Skip to main content
Top
Published in: BMC Cancer 1/2007

Open Access 01-12-2007 | Study protocol

Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH): study protocol

Authors: Diana Eccles, Sue Gerty, Peter Simmonds, Victoria Hammond, Sarah Ennis, Douglas G Altman, the POSH steering group

Published in: BMC Cancer | Issue 1/2007

Login to get access

Abstract

Background

Young women presenting with breast cancer are more likely to have a genetic predisposition to the disease than breast cancer patients in general. A genetic predisposition is known to increase the risk of new primary breast (and other) cancers. It is unclear from the literature whether genetic status should be taken into consideration when planning adjuvant treatment in a young woman presenting with a first primary breast cancer. The primary aim of the POSH study is to establish whether genetic status influences the prognosis of primary breast cancer independently of known prognostic factors.

Methods/design

The study is a prospective cohort study recruiting 3,000 women aged 40 years or younger at breast cancer diagnosis; the recruiting period covers 1st June 2001 to 31st December 2007. Written informed consent is obtained at study entry. Family history and known epidemiological risk data are collected by questionnaire. Clinical information about diagnosis, treatment and clinical course is collected and blood is stored. Follow up data are collected annually after the first year. An additional recruitment category includes women aged 41 to 50 years who are found to be BRCA1 or BRCA2 gene carriers and were diagnosed with their first breast cancer during the study recruiting period.

