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B L Weber

Publications and source records attributed to B L Weber.

At least 55 records · Page 3Linked to original sources
PubMed1999

Breast cancer risk after bilateral prophylactic oophorectomy in BRCA1 mutation carriers.

BACKGROUND: The availability of genetic testing for inherited mutations in the BRCA1 gene provides potentially valuable information to women at high risk of breast or ovarian cancer; however, carriers of BRCA1 mutations have few clinical management options to reduce their cancer risk. Decreases in ovarian hormone exposure following bilateral prophylactic oophorectomy (i.e., surgical removal of the ovaries) may alter cancer risk in BRCA1 mutation carriers. This study was undertaken to evaluate whether bilateral prophylactic oophorectomy is associated with a reduction in breast cancer risk in BRCA1 mutation carriers. METHODS: We studied a cohort of women with disease-associated germline BRCA1 mutations who were assembled from five North American centers. Surgery subjects (n = 43) included women with BRCA1 mutations who underwent bilateral prophylactic oophorectomy but had no history of breast or ovarian cancer and had not had a prophylactic mastectomy. Control subjects included women with BRCA1 mutations who had no history of oophorectomy and no history of breast or ovarian cancer (n = 79). Control subjects were matched to the surgery subjects according to center and year of birth. RESULTS: We found a statistically significant reduction in breast cancer risk after bilateral prophylactic oophorectomy, with an adjusted hazard ratio (HR) of 0.53 (95% confidence interval [CI] = 0.33-0.84). This risk reduction was even greater in women who were followed 5-10 (HR = 0. 28; 95% CI = 0.08-0.94) or at least 10 (HR = 0.33; 95% CI = 0.12-0.91) years after surgery. Use of hormone replacement therapy did not negate the reduction in breast cancer risk after surgery. CONCLUSIONS: Bilateral prophylactic oophorectomy is associated with a reduced breast cancer risk in women who carry a BRCA1 mutation. The likely mechanism is reduction of ovarian hormone exposure. These findings have implications for the management of breast cancer risk in women who carry BRCA1 mutations.

Age Factors↗
PubMed1999

Modification of BRCA1-associated breast cancer risk by the polymorphic androgen-receptor CAG repeat.

Compared with the general population, women who have inherited a germline mutation in the BRCA1 gene have a greatly increased risk of developing breast cancer. However, there is also substantial interindividual variability in the occurrence of breast cancer among BRCA1 mutation carriers. We hypothesize that other genes, particularly those involved in endocrine signaling, may modify the BRCA1-associated age-specific breast cancer risk. We studied the effect of the CAG repeat-length polymorphism found in exon 1 of the androgen-receptor (AR) gene (AR-CAG). AR alleles containing longer CAG repeat lengths are associated with a decreased ability to activate androgen-responsive genes. Using a sample of women who inherited germline BRCA1 mutations, we compared AR-CAG repeat length in 165 women with and 139 women without breast cancer. We found that women were at significantly increased risk of breast cancer if they carried at least one AR allele with >/=28 CAG repeats. Women who carried an AR-CAG allele of >/=28, >/=29, or >/=30 repeats were given a diagnosis 0.8, 1.8, or 6.3 years earlier than women who did not carry at least one such allele. All 11 women in our sample who carried at least one AR-CAG allele with >/=29 repeats had breast cancer. Our results support the hypothesis that age at breast cancer diagnosis is earlier among BRCA1 mutation carriers who carry very long AR-CAG repeats. These results suggest that pathways involving androgen signaling may affect the risk of BRCA1-associated breast cancer.

Adult↗
PubMed1999

Recent advances in breast cancer biology.

Breast cancer remains the leading cause of death in American women 30 to 70 years of age, and research in the field of breast cancer continues at an explosive pace. Our understanding of the molecular basis of familial breast cancer has advanced significantly through investigation of the tumor suppressor gene BRCA1, as has our knowledge of the role of the ATM gene and predisposition to breast cancer in ataxia-telangiectasia carriers. In addition, progress has been made in understanding the role of HER-2/neu as a prognostic factor in breast cancer. In this review, some of the recent advances in breast cancer biology that are relevant to these areas of study are highlighted.

Animals↗
PubMed1999

Polymorphisms in PTEN in breast cancer families.

