Quality of Life of Women with Polycystic Ovary Syndrome

Background and Objectives: Polycystic ovary syndrome (PCOS) is an endocrine disorder characterized by multiple hormonal and metabolic abnormalities, including insulin resistance, hyperandrogenism, and disturbances in lipid and carbohydrate metabolism. The objective of this study is to assess the quality of life of women diagnosed with polycystic ovary syndrome (PCOS) and to identify any factors within the study group that may impact the scores related to quality of life. Materials and Methods: This research was carried out among women diagnosed with PCOS. An original questionnaire, developed through an online Google Forms survey, was utilized as the research instrument and distributed through social networks and support groups to women facing PCOS. This study encompassed a participant pool of 200 women with PCOS, aged 24 years or older. For the analytical component, Pearson's χ2 test was employed-a nonparametric test designed to assess the relationship between two variables measured on a qualitative scale. The chosen level of statistical significance was set at p < 0.05. Results: The analysis revealed that the quality of life of the women under study was not linked to the duration of the disease or comorbidities. However, a significant association was observed with the inconvenience caused by PCOS symptoms. Women experiencing very bothersome symptoms of PCOS reported a lower quality of life compared to those with symptoms rated as not very bothersome. Despite the majority of women with PCOS rating their quality of life as good or very good, they often find the associated symptoms of PCOS bothersome. Women reporting lower quality of life tend to acknowledge the impact of PCOS on their lives, experience a sense of lack of control over the disease, struggle with depression, and do not accept their physical appearance. Conclusions: Hence, the support from specialists like endocrinologists, gynecologists, and nutritionists becomes crucial for many women dealing with PCOS. Adopting a healthy lifestyle, incorporating a balanced diet, and engaging in regular physical activity can assist in managing the troublesome symptoms of PCOS, thereby enhancing overall quality of life. In instances of emotional difficulties, seeking psychological support is equally important, and the significance of support and acceptance from loved ones should not be overlooked.

Factors Affecting Women's Assessment and Satisfaction with Their Childbirth

Background and Objective: Childbirth is one of the most significant experiences in a woman's life. The manner in which childbirth unfolds and is experienced can be influenced by various factors, including the birthing environment and the woman's attitude and preparation. Taking a holistic view of childbirth, it becomes apparent that addressing the basic physiological needs during childbirth can significantly influence the comfort and sense of security of laboring women. The aim of this research was to assess the level of satisfaction among women with their experience during childbirth and to identify its determinants. Materials and Methods: This study included 275 women who had given birth within the past 15 years and were up to 40 years of age. The research method employed was a diagnostic survey, involving a self-designed questionnaire. Results: discussing the birth plan with the midwife, the ability to ask questions during labor, consuming meals during labor, water immersion, listening to music during labor, assuming vertical positions during the second stage of labor, and skin-to-skin contact are associated with increased satisfaction with the childbirth experience. Conclusions: The study findings revealed that the highest levels of satisfaction were reported in connection with the interactions with medical staff during childbirth and the quality of facilities available during delivery. Conversely, the lowest levels of satisfaction were associated with the possibility of using pain relief methods during labor.

A genome-wide gene-environment interaction study of breast cancer risk for women of European ancestry

BACKGROUND

Genome-wide studies of gene-environment interactions (G×E) may identify variants associated with disease risk in conjunction with lifestyle/environmental exposures. We conducted a genome-wide G×E analysis of ~ 7.6 million common variants and seven lifestyle/environmental risk factors for breast cancer risk overall and for estrogen receptor positive (ER +) breast cancer.

METHODS

Analyses were conducted using 72,285 breast cancer cases and 80,354 controls of European ancestry from the Breast Cancer Association Consortium. Gene-environment interactions were evaluated using standard unconditional logistic regression models and likelihood ratio tests for breast cancer risk overall and for ER + breast cancer. Bayesian False Discovery Probability was employed to assess the noteworthiness of each SNP-risk factor pairs.

RESULTS

Assuming a 1 × 10-5 prior probability of a true association for each SNP-risk factor pairs and a Bayesian False Discovery Probability < 15%, we identified two independent SNP-risk factor pairs: rs80018847(9p13)-LINGO2 and adult height in association with overall breast cancer risk (ORint = 0.94, 95% CI 0.92-0.96), and rs4770552(13q12)-SPATA13 and age at menarche for ER + breast cancer risk (ORint = 0.91, 95% CI 0.88-0.94).

CONCLUSIONS

Overall, the contribution of G×E interactions to the heritability of breast cancer is very small. At the population level, multiplicative G×E interactions do not make an important contribution to risk prediction in breast cancer.

Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival

BACKGROUND

Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers.

AIM

To assessed the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS.

METHODS

Analyses were based on 82,701 women diagnosed with a first primary invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations with treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death.

RESULTS

There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status. The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR (95% CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR (95% CI): 1.30 (1.09-1.56)].

CONCLUSION

Systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk.

New Possibilities for Hormonal Vaginal Treatment in Menopausal Women

Hormonal vaginal therapy is an effective treatment option for women who experience vaginal symptoms related to hormonal changes. Estrogen and prasterone are widely used as vaginal treatments, particularly for urogenital atrophy. These symptoms may include vaginal dryness, itching, burning, and pain during sexual intercourse, all of which can significantly affect a woman's quality of life. Previous studies have indicated that such treatment improves tissue elasticity, moisturizes the vagina, and can have a substantial impact on urine incontinence and vaginal microflora and decreases dyspareunia. Hormonal therapy is also useful and commonly used before vaginal surgical treatment. Prasterone is quite a new option for vaginal therapy in Poland and is mainly recommended for dyspareunia in menopausal women. The study related to prasterone therapy emphasizes its effectiveness and safety, making it advantageous to explore its beneficial impact. This paperwork aims to summarize the mechanism of action as well as the effects of both drugs and their beneficial action during vaginal treatment.

Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival

Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. We aimed to assess the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. Analyses were based on 82,701 women diagnosed with invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations of treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR(95%CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR(95%CI) :1.30 (1.09-1.56)]. In conclusion, systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk. (Main MS: 3201 words).

