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Nat Commun. 2021 Nov 03;12(1):6341. doi: 10.1038/s41467-021-26505-3.

Postpartum breast cancer has a distinct molecular profile that predicts poor outcomes.

Nature communications

Sonali Jindal, Nathan D Pennock, Duanchen Sun, Wesley Horton, Michelle K Ozaki, Jayasri Narasimhan, Alexandra Q Bartlett, Sheila Weinmann, Paul E Goss, Virginia F Borges, Zheng Xia, Pepper Schedin

Affiliations

  1. Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR, USA.
  2. Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA.
  3. Computational Biology Program, Oregon Health & Science University, Portland, OR, USA.
  4. Center for Health Research, Kaiser Permanente Northwest, 3800N. Interstate Ave., Portland, OR, USA.
  5. Massachusetts General Hospital Cancer Center, Harvard University, Boston, MA, USA.
  6. Division of Medical Oncology, Department of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
  7. Young Women's Breast Cancer Translational Program, University of Colorado Cancer Center, Aurora, CO, USA.
  8. Department of Molecular Microbiology and Immunology, Oregon Health & Science University, Portland, OR, USA.
  9. Department of Cell, Developmental and Cancer Biology, Oregon Health & Science University, Portland, OR, USA. [email protected].
  10. Knight Cancer Institute, Oregon Health & Science University, Portland, OR, USA. [email protected].
  11. Young Women's Breast Cancer Translational Program, University of Colorado Cancer Center, Aurora, CO, USA. [email protected].

PMID: 34732713 PMCID: PMC8566602 DOI: 10.1038/s41467-021-26505-3

Abstract

Young women's breast cancer (YWBC) has poor prognosis and known interactions with parity. Women diagnosed within 5-10 years of childbirth, defined as postpartum breast cancer (PPBC), have poorer prognosis compared to age, stage, and biologic subtype-matched nulliparous patients. Genomic differences that explain this poor prognosis remain unknown. In this study, using RNA expression data from clinically matched estrogen receptor positive (ER+) cases (n = 16), we observe that ER+ YWBC can be differentiated based on a postpartum or nulliparous diagnosis. The gene expression signatures of PPBC are consistent with increased cell cycle, T-cell activation and reduced estrogen receptor and TP53 signaling. When applied to a large YWBC cohort, these signatures for ER+ PPBC associate with significantly reduced 15-year survival rates in high compared to low expressing cases. Cumulatively these results provide evidence that PPBC is a unique entity within YWBC with poor prognostic phenotypes.

© 2021. The Author(s).

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