title: Exonic expression profiling of breast cancer and benign lesions: a retrospective analysis.
abstract: BACKGROUND
  Gene-expression arrays have generated molecular predictors of relapse and drug sensitivity in breast cancer. We aimed to identify exons differently expressed in malignant and benign breast lesions and to generate a molecular classifier for breast-cancer diagnosis.
  
  
  METHODS
  165 breast samples were obtained by fine-needle aspiration. Complementary DNA was hybridised on splice array. A nearest centroid prediction rule was developed to classify lesions as malignant or benign on a training set, and its performance was assessed on an independent validation set. A two-way ANOVA model identified probe sets with differential expression in malignant and benign lesions while adjusting for scan dates.
  
  
  RESULTS
  120 breast cancers and 45 benign lesions were included in the study. A molecular classifier for breast-cancer diagnosis with 1228 probe sets was generated from the training set (n=94). This signature accurately classified all samples (100% accuracy, 95% CI 96-100%). In the validation set (n=71), the molecular predictor accurately classified 68 of 71 tumours (96%, 88-99%). When the 165 samples were taken into account, 37 858 exon probe sets (5.4%) and 3733 genes (7.0%) were differently expressed in malignant and benign lesions (threshold: adjusted p<0.05). Genes involved in spliceosome assembly were significantly overexpressed in malignant disease (permutation p=0.002). In the same population of 165 samples, 956 exon probe sets presented both higher intensity and higher splice index in breast cancer than in benign lesions, although located on unchanged genes.
  
  
  CONCLUSIONS
  Many exons are differently expressed by breast cancer and benign lesions, and alternative transcripts contribute to the molecular characteristics of breast malignancy. Development of molecular classifiers for breast-cancer diagnosis with fine-needle aspiration should be possible.
authors.affiliation: Breast Cancer Unit, Department of Medical Oncology, Institut Gustave Roussy France, Villejuif, France.
authors.forename: Fabrice
authors.initials: F
authors.lastname: André
authors.forename: Stefan
authors.initials: S
authors.lastname: Michiels
authors.forename: Philippe
authors.initials: P
authors.lastname: Dessen
authors.forename: Veronique
authors.initials: V
authors.lastname: Scott
authors.forename: Voichita
authors.initials: V
authors.lastname: Suciu
authors.forename: Catherine
authors.initials: C
authors.lastname: Uzan
authors.forename: Vladimir
authors.initials: V
authors.lastname: Lazar
authors.forename: Ludovic
authors.initials: L
authors.lastname: Lacroix
authors.forename: Gilles
authors.initials: G
authors.lastname: Vassal
authors.forename: Marc
authors.initials: M
authors.lastname: Spielmann
authors.forename: Philippe
authors.initials: P
authors.lastname: Vielh
authors.forename: Suzette
authors.initials: S
authors.lastname: Delaloge
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D014408:Biomarkers, Tumor / Q000235:genetics / Q000378:metabolism; D044963:Biopsy, Fine-Needle; D001943:Breast Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D018270:Carcinoma, Ductal, Breast / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D018275:Carcinoma, Lobular / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D002291:Carcinoma, Papillary / Q000188:drug therapy / Q000235:genetics / Q000556:secondary; D005091:Exons / Q000235:genetics*; D005260:Female; D020869:Gene Expression Profiling; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D008875:Middle Aged; D009367:Neoplasm Staging; D009369:Neoplasms / Q000188:drug therapy / Q000235:genetics* / Q000473:pathology; D020411:Oligonucleotide Array Sequence Analysis; D011379:Prognosis; D012326:RNA Splicing / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics / Q000378:metabolism; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D016896:Treatment Outcome; D054928:Validation Studies as Topic; D055815:Young Adult
chemical_list: D014408:Biomarkers, Tumor; D012333:RNA, Messenger