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Genetic variants associated with breast cancer risk for Ashkenazi Jewish women with strong family histories but no identifiable BRCA1/2 mutation
Authors:Erica S Rinella  Yongzhao Shao  Lauren Yackowski  Sreemanta Pramanik  Ruth Oratz  Freya Schnabel  Saurav Guha  Charles LeDuc  Christopher L Campbell  Susan D Klugman  Mary Beth Terry  Ruby T Senie  Irene L Andrulis  Mary Daly  Esther M John  Daniel Roses  Wendy K Chung  Harry Ostrer
Institution:1. Department of Surgery, New York University Langone Medical Center, New York, NY, USA
2. Division of Biostatistics, New York University School of Medicine, New York, NY, USA
3. Department of Pathology, Albert Einstein College of Medicine, Ullman 715, 1300 Morris Park Rd, Bronx, NY, 10461, USA
4. Kolkata Zonal Laboratory, National Environmental Engineering Research Institute, Kolkata, India
12. Department of Medicine, New York University Langone Medical Center, New York, NY, USA
5. Department of Pediatrics, Columbia University Medical Center, New York, NY, USA
6. Department of Obstetrics and Gynecology and Women’s Health, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
7. Department of Epidemiology, Mailman School of Public Health of Columbia University, New York, NY, USA
8. Department of Molecular Genetics, University of Toronto, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, Toronto, ON, Canada
9. Clinical Genetics, Fox Chase Cancer Center, Philadelphia, PA, USA
10. Cancer Prevention Institute of California, Fremont, CA, USA
11. Stanford University School of Medicine and Stanford Cancer Institute, Stanford, CA, USA
Abstract:The ability to establish genetic risk models is critical for early identification and optimal treatment of breast cancer. For such a model to gain clinical utility, more variants must be identified beyond those discovered in previous genome-wide association studies (GWAS). This is especially true for women at high risk because of family history, but without BRCA1/2 mutations. This study incorporates three datasets in a GWAS analysis of women with Ashkenazi Jewish (AJ) homogeneous ancestry. Two independent discovery cohorts comprised 239 and 238 AJ women with invasive breast cancer or preinvasive ductal carcinoma in situ and strong family histories of breast cancer, but lacking the three BRCA1/2 founder mutations, along with 294 and 230 AJ controls, respectively. An independent, third cohort of 203 AJ cases with familial breast cancer history and 263 healthy controls of AJ women was used for validation. A total of 19 SNPs were identified as associated with familial breast cancer risk in AJ women. Among these SNPs, 13 were identified from a panel of 109 discovery SNPs, including an FGFR2 haplotype. In addition, six previously identified breast cancer GWAS SNPs were confirmed in this population. Seven of the 19 markers were significant in a multivariate predictive model of familial breast cancer in AJ women, three novel SNPs rs17663555(5q13.2), rs566164(6q21), and rs11075884(16q22.2)], the FGFR2 haplotype, and three previously published SNPs rs13387042(2q35), rs2046210(ESR1), and rs3112612(TOX3)], yielding moderate predictive power with an area under the curve (AUC) of the ROC (receiver-operator characteristic curve) of 0.74. Population-specific genetic variants in addition to variants shared with populations of European ancestry may improve breast cancer risk prediction among AJ women from high-risk families without founder BRCA1/2 mutations.
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