Functional annotation of the 2q35 breast cancer risk locus implicates a structural variant in influencing activity of a long-range enhancer element

A combination of genetic and functional approaches has identified three independent breast cancer risk loci at 2q35. A recent fine-scale mapping analysis to refine these associations resulted in 1 (signal 1), 5 (signal 2), and 42 (signal 3) credible causal variants at these loci. We used publicly available in silico DNase I and ChIP-seq data with in vitro reporter gene and CRISPR assays to annotate signals 2 and 3. We identified putative regulatory elements that enhanced cell-type-specific transcription from the IGFBP5 promoter at both signals (30- to 40-fold increased expression by the putative regulatory element at signal 2, 2- to 3-fold by the putative regulatory element at signal 3). We further identified one of the five credible causal variants at signal 2, a 1.4 kb deletion (esv3594306), as the likely causal variant; the deletion allele of this variant was associated with an average additional increase in IGFBP5 expression of 1.3-fold (MCF-7) and 2.2-fold (T-47D). We propose a model in which the deletion allele of esv3594306 juxtaposes two transcription factor binding regions (annotated by estrogen receptor alpha ChIP-seq peaks) to generate a single extended regulatory element. This regulatory element increases cell-type-specific expression of the tumor suppressor gene IGFBP5 and, thereby, reduces risk of estrogen receptor-positive breast cancer (odds ratio = 0.77, 95% CI 0.74-0.81, p = 3.1 × 10-31).

Common Susceptibility Loci for Male Breast Cancer

BACKGROUND

The etiology of male breast cancer (MBC) is poorly understood. In particular, the extent to which the genetic basis of MBC differs from female breast cancer (FBC) is unknown. A previous genome-wide association study of MBC identified 2 predisposition loci for the disease, both of which were also associated with risk of FBC.

METHODS

We performed genome-wide single nucleotide polymorphism genotyping of European ancestry MBC case subjects and controls in 3 stages. Associations between directly genotyped and imputed single nucleotide polymorphisms with MBC were assessed using fixed-effects meta-analysis of 1380 cases and 3620 controls. Replication genotyping of 810 cases and 1026 controls was used to validate variants with P values less than 1 × 10-06. Genetic correlation with FBC was evaluated using linkage disequilibrium score regression, by comprehensively examining the associations of published FBC risk loci with risk of MBC and by assessing associations between a FBC polygenic risk score and MBC. All statistical tests were 2-sided.

RESULTS

The genome-wide association study identified 3 novel MBC susceptibility loci that attained genome-wide statistical significance (P < 5 × 10-08). Genetic correlation analysis revealed a strong shared genetic basis with estrogen receptor-positive FBC. Men in the top quintile of genetic risk had a fourfold increased risk of breast cancer relative to those in the bottom quintile (odds ratio = 3.86, 95% confidence interval = 3.07 to 4.87, P = 2.08 × 10-30).

CONCLUSIONS

These findings advance our understanding of the genetic basis of MBC, providing support for an overlapping genetic etiology with FBC and identifying a fourfold high-risk group of susceptible men.

CYP3A7*1C allele: linking premenopausal oestrone and progesterone levels with risk of hormone receptor-positive breast cancers

BACKGROUND

Epidemiological studies provide strong evidence for a role of endogenous sex hormones in the aetiology of breast cancer. The aim of this analysis was to identify genetic variants that are associated with urinary sex-hormone levels and breast cancer risk.

METHODS

We carried out a genome-wide association study of urinary oestrone-3-glucuronide and pregnanediol-3-glucuronide levels in 560 premenopausal women, with additional analysis of progesterone levels in 298 premenopausal women. To test for the association with breast cancer risk, we carried out follow-up genotyping in 90,916 cases and 89,893 controls from the Breast Cancer Association Consortium. All women were of European ancestry.

RESULTS

For pregnanediol-3-glucuronide, there were no genome-wide significant associations; for oestrone-3-glucuronide, we identified a single peak mapping to the CYP3A locus, annotated by rs45446698. The minor rs45446698-C allele was associated with lower oestrone-3-glucuronide (-49.2%, 95% CI -56.1% to -41.1%, P = 3.1 × 10-18); in follow-up analyses, rs45446698-C was also associated with lower progesterone (-26.7%, 95% CI -39.4% to -11.6%, P = 0.001) and reduced risk of oestrogen and progesterone receptor-positive breast cancer (OR = 0.86, 95% CI 0.82-0.91, P = 6.9 × 10-8).

CONCLUSIONS

The CYP3A7*1C allele is associated with reduced risk of hormone receptor-positive breast cancer possibly mediated via an effect on the metabolism of endogenous sex hormones in premenopausal women.

HEALTH RISK RELATED TO EXPOSURE TO TOXIC COMPOUNDS CONTAINED IN MINERAL AND SPRING WATERS

OBJECTIVE

The aim: The study aimed to assess the content of selected toxic compounds in mineral and spring waters available on the Polish market regarding potential health risks to consumers.

PATIENTS AND METHODS

Materials and methods: Selected mineral and spring waters available on the Polish market were the study's objects. The content of such chemical compounds as arsenic, cadmium, lead, copper, and mercury in selected mineral and spring waters was analyzed. The content of metals in the samples was determined by inductively coupled plasma mass spectrometry (ICP-MS). Additionally, a literature review was performed to determine nitrates contamination of bottled waters available on the Polish market. Based on the collected data, an assessment of exposure and health risk to consumers was performed.

RESULTS

Results: Arsenic had the highest mean concentration in the analyzed water samples. Consumption of such contaminated waters may be a significant health risk factor for consumers. Literature data indicate a relatively low content of nitrates in bottled waters available on the Polish market. Consumption of such mineral waters is not a significant source of exposure and does not translate into a significant health risk for consumers.

CONCLUSION

Conclusions: To ensure consumers' health safety, there is a need to monitor the content of potentially harmful compounds in mineral and spring waters available on the Polish market.

KNOWLEDGE AND ATTITUDES OF YOUNG PEOPLE IN THE FIELD OF EATING DISORDERS

OBJECTIVE

The aim: To examine the level of knowledge and attitudes of high school students in the field of eating disorders.

PATIENTS AND METHODS

Materials and methods: The study group consisted of students of a randomly selected village school (Jendrzejow) and the municipal school (Siemianowice Slaskie). The study was conducted using an original survey consisting of 10 questions regarding the knowledge and attitudes of respondents towards eating disorders.

RESULTS

Results: A total of 313 students (242 female and 71 male) participated in the study. 44.7% of respondents from the village school and 56.6% of respondents from the municipal school were dissatisfied with their appearance; 21.6% and 27.9%, respectively, were currently using the diet. 68% of students from Jędrzejow and 53.3% of students from Siemianowice Slaskie made an attempt to reduce body weight at least once in their lives. 55.1% of the village school respondents and 47.4% of the municipal school respondents noticed the influence of the media on the desire to achieve a slim figure. Girls showed better knowledge about eating disorders than boys (p = 0.008). Over 70% of students of both surveyed high schools believed that people with eating disorders are unable to cope with the disease on their own. Only 6.7% of students of the municipal school and 12.92% of students of the village school gave themselves a very good grade.

