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The Nccn Criterion Young Age at Onset Alone Is Not an Indicator of Hereditary Breast Cancer in Iranian Population Publisher Pubmed



Ebrahimi E1, 2 ; Sellars E3 ; Shirkoohi R1, 2 ; Harirchi I2 ; Ghiasvand R4 ; Mohebbi E2 ; Zendehdel K1, 2, 5, 8 ; Akbari MR3, 6, 7, 9
Authors
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Authors Affiliations
  1. 1. Cancer Biology Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
  2. 2. Cancer Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
  3. 3. Women's College Research Institute, Women's College Hospital, Toronto, Canada
  4. 4. Oslo Centre for Biostatistics and Epidemiology, University of Oslo, Oslo, Norway
  5. 5. Breast Diseases Research Center, Cancer Institute of Iran, Tehran University of Medical Sciences, Tehran, Iran
  6. 6. Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
  7. 7. Institute of Medical Science, University of Toronto, Toronto, Canada
  8. 8. Cancer Institute of Iran, Tehran, 13145-158, Iran
  9. 9. Women's College Hospital, 76 Grenville St. Room 6421, Toronto, M5S 1B2, ON, Canada

Source: Cancer Prevention Research Published:2019


Abstract

Because the contribution of genetic factors to the burden of breast cancer is not well investigated in Iran, we aimed to examine the prevalence of mutations in breast cancer susceptibility genes, BRCA1/2 and PALB2, and to investigate the predictive potential of hereditary breast cancer risk criteria for genetic testing in Iranian population. Next-generation sequencing was conducted on a population consisting of 299 and 125 patients with breast cancer, with and without hereditary cancer risk criteria for genetic testing, respectively. The pathogenic mutation frequency rate was 10.7% in patients with hereditary cancer criteria versus 1.6% in no criteria group (P ¼ 0.0017). None of the 107 tested patients with only young age at onset (<40) criterion had a pathogenic mutation. Patients who had only a single heritable risk criterion [OR, 6.15; 95% confidence interval (CI), 1.26–58.59; P ¼ 0.009] and patients with multiple heritable risk criteria (OR, 22.5; 95% CI, 5.19–201.31; P < 0.0001) had higher probabilities of carrying a mutation compared with no criteria group. Our results showed that young age at onset alone is not an indicator of hereditary breast cancer at least in the Iranian population. This is while women with multiple hereditary breast cancer risk criteria were enriched for BRCA1/2 mutations. Given such high risk of identification of a disease-causing mutation, multiple hereditary criteria should be regarded as a strong predictor for a hereditary breast cancer syndrome. These findings are important concerning the optimization of genetic counseling and furthermore establishing criteria for BRCA1/2 testing of the Iranian population. © 2019 American Association for Cancer Research.