primary tumors (n = 12 cases and 9 controls) were at an increased risk of CBC compared with normal weight women (BMI < 25 kg/m(2)) (n = 43 cases and 98 controls) (RR = 5.64 (95% CI 1.76, 18.1)). No association between BMI and CBC risk was seen in premenopausal or postmenopausal women with ER-positive first primaries. Overall, BMI is not associated with CBC risk in this population of young breast cancer survivors. Our finding of an over five-fold higher risk of CBC in a small subgroup of obese postmenopausal women with an ER-negative first primary breast cancer is based on limited numbers and requires confirmation in a larger study.
Collapse
Affiliation(s)
- Jennifer D Brooks
- Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 E 63rd Street, 3rd Floor, New York, NY, USA.
| | | | | | | | | | | | | | | | | | | | | |
Collapse
|