Genome-Wide Association Study to Identify Susceptibility Loci That Modify Radiation-Related Risk for Breast Cancer After Childhood Cancer.

TitleGenome-Wide Association Study to Identify Susceptibility Loci That Modify Radiation-Related Risk for Breast Cancer After Childhood Cancer.
Publication TypeJournal Article
Year of Publication2017
AuthorsMorton LM, Sampson JN, Armstrong GT, Chen T-H, Hudson MM, Karlins E, Dagnall CL, Li SAlfred, Wilson CL, Srivastava DKumar, Liu W, Kang G, Oeffinger KC, Henderson TO, Moskowitz CS, Gibson TM, Merino DM, Wong JR, Hammond S, Neglia JP, Turcotte LM, Miller J, Bowen L, Wheeler WA, Leisenring WM, Whitton JA, Burdette L, Chung C, Hicks BD, Jones K, Machiela MJ, Vogt A, Wang Z, Yeager M, Neale G, Lear M, Strong LC, Yasui Y, Stovall M, Weathers RE, Smith SA, Howell R, Davies SM, Radloff GA, Onel K, de González ABerrington, Inskip PD, Rajaraman P, Fraumeni JF, Bhatia S, Chanock SJ, Tucker MA, Robison LL
JournalJ Natl Cancer Inst
Volume109
Issue11
Date Published2017 11 01
ISSN1460-2105
KeywordsAdolescent, Adult, Breast, Breast Neoplasms, Child, Child, Preschool, Cohort Studies, Female, Genetic Predisposition to Disease, Genome-Wide Association Study, Hodgkin Disease, Homeodomain Proteins, Humans, Infant, Leukemia, Microfilament Proteins, Middle Aged, Muscle Proteins, Neoplasms, Radiation-Induced, Neoplasms, Second Primary, Proportional Hazards Models, Radiotherapy Dosage, raf Kinases, Retrospective Studies, Ribosomal Protein S6 Kinases, Survivors, Tumor Suppressor Proteins, Young Adult
Abstract

Background: Childhood cancer survivors treated with chest-directed radiotherapy have substantially elevated risk for developing breast cancer. Although genetic susceptibility to breast cancer in the general population is well studied, large-scale evaluation of breast cancer susceptibility after chest-directed radiotherapy for childhood cancer is lacking.

Methods: We conducted a genome-wide association study of breast cancer in female survivors of childhood cancer, pooling two cohorts with detailed treatment data and systematic, long-term follow-up: the Childhood Cancer Survivor Study and St. Jude Lifetime Cohort. The study population comprised 207 survivors who developed breast cancer and 2774 who had not developed any subsequent neoplasm as of last follow-up. Genotyping and subsequent imputation yielded 16 958 466 high-quality variants for analysis. We tested associations in the overall population and in subgroups stratified by receipt of lower than 10 and 10 or higher gray breast radiation exposure. We report P values and pooled per-allele risk estimates from Cox proportional hazards regression models. All statistical tests were two-sided.

Results: Among survivors who received 10 or higher gray breast radiation exposure, a locus on 1q41 was associated with subsequent breast cancer risk (rs4342822, nearest gene PROX1 , risk allele frequency in control subjects [RAF controls ] = 0.46, hazard ratio = 1.92, 95% confidence interval = 1.49 to 2.44, P = 7.09 × 10 -9 ). Two rare variants also showed potentially promising associations (breast radiation ≥10 gray: rs74949440, 11q23, TAGLN , RAF controls = 0.02, P = 5.84 × 10 -8 ; <10 gray: rs17020562, 1q32.3, RPS6KC1 , RAF controls = 0.0005, P = 6.68 × 10 -8 ). Associations were restricted to these dose subgroups, with consistent findings in the two survivor cohorts.

Conclusions: Our study provides strong evidence that germline genetics outside high-risk syndromes could modify the effect of radiation exposure on breast cancer risk after childhood cancer.

DOI10.1093/jnci/djx058
Alternate JournalJ. Natl. Cancer Inst.
PubMed ID29059430
Grant ListP30 CA008748 / CA / NCI NIH HHS / United States
U01 CA195547 / CA / NCI NIH HHS / United States

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