Breast cancer in the GCC countries: A focus on BRCA1/2 and non-BRCA1/2 genes

Abstract

The GCC is an economic alliance of six Arab countries, including Bahrain, Kuwait, Oman, Qatar, Saudi Arabia, and United Arab Emirates (UAE). The rate of endogamous marriage among the GCC countries is approaching 100%, with very high consanguineous marriage rates. Although breast cancer is on the rise in the GCC countries, there are dearth of studies reporting on the genetic epidemiology of breast cancer. In this study, we investigated the frequency of BRCA1/2 and non-BRCA1/2 mutations in breast cancer patients in the GCC countries. BRCA1/2 mutations seem not to be significantly involved in hereditary breast cancer in the GCC countries, which is the most reported form of cancer in Oman, however no available data about the BRCA1/2 mutations role in breast cancer in the UAE. Mutations in more than 30 non-BRCA1/2 genes were reported to be associated with breast cancer patients in the GCC countries, some with comparable frequencies to the BRCA1/2 genes. Arab patients with breast cancer showed advanced stages of cancer and younger ages of onset compared to other Western countries. The Arab genome project pioneered by Saudi Arabia, followed by Qatar, Kuwait, and UAE, will help in the identification of new biomarkers for breast cancer that will be a target for new therapeutics and is expected to improve the prognosis of the disease. However, there is an urgent need for extensive well-controlled genetic epidemiological studies to provide accurate estimates of the frequency of genetic variants in both BRCA1/2 and non-BRCA1/2 among patients with breast cancer in the Gulf States, to provide better care and genetic counseling for Arab patients with predisposing genetic mutations to breast cancer.

Keywords: BRCA1/2; Breast cancer; Clinical molecular diagnostics; GCC countries; Genetic variants; Non-BRCA1/2; Variant interpretation.