title: Humoral immune responses to MUC1 in women with a BRCA1 or BRCA2 mutation.
abstract: BACKGROUND
  Breast cancer patients with early disease and a natural humoral response to MUC1 have a favourable prognosis, suggesting a possible role of MUC1 antibodies (ab) in controlling haematogenous tumour dissemination and outgrowth. The aim of the study was to evaluate humoral immune responses to MUC1 in women at hereditary high risk of breast cancer to investigate whether this immune response could play a role in the prevention of disease.
  
  
  METHODS
  CA15.3 (U/mL), and IgG and IgM ab to MUC1 (arbitrary units per mL, Arb-U/mL) were measured in serum samples obtained from 422 women at hereditary high risk of breast/ovarian cancer, of whom 127 BRCA1/2 carriers, attending the Familial Cancer Clinic of the VU University Medical Centre, and from 370 age-matched healthy controls. Serum samples obtained from women who developed breast cancer (N=12) or breast cancer recurrence (N=17), and from women who underwent prophylactic mastectomy (N=12) and had no breast lesions were also tested.
  
  
  RESULTS
  CA15.3 ranked significantly higher in mutation carriers than in controls (P=0.03). MUC1 IgG ab levels ranked significantly lower in BRCA1/2 mutation carriers than in controls (P=0.003). MUC1 IgG levels were not significantly different (P=0.53) between women who developed primary breast cancer (median 0.72Arb-U/ml, range 0.52-2.44Arb-U/ml) and women who underwent prophylactic mastectomy and had no breast lesions (median 1.04Arb-U/ml, range 0.43-2.88Arb-U/ml).
  
  
  CONCLUSIONS
  Serum levels of natural IgG ab to MUC1 are lower in BRCA1/2 mutation carriers than in healthy controls. Furthermore, in contrast to previous results in women with sporadic breast cancer, no elevated MUC1 IgG ab were seen in women at hereditary high risk who developed breast cancer. Prophylactic immunotherapy with MUC1 substrates may be a strategy to reduce the risk of breast cancer in BRCA1/2 mutation carriers, strengthening tumour immune surveillance.
authors.affiliation: Department of Obstetrics and Gynaecology, VU University Medical Centre, De Boelenlaan 1117, 1081 HV Amsterdam, The Netherlands. b.hermsen@vumc.nl
authors.forename: B B J
authors.initials: BB
authors.lastname: Hermsen
authors.forename: R H M
authors.initials: RH
authors.lastname: Verheijen
authors.forename: F H
authors.initials: FH
authors.lastname: Menko
authors.forename: J J P
authors.initials: JJ
authors.lastname: Gille
authors.forename: K
authors.initials: K
authors.lastname: van Uffelen
authors.forename: M A
authors.initials: MA
authors.lastname: Blankenstein
authors.forename: S
authors.initials: S
authors.lastname: Meijer
authors.forename: P J
authors.initials: PJ
authors.lastname: van Diest
authors.forename: P
authors.initials: P
authors.lastname: Kenemans
authors.forename: S
authors.initials: S
authors.lastname: von Mensdorff-Pouilly
mesh_terms: D000328:Adult; D000368:Aged; D000906:Antibodies / Q000276:immunology*; D000917:Antibody Formation / Q000235:genetics; D001943:Breast Neoplasms / Q000235:genetics / Q000276:immunology*; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D019398:Genes, BRCA1; D024522:Genes, BRCA2; D006801:Humans; D007075:Immunoglobulin M / Q000276:immunology; D008875:Middle Aged; D018396:Mucin-1 / Q000276:immunology*; D009154:Mutation / Q000235:genetics; D010051:Ovarian Neoplasms / Q000235:genetics / Q000276:immunology*
chemical_list: D000906:Antibodies; D007075:Immunoglobulin M; D018396:Mucin-1