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Genetic and lifestyle factors in breast cancer prognostication
Based on data from a large international cohort of breast cancer patients, we found clear associations of several known lifestyle breast cancer risk factors...Show moreBreast cancer is a heterogeneous disease with substantial variability in outcome, risk factors and response to treatment. Therefore, a better understanding of the factors influencing breast cancer outcome could lead to improved prognostication and better stratification of patients into treatment subgroups. To this end, we investigated the association of hereditary genetic variants and non-genetic breast cancer risk factors with breast cancer outcome, and assessed the evidence of potential differential associations across specific tumor subtypes and patient subgroups defined by clinic-pathological variables related to tumor biology and type of systemic treatment. We focused on two breast cancer outcomes, namely survival and risk of developing a second breast cancer in the contralateral breast (contralateral breast cancer).
Based on data from a large international cohort of breast cancer patients, we found clear associations of several known lifestyle breast cancer risk factors with survival in breast cancer patients, independently from specific tumor subtype, and of coding hereditary genetic variants in five known breast cancer susceptibility genes with contralateral breast cancer risk. There was also evidence of association of coding hereditary genetic variants in three known breast cancer genes with breast cancer-specific survival (time to death due to breast cancer), although weaker than for contralateral breast cancer risk. These factors could be incorporated into prediction models for breast cancer outcome thereby potentially improving prognostic estimates and breast cancer counseling. In particular, the findings related to contralateral breast cancer risk are relevant to treatment decisions, follow-up and screening of breast cancer patients.
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- All authors
- Morra, A.G.T.
- Supervisor
- Schmidt, M.K.
- Co-supervisor
- Hooning, M.J.
- Committee
- Asperen, C.J. van; Leeuwen, F. van; Devilee, P.; Hauptmann, M.
- Qualification
- Doctor (dr.)
- Awarding Institution
- Faculty of Medicine, Leiden University Medical Center (LUMC) , Leiden University
- Date
- 2023-04-11
- ISBN
- 9789464196962
Funding
- Sponsorship
- The research was supported by the European Union's Horizon 2020 Research and Innovation Programme B-CAST grant (number 633784) and an institutional grant of the Dutch Cancer Society and of the Dutch Ministry of Health, Welfare and Sport.