Germline mutations in PTEN are the underlying genetic defect in Cowden disease, which is associated with a lifetime risk of 25-50% of developing breast cancer. To investigate the role of PTEN in inherited breast cancer in the absence of manifestations of Cowden disease, we screened 177 unrelated subjects with breast cancer who also had a family history of breast cancer in at least one relative. We found no disease associated PTEN mutations in this cohort, supporting previous studies suggesting that PTEN mutations do not contribute to inherited susceptibility to breast cancer without associated manifestations of Cowden disease. We did identify an association between a common polymorphism in intron 4 and lower mean age of diagnosis of breast cancer. While preliminary, these findings suggest that further study is warranted to determine whether this allelic variant of PTEN could function as a low penetrance breast cancer susceptibility allele.

Age Factors↗
PubMed1998

Effect of smoking on breast cancer in carriers of mutant BRCA1 or BRCA2 genes.

BACKGROUND: Smoking has carcinogenic effects, and possibly antiestrogenic effects as well, but it has not been found to be a risk factor for breast cancer in women in the general population. However, hereditary breast cancer is primarily a disease of premenopausal women, and interactions between genes and hormonal and environmental risk factors may be particularly important in this subgroup. METHODS: We conducted a matched case-control study of breast cancer among women who have been identified to be carriers of a deleterious mutation in either the BRCA1 or the BRCA2 gene. These women were assessed for genetic risk at one of several genetic counseling programs for cancer in North America. Information about lifetime smoking history was derived from a questionnaire routinely administered to women who were found to carry a mutation in either gene. Smoking histories of case subjects with breast cancer and age-matched healthy control subjects were compared. Odds ratios for developing breast cancer were determined for smokers versus nonsmokers by use of conditional logistic regression for matched sets after adjustment for other known risk factors. RESULTS: Subjects with BRCA1 or BRCA2 gene mutations and breast cancer were significantly more likely to have been nonsmokers than were subjects with mutations and without breast cancer (two-sided P = .007). In a multivariate analysis, subjects with BRCA1 or BRCA2 mutations who had smoked cigarettes for more than 4 pack-years (i.e., number of packs per day multiplied by the number of years of smoking) were found to have a lower breast cancer risk (odds ratio = 0.46, 95% confidence interval = 0.27-0.80; two-sided P = .006) than subjects with mutations who never smoked. CONCLUSIONS: This study raises the possibility that smoking reduces the risk of breast cancer in carriers of BRCA1 or BRCA2 gene mutations.

Breast Neoplasms↗
PubMed1998

BRCA1 physically associates with p53 and stimulates its transcriptional activity.

Mutations of the BRCA1 tumor suppressor gene are the most commonly detected alterations in familial breast and ovarian cancer. Although BRCA1 is required for normal mouse development, the molecular basis for its tumor suppressive function remains poorly understood. We show here that BRCA1 increases p53-dependent transcription from the p21WAF1/CIP1 and bax promoters. We also show that BRCA1 and p53 proteins interact both in vitro and in vivo. The interacting regions map, in vitro, to aa 224-500 of BRCA1 and the C-terminal domain of p53. Tumor-derived transactivation-deficient BRCA1 mutants are defective in co-activation of p53-dependent transcription and a truncation mutant of BRCA1 that retains the p53-interacting region acts as a dominant inhibitor of p53-dependent transcription. BRCA1 and p53 cooperatively induce apoptosis of cancer cells. The results indicate that BRCA1 and p53 may coordinately regulate gene expression in their role as tumor suppressors.

Animals↗
PubMed1998

Constant denaturant gel electrophoresis (CDGE) in BRCA1 mutation screening.

Screening for mutations in the breast and ovarian cancer susceptibility gene, BRCA1, is complicated by the wide spectrum of mutations found in this large gene. In the present study a constant denaturant gel electrophoresis (CDGE) mutation screening strategy was established for approximately 80% of the genomic coding sequence (exons 2, 11, 13-16, 20, 24). This strategy was applied to screen genomic DNA from 50 familial breast and/or ovarian cancer patients who had previously been examined for BRCA1 mutations by SSCP. A total of 14 carriers of 12 distinct disease-associated mutations and 7 carriers of 6 distinct rare substitutions leading to amino acid substitutions were identified. The SSCP failed to detect 40% of the different deletions/insertions (4/10) and 75% (6/8) of the different base substitutions leading to terminating codons or rare amino acid changes. SSCP did, however, identify one rare base substitution that could not be detected in the CDGE screening. To evaluate the CDGE mutation screening strategy further, 25 unrelated patients from Norwegian breast and/or ovarian cancer families were examined for BRCA1 mutations using a combined genomic DNA/cDNA approach covering the entire coding sequence of the gene. A total of six mutation carriers were detected, all of whom had cases of ovarian cancer in their families. Three patients from independent families carried an 1135insA mutation in exon 11, two others had a Gly484ter and an 1675delA mutation, respectively, and the sixth carried a splice mutation (5194-2 a-->c) causing deletion of exon 18. CDGE may become an efficient tool in diagnostic and population based screening for BRCA1 mutations.

