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Polygenic Risk Scores for Prediction of Breast Cancer and Breast Cancer Subtypes.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Michailidou, Kyriaki 
Lush, Michael 
Fachal, Laura 

Abstract

Stratification of women according to their risk of breast cancer based on polygenic risk scores (PRSs) could improve screening and prevention strategies. Our aim was to develop PRSs, optimized for prediction of estrogen receptor (ER)-specific disease, from the largest available genome-wide association dataset and to empirically validate the PRSs in prospective studies. The development dataset comprised 94,075 case subjects and 75,017 control subjects of European ancestry from 69 studies, divided into training and validation sets. Samples were genotyped using genome-wide arrays, and single-nucleotide polymorphisms (SNPs) were selected by stepwise regression or lasso penalized regression. The best performing PRSs were validated in an independent test set comprising 11,428 case subjects and 18,323 control subjects from 10 prospective studies and 190,040 women from UK Biobank (3,215 incident breast cancers). For the best PRSs (313 SNPs), the odds ratio for overall disease per 1 standard deviation in ten prospective studies was 1.61 (95%CI: 1.57-1.65) with area under receiver-operator curve (AUC) = 0.630 (95%CI: 0.628-0.651). The lifetime risk of overall breast cancer in the top centile of the PRSs was 32.6%. Compared with women in the middle quintile, those in the highest 1% of risk had 4.37- and 2.78-fold risks, and those in the lowest 1% of risk had 0.16- and 0.27-fold risks, of developing ER-positive and ER-negative disease, respectively. Goodness-of-fit tests indicated that this PRS was well calibrated and predicts disease risk accurately in the tails of the distribution. This PRS is a powerful and reliable predictor of breast cancer risk that may improve breast cancer prevention programs.

Description

Keywords

breast, cancer, epidemiology, genetic, polygenic, prediction, risk, score, screening, stratification, Adult, Age Factors, Aged, Aged, 80 and over, Breast Neoplasms, Female, Genetic Predisposition to Disease, Humans, Medical History Taking, Middle Aged, Multifactorial Inheritance, Polymorphism, Single Nucleotide, Receptors, Estrogen, Reproducibility of Results, Risk Assessment

Journal Title

Am J Hum Genet

Conference Name

Journal ISSN

0002-9297
1537-6605

Volume Title

104

Publisher

Elsevier BV
Sponsorship
Cancer Research Uk (None)
Medical Research Council (MR/P012930/1)
National Cancer Institute (U19CA148065)
European Commission (223175)
European Commission Horizon 2020 (H2020) Societal Challenges (634935)
European Commission Horizon 2020 (H2020) Societal Challenges (633784)
Cancer Research UK (10710)
Cancer Research UK (16563)
Cancer Research UK (10118)
Cancer Research UK (20861)
Cancer Research Uk (None)
Cancer Research Uk (None)
Cancer Research Uk (None)