CONCLUSION

Conclusions: There is a need to educate young people more broadly about eating disorders and the risk factors for their occurrence.

DNA methylation of the long intergenic noncoding RNA 299 gene in triple-negative breast cancer: results from a prospective study

Triple-negative breast cancer (TNBC) is an aggressive breast cancer subtype associated with a high rate of recurrence and poor prognosis. Recently we identified a hypermethylation in the long noncoding RNA 299 (LINC00299) gene in blood-derived DNA from TNBC patients compared with healthy controls implying that LINC00299 hypermethylation may serve as a circulating biomarker for TNBC. In the present study, we investigated whether LINC00299 methylation is associated with TNBC in a prospective nested breast cancer case-control study within the Generations Study. Methylation at cg06588802 in LINC00299 was measured in 154 TNBC cases and 159 breast cancer-free matched controls using MethyLight droplet digital PCR. To assess the association between methylation level and TNBC risk, logistic regression was used to calculate odd ratios and 95% confidence intervals, adjusted for smoking status. We found no evidence for association between methylation levels and TNBC overall (P = 0.062). Subgroup analysis according to age at diagnosis and age at blood draw revealed increased methylation levels in TNBC cases compared with controls in the young age groups [age 26-52 (P = 0.0025) and age 22-46 (P = 0.001), respectively]. Our results suggest a potential association of LINC00299 hypermethylation with TNBC in young women.

ASSESSMENT OF ADULT EATING HABITS IN THE NUTRITIONAL PREVENTION OF STROKE

OBJECTIVE

Introduction: Lifestyle modification, including changing eating habits, plays an essential role in the prevention of stroke. The aim: The study aimed to assess the nutritional prevention of cerebrovascular diseases in adult inhabitants of Poland.

PATIENTS AND METHODS

Material and Methods: The study was conducted using the author's questionnaire among 145 women and 76 men, aged 18 - 30 (53.9%) and 50 - 70 (46.1%) years.

RESULTS

Results: The following stroke risk factors were found in the examined group: overweight or obesity (46.6%), lack of regular physical activity (48%), smoking (33%), hypertension (22.1%), dyslipidemia (8.6%), diabetes (5.9%), and cardiac arrhythmias (6.3%). The younger subjects compared to older ones more often declared the daily consumption of whole-grain cereal products and vegetables, fish at least once a week, and they preferred vegetable oils. On the other hand, older subjects declared the consumption of sweets, sweet drinks, salt, and fast food less frequently than younger ones. Also, fruits were more often chosen by older people. Both groups declared similar moderate consumption of milk and dairy products with reduced fat content, lean meat, and alcohol. Only 38% of respondents considered their eating habits to be appropriate.

CONCLUSION

Conclusions: The eating habits of examined adults only partially met the recommendations regarding the nutritional prevention of stroke. In some elements, younger people were more likely to follow appropriate dietary recommendations, while older people were more appropriate in others. The education regarding the principles of the nutritional prevention of cerebrovascular diseases is still necessary and should be age-appropriate.

ASSOCIATION BETWEEN EATING HABITS AND PHYSICAL ACTIVITY IN PRIMARY SCHOOL STUDENTS

OBJECTIVE

The aim: The study aimed to assess the association between the physical activity level and eating habits of primary school students.

PATIENTS AND METHODS

Material and methods: 139 children attending one of the Polish primary school or football school were included. The research tool was author's anonymous survey.

RESULTS

Results: The high physical activity level was observed in 34.1% of boys and in 8.8% of girls. As the level of physical activity increased, the consumption of vegetables and fruits also increased. Whole grain bread, coarse-grained groats, whole grain pasta and brown rice were more popular among students with a high physical activity level. The greater the physical activity, the greater the amount of water drank by students. The consumption of sweets, fast food, and ready-made meals, such as frozen pizza or Chinese soup, decreased with increased physical activity. The choice of healthier substitutes for unhealthy snacks was declared by students with moderate or high physical activity level. There was no correlation between BMI and age and the physical activity level. Girls were less active than boys.

CONCLUSION

Conclusions: More active physically children had better eating habits and were more aware of healthy eating principles than less active people.

Epigenome-wide association study for lifetime estrogen exposure identifies an epigenetic signature associated with breast cancer risk

BACKGROUND

It is well established that estrogens and other hormonal factors influence breast cancer susceptibility. We hypothesized that a woman's total lifetime estrogen exposure accumulates changes in DNA methylation, detectable in the blood, which could be used in risk assessment for breast cancer.

METHODS

An estimated lifetime estrogen exposure (ELEE) model was defined using epidemiological data from EPIC-Italy (n = 31,864). An epigenome-wide association study (EWAS) of ELEE was performed using existing Illumina HumanMethylation450K Beadchip (HM450K) methylation data obtained from EPIC-Italy blood DNA samples (n = 216). A methylation index (MI) of ELEE based on 31 CpG sites was developed using HM450K data from EPIC-Italy and the Generations Study and evaluated for association with breast cancer risk in an independent dataset from the Generations Study (n = 440 incident breast cancer cases matched to 440 healthy controls) using targeted bisulfite sequencing. Lastly, a meta-analysis was conducted including three additional cohorts, consisting of 1187 case-control pairs.

RESULTS

We observed an estimated 5% increase in breast cancer risk per 1-year longer ELEE (OR = 1.05, 95% CI 1.04-1.07, P = 3 × 10-12) in EPIC-Italy. The EWAS identified 694 CpG sites associated with ELEE (FDR Q < 0.05). We report a DNA methylation index (MI) associated with breast cancer risk that is validated in the Generations Study targeted bisulfite sequencing data (ORQ4_vs_Q1 = 1.77, 95% CI 1.07-2.93, P = 0.027) and in the meta-analysis (ORQ4_vs_Q1 = 1.43, 95% CI 1.05-2.00, P = 0.024); however, the correlation between the MI and ELEE was not validated across study cohorts.

CONCLUSION

We have identified a blood DNA methylation signature associated with breast cancer risk in this study. Further investigation is required to confirm the interaction between estrogen exposure and DNA methylation in the blood.