BRCA1 Protein↗
PubMed1998

Update on breast cancer susceptibility genes.

BRCA1 and BRCA2 have now been isolated and a large number of families characterized for the presence of mutations in these breast cancer susceptibility genes. Data from these studies are beginning to provide us with answers to many important questions. It is clear that estimates of attributable risk and penetrance are dependent on the population being studied. For example, studies of large, extensively affected families suggest that 45% of inherited breast cancer is due to BRCA1 mutations, while similar studies in individuals ascertained from breast cancer risk evaluation clinics suggest that the attributable risk is only 15%-20%. Similarly the large families yield penetrance estimates of 87% by age 85, while a more population-based study suggests somewhat lower rates--60% by age 70. In addition, studies of BRCA1-related tumors suggest that there may be some important molecular differences as compared to sporadic tumors, with a predominance of high grade lesions that are ER negative and an increased rate of p53 mutations. Controversy remains about the potential for genotype/phenotype correlation, and previous anecdotal reports of improved survival in families with familial breast cancer have yet to be fully evaluated. Finally, clinical recommendations are being formulated, with current recommendations centered on screening for breast cancer risk and prophylactic oophorectomy for presumed reduction of ovarian cancer risk.

BRCA2 Protein↗
PubMed1998

Stable interaction between the products of the BRCA1 and BRCA2 tumor suppressor genes in mitotic and meiotic cells.

BRCA1 and BRCA2 account for most cases of familial, early onset breast and/or ovarian cancer and encode products that each interact with hRAD51. Results presented here show that BRCA1 and BRCA2 coexist in a biochemical complex and colocalize in subnuclear foci in somatic cells and on the axial elements of developing synaptonemal complexes. Like BRCA1 and RAD51, BRCA2 relocates to PCNA+ replication sites following exposure of S phase cells to hydroxyurea or UV irradiation. Thus, BRCA1 and BRCA2 participate, together, in a pathway(s) associated with the activation of double-strand break repair and/or homologous recombination. Dysfunction of this pathway may be a general phenomenon in the majority of cases of hereditary breast and/or ovarian cancer.

Antibodies, Monoclonal↗
PubMed1998

Managing cancer risk without adequate data: a necessary evil.

While the French guidelines could be exhaustively deconstructed, to do so would be unlikely to produce a better justified set of guidelines. As is usually the case, the absence of data produces as many opinions as there are experts. However, the salient points are that data are not yet available and may not be available for several years. Clinicians and their patients want, and need, guidance now. The development of these guidelines, and the process used to do so, are to be applauded. Both serve as models for similar work in other countries.

France↗
PubMed1998

Recent advances in breast cancer biology.

Recent advances have been made in several areas of molecular biology that have improved our understanding of the development and spread of breast cancer. Previous epidemiological studies provided incontrovertible evidence that hormones are crucial determinants of breast cancer susceptibility, and recent discoveries have further defined the interaction of estrogen with its receptors. Additional progress has been made in understanding the role of apoptosis and telomerase expression in breast cancer development and prognosis. Finally, rapid progress continues to be made in the area of breast cancer genetics.

BRCA2 Protein↗
PubMed1998

BRCA1 and BRCA2: from molecular genetics to clinical medicine.

Inherited susceptibility to breast cancer has been an area of intense investigation for the past 10 years. Early work focused on identifying modes of transmission, which culminated in the identification of chromosome 17q12-21 as the first human genomic region that harbored an autosomal dominant susceptibility gene for breast cancer (BRCA1) in 1990. BRCA1 was subsequently identified and was followed shortly by the identification of BRCA2. Research in the past 3 years has elucidated much about the mutation spectrum and mutation frequency of these genes in specific populations and is beginning to identify potential functions. Whereas progress in this area has been rapid and much is now known about inherited susceptibility to breast cancer, much more needs to be done to make these discoveries useful in the diagnosis, treatment, and ultimately, the prevention of breast cancer.

Animals↗