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

AbstractBackground:
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.
AuthorsLindsay M Morton, Joshua N Sampson, Gregory T Armstrong, Ting-Huei Chen, Melissa M Hudson, Eric Karlins, Casey L Dagnall, Shengchao Alfred Li, Carmen L Wilson, Deo Kumar Srivastava, Wei Liu, Guolian Kang, Kevin C Oeffinger, Tara O Henderson, Chaya S Moskowitz, Todd M Gibson, Diana M Merino, Jeannette R Wong, Sue Hammond, Joseph P Neglia, Lucie M Turcotte, Jeremy Miller, Laura Bowen, William A Wheeler, Wendy M Leisenring, John A Whitton, Laurie Burdette, Charles Chung, Belynda D Hicks, Kristine Jones, Mitchell J Machiela, Aurelie Vogt, Zhaoming Wang, Meredith Yeager, Geoffrey Neale, Matthew Lear, Louise C Strong, Yutaka Yasui, Marilyn Stovall, Rita E Weathers, Susan A Smith, Rebecca Howell, Stella M Davies, Gretchen A Radloff, Kenan Onel, Amy Berrington de González, Peter D Inskip, Preetha Rajaraman, Joseph F Fraumeni Jr, Smita Bhatia, Stephen J Chanock, Margaret A Tucker, Leslie L Robison
JournalJournal of the National Cancer Institute (J Natl Cancer Inst) Vol. 109 Issue 11 (11 01 2017) ISSN: 1460-2105 [Electronic] United States
PMID29059430 (Publication Type: Journal Article, Multicenter Study, Research Support, Non-U.S. Gov't, Research Support, N.I.H., Extramural)
CopyrightPublished by Oxford University Press 2017. This work is written by US Government employees and is in the public domain in the US.
Chemical References
  • Homeodomain Proteins
  • Microfilament Proteins
  • Muscle Proteins
  • Tumor Suppressor Proteins
  • prospero-related homeobox 1 protein
  • transgelin
  • RPS6KC1 protein, human
  • Ribosomal Protein S6 Kinases
  • raf Kinases
Topics
  • Adolescent
  • Adult
  • Breast (radiation effects)
  • Breast Neoplasms (genetics)
  • Child
  • Child, Preschool
  • Cohort Studies
  • Female
  • Genetic Predisposition to Disease
  • Genome-Wide Association Study
  • Hodgkin Disease (radiotherapy)
  • Homeodomain Proteins (genetics)
  • Humans
  • Infant
  • Leukemia (radiotherapy)
  • Microfilament Proteins (genetics)
  • Middle Aged
  • Muscle Proteins (genetics)
  • Neoplasms, Radiation-Induced (genetics)
  • Neoplasms, Second Primary (genetics)
  • Proportional Hazards Models
  • Radiotherapy Dosage
  • Retrospective Studies
  • Ribosomal Protein S6 Kinases (genetics)
  • Survivors
  • Tumor Suppressor Proteins (genetics)
  • Young Adult
  • raf Kinases (genetics)

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