title: Predominance of high-grade pathway in breast cancer development of Middle East women.
abstract: Recent data have suggested considerable molecular differences in cancers from various ethnical groups. As molecular features are increasingly used for predicting cancer prognosis and response to therapy, better knowledge of ethnic molecular features is important. To identify potential molecular differences between breast cancers in Europe and the Middle East, we analyzed consecutive breast cancer series from Switzerland (n=2197) and Saudi Arabia (n=204). Tissue microarrays were analyzed by fluorescence in situ hybridization for HER2, CCND1, MYC, and EGFR amplification. The data revealed marked differences between Saudi and Swiss patients. Saudi breast cancers had a markedly higher frequency of HER2 (31 vs 17%; P<0.0001) and MYC (16 vs 5%; P<0.0001) amplifications than Swiss breast cancers. Remarkably, this was partly due to a much higher incidence of grade 3 cancers in the Saudi than in the Swiss population (65 vs 32%; P<0.0001). However, differences in amplification frequency hold also true within grade 3 cancers (HER2: 40 vs 30%, P<0.05; MYC: 22 vs 11%, P=0.002). Interestingly, in combination with known age standardized incidence rates of breast cancer in Saudi Arabia (21.6/100 000) and Switzerland (70.1/100 000), these data suggest that the incidence of high-grade breast cancer is comparable for Saudi and Swiss women, while the incidence of low-grade breast cancers is about 14 times lower in Saudi than for Swiss women. These observations suggest that a difference in genetic susceptibility and/or lifestyle between Saudi and Swiss women has a substantial and much higher than expected impact on the risk of low-grade breast cancer.
authors.affiliation: King Faisal Specialist Hospital and Research Centre, Riyadh, Saudi Arabia.
authors.forename: Khawla
authors.initials: K
authors.lastname: Al-Kuraya
authors.forename: Peter
authors.initials: P
authors.lastname: Schraml
authors.forename: Salwa
authors.initials: S
authors.lastname: Sheikh
authors.forename: Samir
authors.initials: S
authors.lastname: Amr
authors.forename: Joachim
authors.initials: J
authors.lastname: Torhorst
authors.forename: Coya
authors.initials: C
authors.lastname: Tapia
authors.forename: Hedvika
authors.initials: H
authors.lastname: Novotny
authors.forename: Hanspeter
authors.initials: H
authors.lastname: Spichtin
authors.forename: Robert
authors.initials: R
authors.lastname: Maurer
authors.forename: Martina
authors.initials: M
authors.lastname: Mirlacher
authors.forename: Ronald
authors.initials: R
authors.lastname: Simon
authors.forename: Guido
authors.initials: G
authors.lastname: Sauter
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000208:ethnology / Q000235:genetics / Q000473:pathology*; D019938:Cyclin D1 / Q000235:genetics; D066246:ErbB Receptors / Q000235:genetics; D005260:Female; D005784:Gene Amplification; D020022:Genetic Predisposition to Disease / Q000235:genetics; D006801:Humans; D017404:In Situ Hybridization, Fluorescence; D008875:Middle Aged; D009367:Neoplasm Staging; D016271:Proto-Oncogene Proteins c-myc / Q000235:genetics; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000235:genetics; D012529:Saudi Arabia; D013557:Switzerland; D046888:Tissue Array Analysis / Q000379:methods
chemical_list: D014408:Biomarkers, Tumor; D019938:Cyclin D1; D066246:ErbB Receptors; D016271:Proto-Oncogene Proteins c-myc; D018719:Erb-b2 Receptor Tyrosine Kinases; C489427:MYC protein, human