Combined Genetic and Nutritional Risk Models of Triple Negative Breast Cancer

Abstract

Triple negative breast cancer (TNBC) presents clinical challenges due to unknown etiology, lack of treatment targets, and poor prognosis. We examined combined genetic and nutritional risk models of TNBC in 354 breast cancer cases. We evaluated 18 DNA-repair nonsynonymous single nucleotide polymorphisms (nsSNPs) and dietary/nutritional intakes. Multivariate Adaptive Regression Splines models were used to select nutrients of interest and define cut-off values for logistic regression models. Our results suggest that TNBC was associated with 6 DNA-repair nsSNPs, ERCC4 R415Q (rs1800067), MSH3 R940Q (rs184967), MSH6 G39E (rs1042821), POLD1 R119H (rs1726801), XRCC1 R194W (rs1799782), and XPC A499V (rs2228000) and/or deficiencies in 3 micronutrients (zinc, folate, and β-carotene). Combined analyses of these 6 nsSNPs and 3 micronutrients showed significant association with TNBC: odds ratios = 2.77 (95% confidence interval = 1.01–7.64) and 10.89 (95% confidence interval = 3.50–33.89) for 2 and at least 3 risk factors, respectively. To the best of our knowledge, this is the first study to suggest that multiple genetic and nutritional factors are associated with TNBC, particularly in combination. Our findings, if validated in larger studies, will have important clinical implication that dietary modulations and/or micronutrient supplementations may prevent or reverse TNBC phenotype, so tumors can be treated with less toxic therapeutic strategies, particularly in genetically susceptible women.

ACKNOWLEDGMENTS

We acknowledge the contributions of Shirley Cothren, Judy Lovelace, Nadine Shelton, Joel Anderson, Jianfeng Xu, S. Lilly Zheng, Jorge L. Rodriguez Gil, Joseph Su, and the Breast Care Center at the Wake Forest University Health Sciences. We are grateful to study participants.

FUNDING

This work was supported by National Cancer Institute R01 CA73629 and the Florida Biomedical Bankhead-Coley Cancer Research Program 1BG04 to Jennifer J. Hu.

SUPPLEMENTAL MATERIAL

Supplemental data for this article can be accessed on the publisher's website.