ABSTRACT
It is well known that founder mutations associated with cancer risk have useful implications for molecular diagnostics. We report the presence of a founder mutation in EPCAM involved in the etiology of Lynch syndrome (LS). The mutation extends nearly 8.7 kb (c.858 + 2478_*4507del) and is shared by 8 Polish families. Family members suffered almost exclusively from colorectal cancer; however, pancreatic and gastric cancers were also apparent. Next to mutations c. 2041G>A in MLH1 gene and c.942+3A>T in MSH2, the deletion mutation encompassing EPCAM is one of the most common causative changes responsible for LS in Poland.
Subject(s)
Base Sequence , Colorectal Neoplasms, Hereditary Nonpolyposis/genetics , Epithelial Cell Adhesion Molecule/genetics , MutS Homolog 2 Protein/genetics , Pancreatic Neoplasms/genetics , Sequence Deletion , Stomach Neoplasms/genetics , Adult , Colorectal Neoplasms, Hereditary Nonpolyposis/diagnosis , Colorectal Neoplasms, Hereditary Nonpolyposis/pathology , Female , Founder Effect , Gene Expression , Humans , Male , Middle Aged , MutL Protein Homolog 1 , Pancreatic Neoplasms/diagnosis , Pancreatic Neoplasms/pathology , Pedigree , Point Mutation , Poland , Stomach Neoplasms/diagnosis , Stomach Neoplasms/pathologyABSTRACT
The aim of the study is to identify treatments which predict survival for women with a BRCA1 mutation, including oophorectomy and chemotherapy. 476 women with stage I to stage III breast cancer who carried a BRCA1 mutation were followed from diagnosis until April 2015. Information on treatment was obtained from chart review and patient questionnaires. Dates of death were obtained from the Poland vital statistics registry. Survival curves were compared for different subgroups according to treatment received. Predictors of overall survival were determined using the Cox proportional hazards model. The ten-year overall survival was 78.3 % (95 % CI 74.2-82.6 %) and the ten-year breast cancer-specific survival was 84.2 % (95 % CI 80.5-88.0 %). Sixty-two patients died of breast cancer, 14 patients died of ovarian cancer, and 2 patients died of peritoneal cancer. Oophorectomy was associated with a significant reduction in all-cause mortality in the entire cohort (adjusted HR = 0.41; 95 % CI 0.24-0.69; p = 0.0008) and in breast cancer-specific mortality among ER-negative breast cancer patients (HR = 0.44; 95 % CI 0.22-0.89; p = 0.02). Among women with breast cancer and a BRCA1 mutation, survival is greatly improved by oophorectomy due to the prevention of deaths from both breast and ovarian cancer.
Subject(s)
BRCA1 Protein/genetics , Breast Neoplasms/mortality , Ovarian Neoplasms/mortality , Ovariectomy/methods , Adult , Aged , Breast Neoplasms/drug therapy , Breast Neoplasms/genetics , Drug Therapy , Female , Humans , Middle Aged , Ovarian Neoplasms/surgery , Proportional Hazards Models , Risk Factors , Survival Analysis , Treatment Outcome , Young AdultABSTRACT
We identified 4316 unselected incident cases of early-onset breast cancers (<51 ears of age at diagnosis) in 18 Polish hospitals between 1996 and 2003. We were able to obtain a blood sample for DNA analysis from 3472 of these (80.4%). All cases were tested for the presence of three founder mutations in BRCA1. The proportion of cases with a BRCA1 mutation was 5.7%. The hereditary proportions were higher than this for women with breast cancer diagnosed before age 40 (9%), for women with cancer of medullary or atypical medullary histology (28%), for those with bilateral cancer (29%) or with a family history of breast or ovarian cancer (13%). It is reasonable to offer genetic testing to women with early-onset breast cancer in Poland.
