title: Epigenetic Biomarkers of Breast Cancer Risk: Across the Breast Cancer Prevention Continuum.
abstract: Epigenetic biomarkers, such as DNA methylation, can increase cancer risk through altering gene expression. The Cancer Genome Atlas (TCGA) Network has demonstrated breast cancer-specific DNA methylation signatures. DNA methylation signatures measured at the time of diagnosis may prove important for treatment options and in predicting disease-free and overall survival (tertiary prevention). DNA methylation measurement in cell free DNA may also be useful in improving early detection by measuring tumor DNA released into the blood (secondary prevention). Most evidence evaluating the use of DNA methylation markers in tertiary and secondary prevention efforts for breast cancer comes from studies that are cross-sectional or retrospective with limited corresponding epidemiologic data, raising concerns about temporality. Few prospective studies exist that are large enough to address whether DNA methylation markers add to the prediction of tertiary and secondary outcomes over and beyond standard clinical measures. Determining the role of epigenetic biomarkers in primary prevention can help in identifying modifiable pathways for targeting interventions and reducing disease incidence. The potential is great for DNA methylation markers to improve cancer outcomes across the prevention continuum. Large, prospective epidemiological studies will provide essential evidence of the overall utility of adding these markers to primary prevention efforts, screening, and clinical care.
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA. mt146@columbia.edu.|Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA. mt146@columbia.edu.
authors.forename: Mary Beth
authors.initials: MB
authors.lastname: Terry
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Jasmine A
authors.initials: JA
authors.lastname: McDonald
authors.affiliation: Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Hui Chen
authors.initials: HC
authors.lastname: Wu
authors.affiliation: Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Sybil
authors.initials: S
authors.lastname: Eng
authors.affiliation: Herbert Irving Comprehensive Cancer Center, Columbia University, New York, NY, USA.|Department of Environmental Health Sciences, Mailman School of Public Health, Columbia University, New York, NY, USA.
authors.forename: Regina M
authors.initials: RM
authors.lastname: Santella
mesh_terms: D000818:Animals; D014408:Biomarkers, Tumor / Q000235:genetics*; D001943:Breast Neoplasms / Q000453:epidemiology / Q000235:genetics* / Q000517:prevention & control*; D019175:DNA Methylation; D018450:Disease Progression; D018572:Disease-Free Survival; D055088:Early Detection of Cancer; D044127:Epigenesis, Genetic; D005260:Female; D015972:Gene Expression Regulation, Neoplastic; D020022:Genetic Predisposition to Disease; D005820:Genetic Testing; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010641:Phenotype; D011237:Predictive Value of Tests; D011322:Primary Prevention; D018570:Risk Assessment; D012307:Risk Factors; D055502:Secondary Prevention; D055512:Tertiary Prevention; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D014408:Biomarkers, Tumor
keywords: Biomarker; Breast cancer; Breast tissues; DNA methylation; Plasma; Prevention; Prognosis; Recurrence; Serum; Survival