Breast Cancer Research and Treatment

, Volume 125, Issue 2, pp 495–504 | Cite as

Possible risk modifications in the association between MnSOD Ala-9Val polymorphism and breast cancer risk: subgroup analysis and evidence-based sample size calculation for a future trial

  • Yun Chen
  • Jianping Pei


Manganese superoxide dismutase (MnSOD) has been identified as an important scavenger of reactive oxygen species (ROS), which can cause oxidative stress followed by breast cancer. A number of subsequent population-based studies have investigated the association between MnSOD Ala-9Val polymorphism and the risk of breast cancer. However, these studies have yielded conflicting results. This fact implies that the effect of MnSOD Ala-9Val polymorphism on the susceptibility to breast cancer may be modified by other risk factors. To provide a more definitive conclusion, a full meta-analysis combining and summarizing 16 studies was first performed using both traditional and Bayesian approaches. During this step, a recessive inheritance mode was determined after a biological justification. The capability of the Bayesian method was highlighted in the estimation of a pooled odds ratio and 95% confidence interval. As a result, no significant association was observed (OR = 0.978, CI = 0.914–1.046). Bayesian meta-regression and subgroup analysis were then conducted to find possible risk modifications by other factors, including menopausal status, ethnicity effect, use of oral contraceptives, use of hormone replacement therapy, fruits and vegetables intake, vitamin supplement, and body mass index. While the power of most subgroups may be insufficient to make a statistical statement, an evidence-based sample size calculation based upon updated meta-analysis was performed to power a future trial. For example, approximately 5,000 subjects are required for a new Asian study (2,500 cases and 2,500 controls) to achieve 80% power.


MnSOD Polymorphism Breast cancer Bayesian meta-regression Subgroup analysis Sample size calculation 



National Natural Science Fund (20905037), Jiangsu Natural Science Fund (BK2009419), and Research fund for the doctoral program of higher education of China (20093234120010) to Dr. Chen are gratefully acknowledged. The authors would also like to thank Chen Jie for his support in data processing.

Supplementary material

10549_2010_978_MOESM1_ESM.ppt (468 kb)
Fig. 1S Cumulative meta-analysis (by sample size) for association between the MnSOD Ala-9Val polymorphism and the risk of breast cancer. The odds ratio and its 95% confidence interval were computed accumulatively (PPT 469 kb)
10549_2010_978_MOESM2_ESM.ppt (82 kb)
Fig. 2S Posterior distribution of mean and standard deviation of pooled odds ratio and between-study variance (τ2) from the full Bayes model (PPT 82 kb)
10549_2010_978_MOESM3_ESM.ppt (61 kb)
Fig. 3S The frequencies of Ala/Ala genotype carriers in control groups of Asian and non-Asian women (PPT 61 kb)


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Copyright information

© Springer Science+Business Media, LLC. 2010

Authors and Affiliations

  1. 1.Department of PharmacologyNanjing Medical UniversityNanjingChina
  2. 2.Jiangsu Provincial Jiaotong Planning and Design InstituteNanjingChina

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