[Influence of dietary trends on the nutrition of the youth]

OBJECTIVE

Introduction: Dietary trends such as consumption of lactose-free and gluten-free products or the use of alternative slimming diets are gaining increasing popularity, especially among young people. They determine their dietary choices, which are important from the point of view of human health. Unconventional diets are still considered as effective weight loss methods. The use of alternative diets may cause shortages of an essential nutrients, increase the risk of chronic non-communicable diseases and lead to the formation of incorrect eating habits. Balanced diet, in contrast to the alternative diet, takes into account the principles of rational nutrition and nutritional recommendations of the Institute of Food and Nutrition (IŻŻ). The aim: To investigate the influence of popular dietary trends on nutrition of high school adolescences.

PATIENTS AND METHODS

Material and methods: Subjects were adolescences in the age of 17-21 years attending high schools in Ruda Slaska (262 students, including 157 women and 105 men). Self-constructed questionnaire was applied in the study. Participation in the study was anonymous and voluntary.

RESULTS

Results: In more than a half of young women (54,8%) and men (52,4%) the body mass deficiency was revealed (BMI<18 kg/m2). 33,6% of the respondents were on the non-balanced diets at least once in their lives. High school students knew gluten-free and lactose-free products but dietary trends, such as the consumption of gluten-free and lactose-free products, did not affect their diet. The main source of nutritional knowledge among respondents were their friends (78,2%).

CONCLUSION

Conclusions: The results of the conducted research indicate the need to implement educational programs on the principles of proper nutrition. The increasing awareness of the youth in this regard may contribute to reducing the interest in still popular alternative diets among young people and taking appropriate health behaviors by them.

[Nutrition in selected old age diseases]

In the population of Poland, as well as in other European countries, an aging process is taking place. It is expected that in Poland in 2050, up to 35% of the population may be seniors. With increasing age, there are numerous changes in the body that necessitate the modification of the current diet. Incorrect diet is a risk factor for many old age diseases, including neurodegenerative diseases, osteoporosis, atherosclerosis, stroke, type 2 diabetes and hypertension. The aim of this study is to review the nutrition recommendations in selected diseases of the elderly. The diet of seniors should provide the right amount of nutrients and be adapted to existing diseases. A proper diet can reduce the risk of complications from senile diseases.

Abstract 5316: DNA methylation index of lifetime estrogen exposure in breast cancer

Breast cancer is the most common female cancer worldwide and makes up 25% of all cancers diagnosed in women. There is a need for improved risk assessment methods to identify women at high risk before the disease develops. It is well established that estrogens are involved in estrogen receptor positive (ER+) breast cancer carcinogenesis, however the mechanisms are not fully understood. We hypothesize that lifetime estrogen exposure accumulates changes in DNA methylation detectable in blood as a surrogate for other tissues. Here, we have identified a methylation signature of estrogen exposure measured in blood DNA that could improve risk assessment for breast cancer.

Our Estimated Lifetime Estrogen Exposure (ELEE) model, taking into account reproductive time (age at menopause minus age at menarche), number of pregnancies and breastfeeding duration, shows a 5% increased risk of developing breast cancer per unit increase in ELEE (range 18 – 44) in the European Prospective into Cancer and Nutrition (EPIC)-Italy study cohort (30671 healthy controls, 1193 cases, age at diagnosis ≥ 50). An Epigenome-Wide Association Study (EWAS) of ELEE was conducted on 450K methylation data in EPIC-Italy (199 controls, 97 cases) and the Generations Study (GS) cohort (n=65 controls). For validation targeted bisulfite sequencing using the Fluidigm 48.48 Access Array was performed on independent DNA samples from the GS cohort (440 matched ER+ case-control pairs). The Methylation Index (MI) of ELEE was developed on 450K data using ridge regression and includes DNA methylation levels at selected CpG sites.

DNA methylation levels at 694 CpG sites show significant (false discovery rate q &lt; 0.05) association with ELEE in the EWAS and of these 42 CpG sites from the top-probes were selected for validation. The MI was developed on 28 CpG sites passing quality control and shows high correlation with ELEE in 450K training data (r=0.69) and significant association with breast cancer risk in EPIC-Italy with an OR of 1.38 per unit MI (range 24 – 43, 95% CI: 1.23 – 1.57, P=2.0E-07). Validation step is yet to be finalized; initial analysis on the first 318 case-control pairs suggests a modest but significant association with ER+ breast cancer risk (unadjusted OR=1.04 per unit MI, 95% CI: 1.00 – 1.07, P=0.030, MI range 20 – 53).

In summary, we show that changes in DNA methylation following estrogen exposure are detectable in blood and we have developed a Methylation Index of ELEE that is significantly increased in breast cancer cases compared to controls in EPIC-Italy, and modestly increased in the GS validation cohort. This molecular measure of estrogen exposure could potentially improve risk assessment methods and be used to identify women at high risk of developing breast cancer.

Citation Format: Annelie Johansson, Domenico Palli, Giovanna Masala, Sara Grioni, Claudia Agnoli, Rosario Tumino, Maria Concetta Giurdanella, Francesca Fasanelli, Carlotta Sacerdote, Salvatore Panico, Amalia Mattiello, Anthony Swerdlow, Minouk Schoemaker, Michael Jones, Nick Orr, Olivia Fletcher, Nichola Johnson, Katarzyna Tomczyk, Paolo Vineis, James M. Flanagan. DNA methylation index of lifetime estrogen exposure in breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 5316.

Abstract 1225: Rare variants in DNA damage repair genes are associated with male breast cancer predisposition

Male breast cancer accounts for approximately 1% of all breast cancers diagnosed each year in the UK. Germline mutations in DNA damage response genes are known to be associated with many forms of cancer, including breast cancer. In order to identify low frequency male breast cancer predisposition genes, we performed targeted resequencing of more than 300 genes that were selected on the basis of involvement in DNA maintenance and repair pathways. Using a cost-effective protocol based on an automated library preparation method and a multiplexed hybridization enrichment step, we sequenced 1,029 male breast cancer cases from the UK Breast Cancer Now male breast cancer study (MBCS) and 1,254 controls from the MBCS and the ICR1000 UK exome series. Rare variants localising to 19 genes were significantly associated with risk of male breast cancer. Genes with an excess of rare coding mutations included the known breast cancer susceptibility genes BRCA2, CHEK2 and ATM as well as multiple members of the Fanconi anaemia (FA) pathway. Loss of heterozygosity (LOH) affecting the wildtype allele of putative predisposition genes was observed more than 10% of cases with matched tumor samples. In addition to LOH in BRCA2 mutation carries, somatic losses were observed that affected CCNE1, ATM, PALB2, BARD1, CHEK2, POLL and RAD9A. These data represent the largest analysis of rare variants in male breast cancer to date and have enabled the identification of known and putative novel susceptibility genes.

