Study Unlocks Key Findings on Asian Carriers of Breast Cancer
Malaysian researchers at Cancer Research Malaysia (CRMY) and the University of Nottingham Malaysia (UNM) have published the largest study to shed light on cancer risk in Asian BRCA carriers. This study provides critical information that can assist in decisions regarding cancer screening and prevention.
Approximately 1 in 500 individuals inherit a mutated BRCA (BReast CAncer) gene. This inheritance significantly increases the risk of cancer, with probabilities ranging from 45% to 87% in European women. Previously, medical professionals in Asia were unable to provide accurate risk estimates for Asian women due to the majority of data being based on European women and the lack of reliable estimates from Asian women. The new study is expected to fill this gap and provide critical information for Asians.
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CRMY Chief Scientific Officer, Professor Datin Paduka Dr Teo Soo Hwang and the lead of the study said, “This study builds on our work in the past two decades to develop better ways of detecting breast cancer early and saving lives. Until recently, only 5% of the genomic and genetic studies globally were conducted in Asians and we are delighted that by continuing to focus on Asians, we can ensure that advances in precision medicine can also benefit the Asian population.”
Women with inherited changes in the breast cancer predisposition genes face challenging decisions, contemplating whether to opt for prophylactic surgery to remove healthy breasts or ovaries, thereby reducing the risk of breast or ovarian cancer.
Alternatively, they may consider more frequent or different types of screening to ensure early detection and increase the chances of successful treatment in case cancer does develop.
In making these decisions, it is critical that they have accurate information about their risk of cancer – for example, if a woman has an 87% chance of developing breast cancer, her choices may be different from that if she has a 45% chance of developing the disease.
As actual risk varies based on other genes, lifestyle, and reproductive choices, such as the number of children a woman has, making these decisions is only possible if we have accurate data on cancer risk in Asians. This then is the area of clinical need: to conduct Asian specific studies to provide accurate information to thousands of Asian BRCA carriers so that they can make informed decisions to save their lives.
Researchers from Malaysia and Singapore collaborated on this study, which received funding from Yayasan Sime Darby, Yayasan Petronas, Estee Lauder Group of Companies, and Vistage Group of Companies, to provide a comprehensive analysis of breast and ovarian cancer risk in Asian women. We found a significant shift: for women born from 1920-1940s, Asian BRCA carriers had about half the risk compared to European carriers.
However, in the GenX generation born from 1960-1970s, the risk aligned with European BRCA carriers. The key takeaway is that lifestyle changes have not only increased cancer risk for the general population but also for BRCA carriers. Doctors should consider the patients’ birth era and lifestyle factors when advising on cancer risk.
“Accurate quantification of disease risk in BRCA carriers demands substantial sample sizes. Our study is a testament to the power of research unity, bringing together brilliant minds from Singapore, University of Cambridge and our home base in Malaysia. Through these expansive collaborative efforts, we’ve achieved a groundbreaking milestone, advancing our understanding of breast and ovarian cancer risks in Asian BRCA carriers and paving the way for more informed decisions in healthcare,” said Associate Professor University of Nottingham Malaysia (UNM) and first author of the study, Dr Ho Weang Kee.
Moving forward, the CRMY-Nottingham team have won the global Basser Grant to identify the lifestyle and genetic factors that are associated with cancer risk in Asian BRCA carriers. This grant aims to create advanced tools tailored for Asian BRCA carriers, offering precise guidance on their risk of breast and other cancers. The upcoming tools developed by Malaysian researchers will integrate additional gene variants and lifestyle factors, enhancing precision in prevention and treatment strategies for Asian women.
“This is a milestone in our efforts in saving Asian lives through precision guidance. Having more accurate risk information for Asian women is crucial when providing genetic counselling to patients and their family members. This development will help us to work with the patients and empower them to make informed, life-saving medical decisions,” said CRMY Consultant Genetic Counsellor, Yoon Sook-Yee.
This study was made possible by the Wellcome Trust Collaborative Science Award to Professors Teo and Doug Easton, led principally by A/Prof Ho. Additionally, the research team has recognized the following hospitals for their participation: Subang Jaya Medical Centre, University Malaya Medical Centre, Beacon Hospital, Gleneagles Penang, Hospital Universiti Sains Malaysia, KPJ Ampang Puteri Specialist Hospital, KPJ Johor Specialist Hospital, KPJ Sabah Specialist Hospital, Loh Guan Lye Specialist Centre, Mount Miriam Cancer Hospital, Pantai Hospital Kuala Lumpur, Penang Adventist Hospital, Universiti Kebangsaan Malaysia Medical Centre, Sunway Medical Centre, National Cancer Centre Singapore, Singapore General Hospital, Changi General Hospital, Tan Tock Seng Hospital, KK Women’s and Children’s Hospital, and National University Hospital Singapore. Their collaboration in recruitment and interviews, according to the researchers, significantly contributed to the success of this study.
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