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Associations of a Breast Cancer Polygenic Risk Score With Tumor Characteristics and Survival

Lopes Cardozo, Josephine M N ; Andrulis, Irene L ; Bojesen, Stig E ; Dörk, Thilo ; Eccles, Diana M ; Fasching, Peter A ; Hooning, Maartje J ; Keeman, Renske ; Nevanlinna, Heli and Rutgers, Emiel J T , et al. (2023) In Journal of clinical oncology : official journal of the American Society of Clinical Oncology 41(10). p.1849-1863
Abstract

PURPOSE: A polygenic risk score (PRS) consisting of 313 common genetic variants (PRS313) is associated with risk of breast cancer and contralateral breast cancer. This study aimed to evaluate the association of the PRS313 with clinicopathologic characteristics of, and survival following, breast cancer.

METHODS: Women with invasive breast cancer were included, 98,397 of European ancestry and 12,920 of Asian ancestry, from the Breast Cancer Association Consortium (BCAC), and 683 women from the European MINDACT trial. Associations between PRS313 and clinicopathologic characteristics, including the 70-gene signature for MINDACT, were evaluated using logistic regression analyses. Associations of PRS313 (continuous, per standard... (More)

PURPOSE: A polygenic risk score (PRS) consisting of 313 common genetic variants (PRS313) is associated with risk of breast cancer and contralateral breast cancer. This study aimed to evaluate the association of the PRS313 with clinicopathologic characteristics of, and survival following, breast cancer.

METHODS: Women with invasive breast cancer were included, 98,397 of European ancestry and 12,920 of Asian ancestry, from the Breast Cancer Association Consortium (BCAC), and 683 women from the European MINDACT trial. Associations between PRS313 and clinicopathologic characteristics, including the 70-gene signature for MINDACT, were evaluated using logistic regression analyses. Associations of PRS313 (continuous, per standard deviation) with overall survival (OS) and breast cancer-specific survival (BCSS) were evaluated with Cox regression, adjusted for clinicopathologic characteristics and treatment.

RESULTS: The PRS313 was associated with more favorable tumor characteristics. In BCAC, increasing PRS313 was associated with lower grade, hormone receptor-positive status, and smaller tumor size. In MINDACT, PRS313 was associated with a low risk 70-gene signature. In European women from BCAC, higher PRS313 was associated with better OS and BCSS: hazard ratio (HR) 0.96 (95% CI, 0.94 to 0.97) and 0.96 (95% CI, 0.94 to 0.98), but the association disappeared after adjustment for clinicopathologic characteristics (and treatment): OS HR, 1.01 (95% CI, 0.98 to 1.05) and BCSS HR, 1.02 (95% CI, 0.98 to 1.07). The results in MINDACT and Asian women from BCAC were consistent.

CONCLUSION: An increased PRS313 is associated with favorable tumor characteristics, but is not independently associated with prognosis. Thus, PRS313 has no role in the clinical management of primary breast cancer at the time of diagnosis. Nevertheless, breast cancer mortality rates will be higher for women with higher PRS313 as increasing PRS313 is associated with an increased risk of disease. This information is crucial for modeling effective stratified screening programs.

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Contribution to journal
publication status
published
subject
keywords
Female, Humans, Breast Neoplasms/pathology, Risk Factors, Prognosis, Proportional Hazards Models, Breast/pathology
in
Journal of clinical oncology : official journal of the American Society of Clinical Oncology
volume
41
issue
10
pages
1849 - 1863
publisher
American Society of Clinical Oncology
external identifiers
  • scopus:85151313050
  • pmid:36689693
ISSN
0732-183X
DOI
10.1200/JCO.22.01978
language
English
LU publication?
yes
id
65d5be86-fa0b-43e3-9de7-02dbf2425791
date added to LUP
2023-11-11 15:53:13
date last changed
2024-04-23 20:23:30
@article{65d5be86-fa0b-43e3-9de7-02dbf2425791,
  abstract     = {{<p>PURPOSE: A polygenic risk score (PRS) consisting of 313 common genetic variants (PRS313) is associated with risk of breast cancer and contralateral breast cancer. This study aimed to evaluate the association of the PRS313 with clinicopathologic characteristics of, and survival following, breast cancer.</p><p>METHODS: Women with invasive breast cancer were included, 98,397 of European ancestry and 12,920 of Asian ancestry, from the Breast Cancer Association Consortium (BCAC), and 683 women from the European MINDACT trial. Associations between PRS313 and clinicopathologic characteristics, including the 70-gene signature for MINDACT, were evaluated using logistic regression analyses. Associations of PRS313 (continuous, per standard deviation) with overall survival (OS) and breast cancer-specific survival (BCSS) were evaluated with Cox regression, adjusted for clinicopathologic characteristics and treatment.</p><p>RESULTS: The PRS313 was associated with more favorable tumor characteristics. In BCAC, increasing PRS313 was associated with lower grade, hormone receptor-positive status, and smaller tumor size. In MINDACT, PRS313 was associated with a low risk 70-gene signature. In European women from BCAC, higher PRS313 was associated with better OS and BCSS: hazard ratio (HR) 0.96 (95% CI, 0.94 to 0.97) and 0.96 (95% CI, 0.94 to 0.98), but the association disappeared after adjustment for clinicopathologic characteristics (and treatment): OS HR, 1.01 (95% CI, 0.98 to 1.05) and BCSS HR, 1.02 (95% CI, 0.98 to 1.07). The results in MINDACT and Asian women from BCAC were consistent.</p><p>CONCLUSION: An increased PRS313 is associated with favorable tumor characteristics, but is not independently associated with prognosis. Thus, PRS313 has no role in the clinical management of primary breast cancer at the time of diagnosis. Nevertheless, breast cancer mortality rates will be higher for women with higher PRS313 as increasing PRS313 is associated with an increased risk of disease. This information is crucial for modeling effective stratified screening programs.</p>}},
  author       = {{Lopes Cardozo, Josephine M N and Andrulis, Irene L and Bojesen, Stig E and Dörk, Thilo and Eccles, Diana M and Fasching, Peter A and Hooning, Maartje J and Keeman, Renske and Nevanlinna, Heli and Rutgers, Emiel J T and Easton, Douglas F and Hall, Per and Pharoah, Paul D P and van 't Veer, Laura J and Schmidt, Marjanka K}},
  issn         = {{0732-183X}},
  keywords     = {{Female; Humans; Breast Neoplasms/pathology; Risk Factors; Prognosis; Proportional Hazards Models; Breast/pathology}},
  language     = {{eng}},
  month        = {{04}},
  number       = {{10}},
  pages        = {{1849--1863}},
  publisher    = {{American Society of Clinical Oncology}},
  series       = {{Journal of clinical oncology : official journal of the American Society of Clinical Oncology}},
  title        = {{Associations of a Breast Cancer Polygenic Risk Score With Tumor Characteristics and Survival}},
  url          = {{http://dx.doi.org/10.1200/JCO.22.01978}},
  doi          = {{10.1200/JCO.22.01978}},
  volume       = {{41}},
  year         = {{2023}},
}