Discussion

Power estimates were based on 10% of the cohort carrying a BRCA1 gene mutation. Preliminary BRCA1 and BRCA2 mutation analysis in a pilot set of study participants confirms we should have 97% power to detect a difference of 10% in event rates between gene carriers and sporadic young onset cases. Most of the recruited patients (>80%) receive an anthracycline containing adjuvant chemotherapy regimen making planned analyses more straightforward.
Appendix
Available only for authorised users
Literature
2.
go back to reference Gonzalez-Angulo AM, Broglio K, Kau SW, Eralp Y, Erlichman J, Valero V, et al: Women age < or = 35 years with primary breast carcinoma: disease features at presentation. Cancer. 2005, 103: 2466-2472. 10.1002/cncr.21070.CrossRefPubMed Gonzalez-Angulo AM, Broglio K, Kau SW, Eralp Y, Erlichman J, Valero V, et al: Women age < or = 35 years with primary breast carcinoma: disease features at presentation. Cancer. 2005, 103: 2466-2472. 10.1002/cncr.21070.CrossRefPubMed
3.
go back to reference Colleoni M, Rotmensz N, Peruzzotti G, Maisonneuve P, Orlando L, Ghisini R, et al: Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease. Ann Oncol. 2006, 10: 1497-1503. 10.1093/annonc/mdl145.CrossRef Colleoni M, Rotmensz N, Peruzzotti G, Maisonneuve P, Orlando L, Ghisini R, et al: Role of endocrine responsiveness and adjuvant therapy in very young women (below 35 years) with operable breast cancer and node negative disease. Ann Oncol. 2006, 10: 1497-1503. 10.1093/annonc/mdl145.CrossRef
4.
go back to reference Euhus DM: Understanding mathematical models for breast cancer risk assessment and counseling. Breast J. 2001, 7: 224-232. 10.1046/j.1524-4741.2001.20012.x.CrossRefPubMed Euhus DM: Understanding mathematical models for breast cancer risk assessment and counseling. Breast J. 2001, 7: 224-232. 10.1046/j.1524-4741.2001.20012.x.CrossRefPubMed
5.
go back to reference Pharoah PD, Dunning AM, Ponder BA, Easton DF: Association studies for finding cancer-susceptibility genetic variants. Nat Rev Cancer. 2004, 4: 850-860. 10.1038/nrc1476.CrossRefPubMed Pharoah PD, Dunning AM, Ponder BA, Easton DF: Association studies for finding cancer-susceptibility genetic variants. Nat Rev Cancer. 2004, 4: 850-860. 10.1038/nrc1476.CrossRefPubMed
6.
go back to reference Rahman N, Seal S, Thompson D, Kelly P, Renwick A, Elliott A, et al: PALB2, which encodes a BRCA2-interacting protein, is a breast cancer susceptibility gene. Nat Genet. 2007, 39: 165-167. 10.1038/ng1959.CrossRefPubMed Rahman N, Seal S, Thompson D, Kelly P, Renwick A, Elliott A, et al: PALB2, which encodes a BRCA2-interacting protein, is a breast cancer susceptibility gene. Nat Genet. 2007, 39: 165-167. 10.1038/ng1959.CrossRefPubMed
7.
go back to reference Renwick A, Thompson D, Seal S, Kelly P, Chagtai T, Ahmed M, et al: ATM mutations that cause ataxia-telangiectasia are breast cancer susceptibility alleles. Nat Genet. 2006, 38: 873-875. 10.1038/ng1837.CrossRefPubMed Renwick A, Thompson D, Seal S, Kelly P, Chagtai T, Ahmed M, et al: ATM mutations that cause ataxia-telangiectasia are breast cancer susceptibility alleles. Nat Genet. 2006, 38: 873-875. 10.1038/ng1837.CrossRefPubMed
8.
go back to reference Seal S, Thompson D, Renwick A, Elliott A, Kelly P, Barfoot R, et al: Truncating mutations in the Fanconi anemia J gene BRIP1 are low-penetrance breast cancer susceptibility alleles. Nat Genet. 2006, 38: 1239-1241. 10.1038/ng1902.CrossRefPubMed Seal S, Thompson D, Renwick A, Elliott A, Kelly P, Barfoot R, et al: Truncating mutations in the Fanconi anemia J gene BRIP1 are low-penetrance breast cancer susceptibility alleles. Nat Genet. 2006, 38: 1239-1241. 10.1038/ng1902.CrossRefPubMed
9.
go back to reference Easton DF, Pooley KA, Dunning AM, Pharoah PD, Thompson D, Ballinger DG, et al: Genome-wide association study identifies novel breast cancer susceptibility loci. Nature. 2007 Easton DF, Pooley KA, Dunning AM, Pharoah PD, Thompson D, Ballinger DG, et al: Genome-wide association study identifies novel breast cancer susceptibility loci. Nature. 2007
10.
go back to reference Palacios J, Honrado E, Osorio A, Cazorla A, Sarrio D, Barroso A, et al: Phenotypic characterization of BRCA1 and BRCA2 tumors based in a tissue microarray study with 37 immunohistochemical markers. Breast Cancer Res Treat. 2005, 90: 5-14. 10.1007/s10549-004-1536-0.CrossRefPubMed Palacios J, Honrado E, Osorio A, Cazorla A, Sarrio D, Barroso A, et al: Phenotypic characterization of BRCA1 and BRCA2 tumors based in a tissue microarray study with 37 immunohistochemical markers. Breast Cancer Res Treat. 2005, 90: 5-14. 10.1007/s10549-004-1536-0.CrossRefPubMed
