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. 2023 Feb 16:13:938042.
doi: 10.3389/fonc.2023.938042. eCollection 2023.

Breast cancer subtype and clinical characteristics in women from Peru

Valentina A Zavala  1 , Sandro Casavilca-Zambrano  2 , Jeannie Navarro-Vásquez  3 , Lizeth I Tamayo  4 , Carlos A Castañeda  5 , Guillermo Valencia  5 , Zaida Morante  5 , Mónica Calderón  5 , Julio E Abugattas  6 , Henry L Gómez  5 , Hugo A Fuentes  5 , Ruddy Liendo-Picoaga  7 , Jose M Cotrina  6 , Silvia P Neciosup  5 , Katia Roque  5 , Jule Vásquez  5 , Luis Mas  5 , Marco Gálvez-Nino  5 , Laura Fejerman  1   8 , Tatiana Vidaurre  5
Affiliations

Breast cancer subtype and clinical characteristics in women from Peru

Valentina A Zavala et al. Front Oncol. .

Abstract

Introduction: Breast cancer is a heterogeneous disease, and the distribution of the different subtypes varies by race/ethnic category in the United States and by country. Established breast cancer-associated factors impact subtype-specific risk; however, these included limited or no representation of Latin American diversity. To address this gap in knowledge, we report a description of demographic, reproductive, and lifestyle breast cancer-associated factors by age at diagnosis and disease subtype for The Peruvian Genetics and Genomics of Breast Cancer (PEGEN-BC) study.

Methods: The PEGEN-BC study is a hospital-based breast cancer cohort that includes 1943 patients diagnosed at the Instituto Nacional de Enfermedades Neoplásicas in Lima, Peru. Demographic and reproductive information, as well as lifestyle exposures, were collected with a questionnaire. Clinical data, including tumor Hormone Receptor (HR) status and Human Epidermal Growth Factor Receptor 2 (HER2) status, were abstracted from electronic medical records. Differences in proportions and mean values were tested using Chi-squared and one-way ANOVA tests, respectively. Multinomial logistic regression models were used for multivariate association analyses.

Results: The distribution of subtypes was 52% HR+HER2-, 19% HR+HER2+, 16% HR-HER2-, and 13% HR-HER2+. Indigenous American (IA) genetic ancestry was higher, and height was lower among individuals with the HR-HER2+ subtype (80% IA vs. 76% overall, p=0.007; 152 cm vs. 153 cm overall, p=0.032, respectively). In multivariate models, IA ancestry was associated with HR-HER2+ subtype (OR=1.38,95%CI=1.06-1.79, p=0.017) and parous women showed increased risk for HR-HER2+ (OR=2.7,95%CI=1.5-4.8, p<0.001) and HR-HER2- tumors (OR=2.4,95%CI=1.5-4.0, p<0.001) compared to nulliparous women. Multiple patient and tumor characteristics differed by age at diagnosis (<50 vs. >=50), including ancestry, region of residence, family history, height, BMI, breastfeeding, parity, and stage at diagnosis (p<0.02 for all variables).

Discussion: The characteristics of the PEGEN-BC study participants do not suggest heterogeneity by tumor subtype except for IA genetic ancestry proportion, which has been previously reported. Differences by age at diagnosis were apparent and concordant with what is known about pre- and post-menopausal-specific disease risk factors. Additional studies in Peru should be developed to further understand the main contributors to the specific age of onset and molecular disease subtypes in this population and develop population-appropriate predictive models for prevention.

Keywords: Hispanics/Latinas; Indigenous American; breast cancer; genetic ancestry; tumor subtype.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Biogeographical regions of Peru. Red star shows the location of INEN. This figure was created using the ggmap, maps, and mapdata R packages.
Figure 2
Figure 2
Population genetic structure of the PEGEN-BC study participants. (A) ADMIXTURE continental ancestry estimates obtained in unsupervised analysis, assuming K = 4. (B, C) Principal components analysis (PCA) including breast cancer patients and 1000 Genomes Project individuals. The first three principal components are shown.
See this image and copyright information in PMC

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