Citation Format: Sarah L. Maguire, Katarzyna Tomczyk, Eleni Perrakis, Edward Saunders, Daniel Leongamornlert, ZSofia Kote-Jarai, Rosalind Eeles, Montserrat Garcia-Closas, Paul Pharoah, Douglas Easton, Christopher J. Lord, Alan Ashworth, Anthony Swerdlow, Nick Orr. Rare variants in DNA damage repair genes are associated with male breast cancer predisposition [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2018; 2018 Apr 14-18; Chicago, IL. Philadelphia (PA): AACR; Cancer Res 2018;78(13 Suppl):Abstract nr 1225.

Identification of toxic metals in human embryonic tissues

INTRODUCTION

The cause of a significant number of miscarriages remains unexplained. There is a need to identify the potential role of environmental, dietary and lifestyle factors in the risk of pregnancy loss. The present study was the first to investigate the content of miscarried embryonic material with respect to eight metals (aluminium, cadmium, chromium, copper, manganese, nickel, lead and zinc).

MATERIAL AND METHODS

Embryonic tissue samples (n = 20) were obtained from women undergoing misoprostol-induced removal of the embryo between the 6^th and 9^th week of gestation. The content of metals was analyzed using microwave-induced nitrogen plasma atomic emission spectrometry. Based on a short questionnaire, the smoking habits, dietary patterns and place of living of the investigated women were determined.

RESULTS

The general mean content of metals (μg/g) decreased in the order copper (33.9) > manganese (24.7) > chromium (13.6) > zinc (13.3) > aluminium (6.5) > nickel (3.0) > lead (2.9) > cadmium (2.5). Profoundly increased concentrations (p < 0.05) of the toxic elements aluminium (over 5-fold), cadmium (over 2-fold) and lead (over 2-fold) were observed in samples obtained from former smoking women. The miscarried material in urban populations also revealed higher levels of cadmium (over 1.5-fold) and lead (over 2-fold) compared to that obtained from women living in rural areas (p < 0.05). No associations with age or diet were found (p > 0.05).

CONCLUSIONS

This study identified increased levels of aluminum, cadmium and lead in miscarried embryonic material and suggests some causative factors.

[Eating habits of the youth from Ruda Slaska]

OBJECTIVE

Introduction: In recent years, interests on dietary and health food have grown considerably. Nutritional knowledge and eating habits determined in the youth have an impact on the health condition in adulthood. The aim: To evaluate the eating habits in the population of young people from Silesian province.

PATIENTS AND METHODS

Materials and methods: The anonymous questionnaire survey was conducted in the group of high school students aged 17-21 years coming from Silesian province, randomly chosen from high schools in Ruda Slaska. The study group consisted of 262 students, 157 (59,9%) women and 105 (40,1%) men. The student`s participation in the study was voluntary.

RESULTS

Results: The analysis showed that as many as 40% of high school students never eat regularly and eating of regular meals reported only 11,5%. Less than a half (46,9%) of participants eat breakfast every day. The most commonly consumed meals was lunch (n = 217; 82,8%) and dinner (n = 143; 54,6%). The vast majority of students (77,5%) didn't know the correct classification of the feeding pyramid floors. Moreover, in more than a half of young women (54,8%) and men (52,4%) the body mass deficiency was revealed (BMI<18kg/m2).

CONCLUSION

Conclusions: The study showed abnormal nutritional behavior of high school youth. Therefore, there is a need to conduct activities under health prevention, which improve the eating habits of young people.

[Knowledge on cardiovascular risk factors and symptoms of stroke among inhabitants of rural communite]

OBJECTIVE

Introduction: Stroke is one of the leading causes of mortality and disability in the world. A wide knowledge of risk factors for cerebrovascular diseases is one of the main elements of primary prevention, while knowledge of stroke symptoms can significantly speed up treatment and reduce negative health effects. The aim: To assess the knowledge about stroke and risk factors of cerebrovascular diseases among the inhabitants of the randomly selected rural community (in Lodz Province).

PATIENTS AND METHODS

Material and methods: The study included 143 adult residents of Rzasnia. The research was carried out using a self-constructed questionnaire, prepared on the basis of available literature.

RESULTS

Results: The average score obtained from the knowledge survey on stroke was 5.79 +/- 3.47 (maximum number of points - 14). The average number of points in people with a family history of stroke was statistically significantly higher (7.46±3.31) than in those with no stroke in the family (4.20±2.98 ) (p <0.001). There was no statistically significant difference between the average number of points and gender (women - 6.13±3.55 points, men - 5.64±3.55, NS) and age (R = -0.1, NS ). However, the positive correlation between educational level and the score obtained in our questionnaire was found (R =0.4, p <0.05). The average number of correctly listed risk factors was: 0.6 ± 1.6. At least one risk factor was reported by only 34% of respondents. Respondents most often mentioned: excessive alcohol consumption (18%), smoking (18%), hypertension (14%), atherosclerosis (11%). The average number of correctly listed symptoms of stroke was: 1.2±1.3. At least one symptom of stroke was reported by only 58% of respondents. The respondents most often reported: headache (29%), speech disorders (22%), gait disturbances (13%), and sensory disorders (13%). If a stroke was suspected, the majority of respondents would call an ambulance (94%).

CONCLUSION

Conclusions: Knowledge of the residents of the chosen rural commune about the stroke is not satisfactory and should be supplemented with an educational program that would include as many people as possible.

Pregnancy in a woman with acromegaly after transsphenoidal partial resection of pituitary macroadenoma - a case report

Acromegaly is a systemic disease caused by an excessive release of growth hormone and the hypopituitarism, which is induced by macroadenoma local mass effect. The gynecological and obstetric disorders include irregular menstrual cycles, anovulatory cycles and infertility. Therefore, pregnancy in patients affected by the disease is rare.

A CASE REPORT

Patient described in this study became pregnant after pharmacological, surgical and infertility treatment. Hence, the following paper presents the course of pregnancy and the discussion of the impact of acromegaly on female fertility, pregnancy, and concerns related to the diagnosis and treatment.

Abstract 1313: Characterization of germline susceptibility to male breast cancer

Male breast cancer (MBC) accounts for approximately 1% of all breast cancer cases. Family history is an established risk factor for MBC and 10% of cases have germline BRCA2 mutations. We recently demonstrated that common germline polymorphisms contribute to MBC predisposition and that there is overlap between genetic susceptibility loci for MBC and female breast cancer (FBC).