11.
go back to reference Honrado E, Osorio A, Palacios J, Milne RL, Sanchez L, Diez O, et al: Immunohistochemical expression of DNA repair proteins in familial breast cancer differentiate BRCA2-associated tumors. J Clin Oncol. 2005, 23: 7503-7511. 10.1200/JCO.2005.01.3698.CrossRefPubMed Honrado E, Osorio A, Palacios J, Milne RL, Sanchez L, Diez O, et al: Immunohistochemical expression of DNA repair proteins in familial breast cancer differentiate BRCA2-associated tumors. J Clin Oncol. 2005, 23: 7503-7511. 10.1200/JCO.2005.01.3698.CrossRefPubMed
12.
go back to reference Lakhani SR, Reis-Filho JS, Fulford L, Penault-Llorca F, van d V, Parry S, et al: Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res. 2005, 11: 5175-5180. 10.1158/1078-0432.CCR-04-2424.CrossRefPubMed Lakhani SR, Reis-Filho JS, Fulford L, Penault-Llorca F, van d V, Parry S, et al: Prediction of BRCA1 status in patients with breast cancer using estrogen receptor and basal phenotype. Clin Cancer Res. 2005, 11: 5175-5180. 10.1158/1078-0432.CCR-04-2424.CrossRefPubMed
13.
go back to reference Porter DE, Cohen BB, Wallace MR, Smyth E, Chetty U, Dixon JM, et al: Breast cancer incidence, penetrance and survival in probable carriers of BRCA1 gene mutation in families linked to BRCA1 on chromosome 17q12-21. Br J Surg. 1994, 81: 1512-1515. 10.1002/bjs.1800811038.CrossRefPubMed Porter DE, Cohen BB, Wallace MR, Smyth E, Chetty U, Dixon JM, et al: Breast cancer incidence, penetrance and survival in probable carriers of BRCA1 gene mutation in families linked to BRCA1 on chromosome 17q12-21. Br J Surg. 1994, 81: 1512-1515. 10.1002/bjs.1800811038.CrossRefPubMed
14.
go back to reference Nicoletto MO, Donach M, De NA, Artioli G, Banna G, Monfardini S: BRCA-1 and BRCA-2 mutations as prognostic factors in clinical practice and genetic counselling. Cancer Treat Rev. 2001, 27: 295-304. 10.1053/ctrv.2001.0233.CrossRefPubMed Nicoletto MO, Donach M, De NA, Artioli G, Banna G, Monfardini S: BRCA-1 and BRCA-2 mutations as prognostic factors in clinical practice and genetic counselling. Cancer Treat Rev. 2001, 27: 295-304. 10.1053/ctrv.2001.0233.CrossRefPubMed
15.
go back to reference Verhoog LC, Brekelmans CT, Seynaeve C, van den Bosch LM, Dahmen G, van Geel AN, et al: Survival and tumour characteristics of breast-cancer patients with germline mutations of BRCA1. Lancet. 1998, 351: 316-321. 10.1016/S0140-6736(97)07065-7.CrossRefPubMed Verhoog LC, Brekelmans CT, Seynaeve C, van den Bosch LM, Dahmen G, van Geel AN, et al: Survival and tumour characteristics of breast-cancer patients with germline mutations of BRCA1. Lancet. 1998, 351: 316-321. 10.1016/S0140-6736(97)07065-7.CrossRefPubMed
16.
go back to reference Eccles D, Simmonds P, Goddard J, Coultas M, Hodgson S, Lalloo F, et al: Familial breast cancer: An investigation into the outcome of treatment for early stage disease. Familial Cancer. 2001, 1: 72-10.1023/A:1013867917101.CrossRef Eccles D, Simmonds P, Goddard J, Coultas M, Hodgson S, Lalloo F, et al: Familial breast cancer: An investigation into the outcome of treatment for early stage disease. Familial Cancer. 2001, 1: 72-10.1023/A:1013867917101.CrossRef
17.
go back to reference Johannsson OT, Ranstam J, Borg A, Olsson H: Survival of BRCA1 breast and ovarian cancer patients: a population-based study from southern Sweden. J Clin Oncol. 1998, 16: 397-404.PubMed Johannsson OT, Ranstam J, Borg A, Olsson H: Survival of BRCA1 breast and ovarian cancer patients: a population-based study from southern Sweden. J Clin Oncol. 1998, 16: 397-404.PubMed
18.
go back to reference Stoppa-Lyonnet D, Ansquer Y, Dreyfus H, Gautier C, Gauthier-Villars M, Bourstyn E, et al: Familial invasive breast cancers: worse outcome related to BRCA1 mutations. J Clin Oncol. 2000, 18: 4053-4059.PubMed Stoppa-Lyonnet D, Ansquer Y, Dreyfus H, Gautier C, Gauthier-Villars M, Bourstyn E, et al: Familial invasive breast cancers: worse outcome related to BRCA1 mutations. J Clin Oncol. 2000, 18: 4053-4059.PubMed
19.
go back to reference Venkitaraman AR: Cancer susceptibility and the functions of BRCA1 and BRCA2. Cell. 2002, 108: 171-182. 10.1016/S0092-8674(02)00615-3.CrossRefPubMed Venkitaraman AR: Cancer susceptibility and the functions of BRCA1 and BRCA2. Cell. 2002, 108: 171-182. 10.1016/S0092-8674(02)00615-3.CrossRefPubMed
20.
go back to reference Seal S, Thompson D, Renwick A, Elliott A, Kelly P, Barfoot R, et al: Truncating mutations in the Fanconi anemia J gene BRIP1 are low-penetrance breast cancer susceptibility alleles. Nat Genet. 2006, 38: 1239-1241. 10.1038/ng1902.CrossRefPubMed Seal S, Thompson D, Renwick A, Elliott A, Kelly P, Barfoot R, et al: Truncating mutations in the Fanconi anemia J gene BRIP1 are low-penetrance breast cancer susceptibility alleles. Nat Genet. 2006, 38: 1239-1241. 10.1038/ng1902.CrossRefPubMed
