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Type: Journal article
Title: Hormonal modulation of breast cancer gene expression: implications for intrinsic subtyping in premenopausal women
Author: Bernhardt, S.M.
Dasari, P.
Walsh, D.
Townsend, A.R.
Price, T.J.
Ingman, W.V.
Citation: Frontiers in Oncology, 2016; 6(NOV):241-1-241-16
Publisher: Frontiers Media
Issue Date: 2016
ISSN: 2234-943X
Statement of
Sarah M. Bernhardt, Pallave Dasari, David Walsh, Amanda R. Townsend, Timothy J. Price, and Wendy V. Ingman
Abstract: Clinics are increasingly adopting gene-expression profiling to diagnose breast cancer subtype, providing an intrinsic, molecular portrait of the tumor. For example, the PAM50- based Prosigna test quantifies expression of 50 key genes to classify breast cancer subtype, and this method of classification has been demonstrated to be superior over traditional immunohistochemical methods that detect proteins, to predict risk of disease recurrence. However, these tests were largely developed and validated using breast cancer samples from postmenopausal women. Thus, the accuracy of such tests has not been explored in the context of the hormonal fluctuations in estrogen and progesterone that occur during the menstrual cycle in premenopausal women. Concordance between traditional methods of subtyping and the new tests in premenopausal women is likely to depend on the stage of the menstrual cycle at which the tissue sample is taken and the relative effect of hormones on expression of genes versus proteins. The lack of knowledge around the effect of fluctuating estrogen and progesterone on gene expression in breast cancer patients raises serious concerns for intrinsic subtyping in premenopausal women, which comprise about 25% of breast cancer diagnoses. Further research on the impact of the menstrual cycle on intrinsic breast cancer profiling is required if premenopausal women are to benefit from the new technology of intrinsic subtyping.
Keywords: Premenopausal breast cancer; intrinsic subtyping; menstrual cycle; gene expression; hormones
Rights: Copyright © 2016 Bernhardt, Dasari, Walsh, Townsend, Price and Ingman. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
DOI: 10.3389/fonc.2016.00241
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