Here we report a comprehensive evaluation of all 107 known FBC predisposition loci in an association analysis of 1,032 MBC cases and 2,795 population matched controls. A total of 21 FBC predisposition single nucleotide polymorphisms (SNPs) showed evidence of association with risk of MBC. For approximately a third of these SNPs, the risk estimates were significantly larger in MBC than FBC. The magnitude of effects observed suggest that common susceptibility variants may be of value for risk stratification in men who have a high absolute risk of breast cancer such as BRCA2 mutation carriers. Although our data suggests that MBC predisposition shares many features in common with FBC, there are striking differences. Surprisingly, given the predominance of hormone receptor positive tumors in MBC, we observed no evidence of association between SNPs at FGFR2 and MBC risk suggesting that the estrogen receptor status of MBC tumors does not explain the observed SNP associations.

In summary, the data presented in this abstract significantly advance our understanding of genetic factors that contribute to MBC predisposition and further underscore the growing consensus that male breast cancer is not simply analogous to hormone receptor positive female breast cancer.

Citation Format: Eleni Perrakis, Sarah Maguire, Katarzyna Tomczyk, Anthony Swerdlow, Nick Orr. Characterization of germline susceptibility to male breast cancer [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2017; 2017 Apr 1-5; Washington, DC. Philadelphia (PA): AACR; Cancer Res 2017;77(13 Suppl):Abstract nr 1313. doi:10.1158/1538-7445.AM2017-1313

New functionality of RNAComposer: an application to shape the axis of miR160 precursor structure

RNAComposer is a fully automated, web-interfaced system for RNA 3D structure prediction, freely available at http://rnacomposer.cs.put.poznan.pl/ and http://rnacomposer.ibch.poznan.pl/. Its main components are: manually curated database of RNA 3D structure elements, highly efficient computational engine and user-friendly web application. In this paper, we demonstrate how the latest additions to the system allow the user to significantly affect the process of 3D model composition on several computational levels. Although in general our method is based on the knowledge of secondary structure topology, currently the RNAComposer offers a choice of six incorporated programs for secondary structure prediction. It also allows to apply a conditional search in the database of 3D structure elements and introduce user-provided elements into the final 3D model. This new functionality contributes to a significant improvement of the predicted 3D model reliability and it facilitates a better model adjustment to the experimental data. This is exemplified based on the RNAComposer application for modelling of the 3D structures of precursors of the miR160 family members.

The impact of factors in work environment (especially shift and night work) on neoplasia of female reproductive organs

Shift work, due to disruption of circadian rhythms, can interfere with a number of physiological functions. It may lead to multiple pathologies (functional gastrointestinal disorders, peptic ulcer disease, hormonal disorders – including impaired melatonin secretion, cardiovascular disease, mental disabilities, neurological disorders etc.). In the last few years, we started to think about the association between disruption in melatonin secretion and the occurrence of certain malignancies. Authors describe and discuss pathophysiology, epidemiological and clinical data concerning influence of shift work to occurrence of some neoplasms.

Have we achieved progress in tocolytic treatment?--results of a retrospective cohort study in a tertiary university hospital

OBJECTIVES

Beta-agonists play an important role in tocolytic treatment. In light of recent changes in the Polish medical care system, we decided to assess the effectiveness of oral continuous treatment (in 2012) and compare it with a 3-day intravenous administration of fenoterol (in 2013). The aim of our study was to contrast cost and effectiveness of fenoterol therapy in pregnant women at risk of preterm labor during two consecutive years: 2012 - when fenoterol had been widely used (group A), and 2013 when its extensive use had been withdrawn (group B).

MATERIAL AND METHODS

Retrospective cohort study of 129 pregnant women: 76 treated with intravenous fenoterol, followed by continuous oral administration (November 2012; group A), and 53 treated with intravenous fenoterol only for 48-72 hours (November 2013; group B).

RESULTS

Perinatal outcomes (based on the Apgar score and neonatal weight) were comparable in both groups. Continuous oral application of fenoterol resulted in earlier gestational age at delivery and lower cost of hospitalization among women from group A as compared to group B. Regardless, the difference was not statistically significant (37 hbd vs. 35 hbd, p = 0.626; 4334,700PLN vs. 5232,470PLN, p = 0.533).

CONCLUSIONS

A 3-day intravenous application of fenoterol is as effective as oral continuous therapy and is characterized by reduced risk of negative side effects.

Epigenome-wide association study reveals decreased average methylation levels years before breast cancer diagnosis

BACKGROUND

Interest in the potential of DNA methylation in peripheral blood as a biomarker of cancer risk is increasing. We aimed to assess whether epigenome-wide DNA methylation measured in peripheral blood samples obtained before onset of the disease is associated with increased risk of breast cancer. We report on three independent prospective nested case-control studies from the European Prospective Investigation into Cancer and Nutrition (EPIC-Italy; n = 162 matched case-control pairs), the Norwegian Women and Cancer study (NOWAC; n = 168 matched pairs), and the Breakthrough Generations Study (BGS; n = 548 matched pairs). We used the Illumina 450k array to measure methylation in the EPIC and NOWAC cohorts. Whole-genome bisulphite sequencing (WGBS) was performed on the BGS cohort using pooled DNA samples, combined to reach 50× coverage across ~16 million CpG sites in the genome including 450k array CpG sites. Mean β values over all probes were calculated as a measurement for epigenome-wide methylation.

RESULTS

In EPIC, we found that high epigenome-wide methylation was associated with lower risk of breast cancer (odds ratio (OR) per 1 SD = 0.61, 95 % confidence interval (CI) 0.47-0.80; -0.2 % average difference in epigenome-wide methylation for cases and controls). Specifically, this was observed in gene bodies (OR = 0.51, 95 % CI 0.38-0.69) but not in gene promoters (OR = 0.92, 95 % CI 0.64-1.32). The association was not replicated in NOWAC (OR = 1.03 95 % CI 0.81-1.30). The reasons for heterogeneity across studies are unclear. However, data from the BGS cohort was consistent with epigenome-wide hypomethylation in breast cancer cases across the overlapping 450k probe sites (difference in average epigenome-wide methylation in case and control DNA pools = -0.2 %).

CONCLUSIONS

We conclude that epigenome-wide hypomethylation of DNA from pre-diagnostic blood samples may be predictive of breast cancer risk and may thus be useful as a clinical biomarker.