21.
go back to reference Quinn JE, Kennedy RD, Mullan PB, Gilmore PM, Carty M, Johnston PG, et al: BRCA1 functions as a differential modulator of chemotherapy-induced apoptosis. Cancer Res. 2003, 63: 6221-6228.PubMed Quinn JE, Kennedy RD, Mullan PB, Gilmore PM, Carty M, Johnston PG, et al: BRCA1 functions as a differential modulator of chemotherapy-induced apoptosis. Cancer Res. 2003, 63: 6221-6228.PubMed
22.
go back to reference Eccles DM, Simmonds P: Clinical Management in Hereditary Breast Cancer. Cancer & Chemotherapy Reviews. 2006, 1: 63-69. Eccles DM, Simmonds P: Clinical Management in Hereditary Breast Cancer. Cancer & Chemotherapy Reviews. 2006, 1: 63-69.
24.
go back to reference Emery J, Walton R, Murphy M, Austoker J, Yudkin P, Chapman C, et al: Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases. BMJ. 2000, 321: 28-32. 10.1136/bmj.321.7252.28.CrossRefPubMedPubMedCentral Emery J, Walton R, Murphy M, Austoker J, Yudkin P, Chapman C, et al: Computer support for interpreting family histories of breast and ovarian cancer in primary care: comparative study with simulated cases. BMJ. 2000, 321: 28-32. 10.1136/bmj.321.7252.28.CrossRefPubMedPubMedCentral
25.
go back to reference Claus EB, Risch N, Thompson WD: Genetic analysis of breast cancer in the cancer and steroid hormone study. Am J Hum Genet. 1991, 48: 232-242.PubMedPubMedCentral Claus EB, Risch N, Thompson WD: Genetic analysis of breast cancer in the cancer and steroid hormone study. Am J Hum Genet. 1991, 48: 232-242.PubMedPubMedCentral
26.
go back to reference Amir E, Evans DG, Shenton A, Lalloo F, Moran A, Boggis C, et al: Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. J Med Genet. 2003, 40: 807-814. 10.1136/jmg.40.11.807.CrossRefPubMedPubMedCentral Amir E, Evans DG, Shenton A, Lalloo F, Moran A, Boggis C, et al: Evaluation of breast cancer risk assessment packages in the family history evaluation and screening programme. J Med Genet. 2003, 40: 807-814. 10.1136/jmg.40.11.807.CrossRefPubMedPubMedCentral
27.
go back to reference Domchek SM, Eisen A, Calzone K, Stopfer J, Blackwood A, Weber BL: Application of breast cancer risk prediction models in clinical practice. J Clin Oncol. 2003, 21: 593-601. 10.1200/JCO.2003.07.007.CrossRefPubMed Domchek SM, Eisen A, Calzone K, Stopfer J, Blackwood A, Weber BL: Application of breast cancer risk prediction models in clinical practice. J Clin Oncol. 2003, 21: 593-601. 10.1200/JCO.2003.07.007.CrossRefPubMed
28.
go back to reference Kang HH, Williams R, Leary J, Ringland C, Kirk J, Ward R: Evaluation of models to predict BRCA germline mutations. Br J Cancer. 2006, 95: 914-920. 10.1038/sj.bjc.6603358.CrossRefPubMedPubMedCentral Kang HH, Williams R, Leary J, Ringland C, Kirk J, Ward R: Evaluation of models to predict BRCA germline mutations. Br J Cancer. 2006, 95: 914-920. 10.1038/sj.bjc.6603358.CrossRefPubMedPubMedCentral
29.
go back to reference Moses LE: Measuring effects without randomized trials? Options, problems, challenges. Med Care. 1995, 33: AS8-14.PubMed Moses LE: Measuring effects without randomized trials? Options, problems, challenges. Med Care. 1995, 33: AS8-14.PubMed
30.
go back to reference Eccles DM, Pichert G: Familial non-BRCA1/BRCA2-associated breast cancer. Lancet Oncol. 2005, 6: 705-711. 10.1016/S1470-2045(05)70318-1.CrossRefPubMed Eccles DM, Pichert G: Familial non-BRCA1/BRCA2-associated breast cancer. Lancet Oncol. 2005, 6: 705-711. 10.1016/S1470-2045(05)70318-1.CrossRefPubMed
Metadata
Title
Prospective study of Outcomes in Sporadic versus Hereditary breast cancer (POSH): study protocol
Authors
Diana Eccles
Sue Gerty
Peter Simmonds
Victoria Hammond
Sarah Ennis
Douglas G Altman
the POSH steering group
Publication date
01-12-2007
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2007
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/1471-2407-7-160

Other articles of this Issue 1/2007

BMC Cancer 1/2007 Go to the issue
Webinar | 19-02-2024 | 17:30 (CET)

Keynote webinar | Spotlight on antibody–drug conjugates in cancer

Antibody–drug conjugates (ADCs) are novel agents that have shown promise across multiple tumor types. Explore the current landscape of ADCs in breast and lung cancer with our experts, and gain insights into the mechanism of action, key clinical trials data, existing challenges, and future directions.

Dr. Véronique Diéras
Prof. Fabrice Barlesi
Developed by: Springer Medicine