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Early onset breast cancer: differences in risk factors, tumor phenotype, and genotype between North African and South European women

Breast Cancer Research and Treatment volume 166, pages 631–639 (2017)Cite this article

Abstract

Purpose

This report compares the risk factors, the tumor phenotypes, and the BRCA1/BRCA2 genotype of early onset breast cancer (EOBC) patients between Southern Europe and North Africa.

Methods

Four hundred and fifty six women with invasive EOBC (≤40 years) were prospectively included from four centers in France (n = 270) and four centers in North Africa (Algeria, Egypt, Morocco, Tunisia; n = 186). Life style, tumor phenotype, familial history, BRCA1/BRCA2 genotype were compared between the two populations.

Results

We found an older age at menarche, a higher number of childbearing, a more frequent breastfeeding, a higher body mass index, a lower use of oral contraceptives in North African women compared to French women. TNM stage at diagnosis was higher in North African women than in French women. North African women had a lower incidence of triple negative and proliferative (Ki 67 index > 20%) tumors. There was a lower rate of BRCA1 mutation in North Africa (7 vs. 15%, P = 0.02). Three putative BRCA1/2 founder mutations were identified in North Africa.

Conclusions

In EOBC, we found significant differences in risk factors, phenotype and a higher incidence of BRCA1 mutations in Southern Europe as compared to North Africa. The worst prognosis previously reported for EOBC in North Africa is more likely due to a higher stage at diagnosis than to a more aggressive phenotype, since triple negative tumors are more common in Southern Europe and advanced tumors in North Africa.

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Abbreviations

APHP:

Assistance Publique et Hôpitaux e Paris

BMI:

Body mass index

BRCA:

Breast cancer

CNV:

Copy number variant

DNA:

Desoxyribonucleic acid

EOBC:

Early onset breast cancer

HRM:

High resolution melting

ICM:

Institut du cancer de Montpellier

INSERM:

Institut National de la Santé et de la Recherche Médicale

MLPA:

Multiplex ligation-dependant probe amplification

PCR:

Polymerase chain reaction

SBR:

Scarff bloom richardson

SD:

Standard deviations

SNV:

Single nucleotide variant

TNM:

Tumor node metastatic

UICC:

Union International Contre le Cancer

UMD:

Universal mutation database

UPEC:

Université Paris-Est Créteil (ex-Université Paris 12)

WBC:

White blood cell

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Acknowledgements

This work was supported by the Ligue Nationale Contre le Cancer, the University and Hospital of Montpellier and genetic testing was supported by the Myriad Genetic company.

Author information

Affiliations

  1. Department of Cancer Genetics, University of Montpellier and University Hospital (CHU), Montpellier, France

    Carole Corsini, Isabelle Coupier, Virginie Galibert, Karen Baudry & Pascal Pujol

  2. University of Mentouri brothers, Constantine, Algeria

    Sarra Henouda

  3. Department of Biology, University of Sciences of Tunis, Tunis, Tunisia

    Dalel Ben Nejima

  4. Department of medical information, University Hospital, Montpellier, France

    Héléna Bertet & Marie-Christine Picot

  5. Department of radiotherapy, Hartmann Radiotherapy Center, American Hospital of Paris, Neuilly, France

    Alain Toledano, Paul Ihout & David Khayat

  6. Department of oncology, Abderrahmen Mami Hospital, Ariana, Tunisia

    Hamouda Boussen

  7. Department of oncology, Oncology Center Al Azhar, Rabat, Morocco

    Faouzi Habib & Asma Mouhout

  8. Alfa Cure Center and Ain Shams University-Hospitals, Cairo, Egypt

    Ahmed Gaballah & Hesham El Ghazaly

  9. Department of radiotherapy, Cancer Institute of Montpellier, ICM Val d’Aurelle, Montpellier, France

    Céline Bourgier

  10. Hormonal and cellular biology laboratory, University Hospital, Montpellier, France

    Paul Vilquin & Jean-Marc Rey

  11. Polytechnique school, Palaiseau, France

    Louise Biquard

  12. Department of radiation oncology and Henri Mondor breast center, APHP Henri Mondor University Hospital, University of Paris-Est Creteil (UPEC), INSERM U955 Eq07, Creteil, France

    Yazid Belkacemi

  13. Department of oncology, EH Didouche Mourad and medical University, Constantine, Algeria

    Assia Bensalem

  14. Unité d’oncogénétique, Centre Hospitalier Universitaire de Montpellier, 371, avenue du doyen Gaston Giraud, 34295, Montpellier cedex 5, France

    Pascal Pujol

Authors
  1. Carole Corsini
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  2. Sarra Henouda
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  3. Dalel Ben Nejima
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  4. Héléna Bertet
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  5. Alain Toledano
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  6. Hamouda Boussen
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  7. Faouzi Habib
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  8. Asma Mouhout
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  9. Ahmed Gaballah
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  10. Hesham El Ghazaly
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  11. Céline Bourgier
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  12. Isabelle Coupier
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  13. Virginie Galibert
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  14. Karen Baudry
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  15. Paul Vilquin
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  16. Louise Biquard
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  17. Jean-Marc Rey
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  18. Yazid Belkacemi
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  19. Paul Ihout
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  20. David Khayat
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  21. Marie-Christine Picot
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  22. Assia Bensalem
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  23. Pascal Pujol
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Corresponding author

Correspondence to Pascal Pujol.

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Corsini, C., Henouda, S., Nejima, D.B. et al. Early onset breast cancer: differences in risk factors, tumor phenotype, and genotype between North African and South European women. Breast Cancer Res Treat 166, 631–639 (2017). https://doi.org/10.1007/s10549-017-4434-y

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  • DOI: https://doi.org/10.1007/s10549-017-4434-y

Keywords

  • Early onset breast cancer
  • North Africa
  • BRCA1
  • BRCA2
  • Phenotype