Mitochondrial DNA Copy Number in Peripheral Blood Cells and Risk of Developing Breast Cancer

Increased mitochondrial DNA (mtDNA) copy number in peripheral blood cells (PBC) has been associated with the risk of developing several tumor types. Here we evaluate sources of variation of this biomarker and its association with breast cancer risk in a prospective cohort study. mtDNA copy number was measured using quantitative real-time PCR on PBC DNA samples from participants in the UK-based Breakthrough Generations Study. Temporal and assay variation was evaluated in a serial study of 91 women, with two blood samples collected approximately 6-years apart. Then, associations with breast cancer risk factors and risk were evaluated in 1,108 cases and 1,099 controls using a nested case-control design. In the serial study, mtDNA copy number showed low assay variation but large temporal variation [assay intraclass correlation coefficient (ICC), 79.3%-87.9%; temporal ICC, 38.3%). Higher mtDNA copy number was significantly associated with younger age at blood collection, being premenopausal, having an older age at menopause, and never taking HRT, both in cases and controls. Based on measurements in a single blood sample taken on average 6 years before diagnosis, higher mtDNA copy number was associated with increased breast cancer risk [OR (95% CI) for highest versus lowest quartile, 1.37 (1.02-1.83); P trend = 0.007]. In conclusion, mtDNA copy number is associated with breast cancer risk and represents a promising biomarker for risk assessment. The relatively large temporal variation should be taken into account in future analyses.

Impact of heavy metals on the female reproductive system

INTRODUCTION

It has been recognized that environmental pollution can affect the quality of health of the human population. Heavy metals are among the group of highly emitted contaminants and their adverse effect of living organisms has been widely studied in recent decades. Lifestyle and quality of the ambient environment are among these factors which can mainly contribute to the heavy metals exposure in humans.

OBJECTIVE

A review of literature linking heavy metals and the female reproductive system and description of the possible associations with emission and exposure of heavy metals and impairments of female reproductive system according to current knowledge.

RESULTS

The potential health disorders caused by chronic or acute heavy metals toxicity include immunodeficiency, osteoporosis, neurodegeneration and organ failures. Potential linkages of heavy metals concentration found in different human organs and blood with oestrogen-dependent diseases such as breast cancer, endometrial cancer, endometriosis and spontaneous abortions, as well as pre-term deliveries, stillbirths and hypotrophy, have also been reported.

CONCLUSIONS

Environmental deterioration can lead to the elevated risk of human exposure to heavy metals, and consequently, health implications including disturbances in reproduction. It is therefore important to continue the investigations on metal-induced mechanisms of fertility impairment on the genetic, epigenetic and biochemical level.

On the presence of aluminium in human endometrial tissue and potential factors that may influence it – a pilot study

Introduction. Aluminium (Al), the most ubiquitous metal in the earth crust, has been shown to reveal a potential metalloestrogenic action. Despite an increasing interest in Al exposure in human, there is essentially no information on its status in the reproduction system. Aim. The present work investigated the content of Al in female endometrial tissue (n = 25) and its association with endometrial thickness and histological image, female age, place of living, history of cigarette smoking and diet. Material and methods. The endometrial samples (n = 25) were obtained during routine procedures. The Al content was determined using microwave induced nitrogen plasma atomic emission spectrometer. The relationships between metal level and histological image, endometrial thickness, female age, place of living, cigarette smoking and diet were investigated.Results. The Al was detected in every analysed sample. Its concentrations varied from 0.9–16.0 µg/kg dry tissue. The lowest Al level was found in atrophic endometrium. The metal content in polyposis, hyperplasia and unaltered tissue was comparable. The study failed to find significant association with the metal content and endometrial thickness, female age, place of living, smoking habits and diet.Conclusion. Human endometrial tissue can contain detectable levels of Al. It, in turn, indicates that endometrium may play a role in systematic accumulation of absorbed Al but also that it may represent an unique route of periodic discharge of this element. Further studies are necessary to elucidate which factors are responsible for the presence of Al in endometrium and what are the possible consequences of its increased content in this tissue.

Temporal stability and determinants of white blood cell DNA methylation in the breakthrough generations study

BACKGROUND

Epigenome-wide association studies (EWAS) using measurements of blood DNA methylation are performed to identify associations of methylation changes with environmental and lifestyle exposures and disease risk. However, little is known about the variation of methylation markers in the population and their stability over time, both important factors in the design and interpretation of EWAS. We aimed to identify stable variable methylated probes (VMP), i.e., markers that are variable in the population, yet stable over time.

METHODS

We estimated the intraclass correlation coefficient (ICC) for each probe on the Illumina 450K methylation array in paired samples collected approximately 6 years apart from 92 participants in the Breakthrough Generations Study. We also evaluated relationships with age, reproductive and hormonal history, weight, alcohol intake, and smoking.

RESULTS

Approximately 17% of probes had an ICC > 0.50 and were considered stable VMPs (stable-VMPs). Stable-VMPs were enriched for probes located in "shores" bordering CpG islands, and at approximately 1.3 kb downstream from the transcription start site in the transition between the unmethylated promoter and methylated gene body. Both cross-sectional and longitudinal data analyses provided strong evidence for associations between changes in methylation levels and aging. Smoking-related probes at 2q37.1 and AHRR were stable-VMPs and related to time since quitting. We also observed associations between methylation and weight changes.

CONCLUSION

Our results provide support for the use of white blood cell DNA methylation as a biomarker of exposure in EWAS.

IMPACT

Larger studies, preferably with repeated measures over time, will be required to establish associations between specific probes and exposures.

Metal status in human endometrium: relation to cigarette smoking and histological lesions

Human endometrium is a thick, blood vessel-rich, glandular tissue which undergoes cyclic changes and is potentially sensitive to the various endogenous and exogenous compounds supplied via the hematogenous route. As recently indicated, several metals including Cd, Pb, Cr and Ni represent an emerging class of potential metalloestrogens and can be implicated in alterations of the female reproductive system including endometriosis and cancer. In the present study, we investigated the content of five metals: Cd, Cr, Ni, Pb and Zn in 25 samples of human endometrium collected from Polish females undergoing diagnostic or therapeutic curettage of the uterine cavity. The overall mean metal concentration (analyzed using microwave induced plasma atomic emission spectrometry MIP-OES) decreased in the following order: Cr>Pb>Zn>Ni>Cd. For the first time it was demonstrated that cigarette smoking significantly increases the endometrial content of Cd and Pb. Concentration of these metals was also positively correlated with years of smoking and the number of smoked cigarettes. Tissue samples with recognized histologic lesions (simple hyperplasia, polyposis and atrophy) were characterized by a 2-fold higher Cd level. No relation between the age of the women and metal content was found. Our study shows that human endometrium can be a potential target of metal accumulation within the human body. Quantitative analyses of endometrial metal content could serve as an additional indicator of potential impairments of the menstrual cycle and fertility.

