Breast cancer (BCa) is a leading cause of cancer-related female deaths worldwide and is a complex disease consisting of many different subtypes with varying clinical course and outcomes. Triple negative breast cancer (TNBC), an aggressive and highly metastatic subtype, is most prevalent in women of African ancestry (WAA) but the causes of this disparity are not fully understood. The goal of this study was to investigate the epidemiological and genetic profiles in ancestrally-related WAA in Barbados and Nigeria to advance knowledge and lay the foundation for development of improved or novel BCa therapeutics.
To gain insight about TNBC across the African continent, a systematic review and meta-analysis was conducted. TNBC frequencies on average across Africa were estimated at 26.8% but were highest in West African countries (46.0%). We also sought to identify the epidemiological profile of BCa in Barbados—a Caribbean island with significant West African ancestry. We reviewed pathological reports for BCa from the sole public hospital in Barbados and compared those data with USA population-based data. We found a high prevalence of high prevalence of TNBC amongst women diagnosed with breast cancer in Barbados (25%), compared to 21% in non-Hispanic Black and 10% in non-Hispanic White women in the USA for the 2010-2016 period. We also investigated the somatic mutational profile of WAA with TNBC in Barbados and Nigeria using whole exome sequencing (WES) of formalin-fixed paraffinembedded TNBC tissues. This investigation revealed novel and pathogenic variants in well-known cancer-associated genes such as TP53, BRCA1 and MDC1. The somatic mutation signature in Nigerian tissues correlated with aflatoxin signature, implying a role for environmental factors influencing the genomics profile in this cohort. Copy number variants were revealed at high frequencies for PIK3CA, FGFR2 and HIF1AN genes. Collectively, these findings uncovered novel epidemiological and genetic trends in WAA
with high prevalence of the aggressive TNBC subtype / Thesis / Doctor of Philosophy (PhD) / Breast cancer (BCa) is a leading cause of cancer-related death in women worldwide. Although Caucasian women are diagnosed with BCa more than women of African ancestry (WAA), more WAA unfortunately die from BCa. The reasons for this disparity are currently unknown, however, a higher proportion of WAA are diagnosed with an aggressive type of BCa called triple negative breast cancer (TNBC). This might partially explain the high cancer death rate in WAA. To understand this disparity in BCa incidence and outcomes, we investigated TNBC disease trends across the African continent and in Barbados (a Caribbean island with predominantly African ancestry) and found a high proportion of TNBC diagnoses in Barbados and West African countries. We also discovered a novel genetic profile within these groups that may be useful to develop new cancer therapies that would decrease TNBC aggressiveness and death in these populations.
| Identifer | oai:union.ndltd.org:mcmaster.ca/oai:macsphere.mcmaster.ca:11375/26920 |
| Date | January 2021 |
| Creators | Hercules, Shawn |
| Contributors | Daniel, Juliet, Biology |
| Source Sets | McMaster University |
| Language | English |
| Detected Language | English |
| Type | Thesis |
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