Abstract P3-08-04: Impact of CYP3A variation on estrone levels and breast cancer risk

Background: Epidemiological studies provide strong evidence for a role of endogenous sex steroids in the etiology of breast cancer. Our aim was to identify common variants in genes involved in sex steroid synthesis or metabolism that were associated with premenopausal hormone levels and breast cancer risk.

Methods: We measured urinary estrone glucuronide (E1G) and pregnanediol glucuronide (PG) using a protocol specifically developed to account for cyclic variation in hormone levels during the menstrual cycle, plasma sex hormone-binding globulin (SHBG) and androgenic precursors in up to 763 healthy premenopausal women. We genotyped 642 single nucleotide polymorphisms (SNPs) in these women; a single SNP was further tested for association with breast cancer risk in data from 10,551 breast cancer case patients and 17,535 control subjects. All statistical tests were two-sided.

Results: rs10273424 mapping approximately 50kb centromeric to the cytochrome P450 3A (CYP3A) cluster (7q22.1) was associated with a 21.8% reduction in E1G levels (P = 2.7 × 10−9) and a modest reduction in breast cancer risk in cases diagnosed at or before age 50 (OR = 0.91; P = 0.03) but not older cases (odds ratio (OR) = 1.01; P = 0.82). A rare non-synonymous SHBG SNP was associated with reduced plasma SHBG levels.

Conclusions: Genetic variation in non-coding sequences flanking the CYP3A locus contributes to variance in premenopausal E1G levels and breast cancer risk in younger cases. Since CYP3A4, the most predominantly expressed CYP3A gene, is responsible for metabolism of endogenous and exogenous hormones and hormonal agents such as tamoxifen, used in the treatment of breast cancer this association may have wider implications.

Citation Information: Cancer Res 2012;72(24 Suppl):Abstract nr P3-08-04.

Genome-wide association study identifies a common variant in RAD51B associated with male breast cancer risk

We conducted a genome-wide association study of male breast cancer using 823 cases and 2,795 controls of European ancestry with validation in independent sample sets totalling 438 cases and 474 controls. A novel variant in RAD51B (14q24.1) was significantly associated with male breast cancer risk (P = 3.02 ×10⁻¹³, odds ratio (OR) = 1.57). TOX3 (16q12.1) was also a susceptibility locus (P = 3.87 ×10⁻¹⁵, OR = 1.50).

Genetic variants at chromosomes 2q35, 5p12, 6q25.1, 10q26.13, and 16q12.1 influence the risk of breast cancer in men

Male breast cancer accounts for approximately 1% of all breast cancer. To date, risk factors for male breast cancer are poorly defined, but certain risk factors and genetic features appear common to both male and female breast cancer. Genome-wide association studies (GWAS) have recently identified common single nucleotide polymorphisms (SNPs) that influence female breast cancer risk; 12 of these have been independently replicated. To examine if these variants contribute to male breast cancer risk, we genotyped 433 male breast cancer cases and 1,569 controls. Five SNPs showed a statistically significant association with male breast cancer: rs13387042 (2q35) (odds ratio (OR)  = 1.30, p = 7.98×10⁻⁴), rs10941679 (5p12) (OR = 1.26, p = 0.007), rs9383938 (6q25.1) (OR = 1.39, p = 0.004), rs2981579 (FGFR2) (OR = 1.18, p = 0.03), and rs3803662 (TOX3) (OR = 1.48, p = 4.04×10⁻⁶). Comparing the ORs for male breast cancer with the published ORs for female breast cancer, three SNPs—rs13387042 (2q35), rs3803662 (TOX3), and rs6504950 (COX11)—showed significant differences in ORs (p<0.05) between sexes. Breast cancer is a heterogeneous disease; the relative risks associated with loci identified to date show subtype and, based on these data, gender specificity. Additional studies of well-defined patient subgroups could provide further insight into the biological basis of breast cancer development.

Breast cancer is the most common female cancer in the United Kingdom but also occurs in men, albeit at a much lower frequency. Relatively little is known regarding risk factors for male breast cancer. Here, we examine the effect of common genetic variants that are known to be associated with female breast cancer to determine whether they also affect risk of male breast cancer. We show that certain of these variants are also associated with male breast cancer risk but that the magnitudes of their effects differ in males from females. Future analyses of the genetics of male breast cancer may shed light on the biology of both male and female breast cancer.

Novel breast cancer susceptibility locus at 9q31.2: results of a genome-wide association study

BACKGROUND

Genome-wide association studies have identified several common genetic variants associated with breast cancer risk. It is likely, however, that a substantial proportion of such loci have not yet been discovered.

METHODS

We compared 296,114 tagging single-nucleotide polymorphisms in 1694 breast cancer case subjects (92% with two primary cancers or at least two affected first-degree relatives) and 2365 control subjects, with validation in three independent series totaling 11,880 case subjects and 12,487 control subjects. Odds ratios (ORs) and associated 95% confidence intervals (CIs) in each stage and all stages combined were calculated using unconditional logistic regression. Heterogeneity was evaluated with Cochran Q and I(2) statistics. All statistical tests were two-sided.

RESULTS

We identified a novel risk locus for breast cancer at 9q31.2 (rs865686: OR = 0.89, 95% CI = 0.85 to 0.92, P = 1.75 × 10(-10)). This single-nucleotide polymorphism maps to a gene desert, the nearest genes being Kruppel-like factor 4 (KLF4, 636 kb centromeric), RAD23 homolog B (RAD23B, 794 kb centromeric), and actin-like 7A (ACTL7A, 736 kb telomeric). We also identified two variants (rs3734805 and rs9383938) mapping to 6q25.1 estrogen receptor 1 (ESR1), which were associated with breast cancer in subjects of northern European ancestry (rs3734805: OR = 1.19, 95% CI = 1.11 to 1.27, P = 1.35 × 10(-7); rs9383938: OR = 1.18, 95% CI = 1.11 to 1.26, P = 1.41 × 10(-7)). A variant mapping to 10q26.13, approximately 300 kb telomeric to the established risk locus within the second intron of FGFR2, was also associated with breast cancer risk, although not at genome-wide statistical significance (rs10510102: OR = 1.12, 95% CI = 1.07 to 1.17, P = 1.58 × 10(-6)).

CONCLUSIONS

These findings provide further evidence on the role of genetic variation in the etiology of breast cancer. Fine mapping will be needed to identify causal variants and to determine their functional effects.