N-glycolylneuraminic acid serum biomarker levels are elevated in breast cancer patients at all stages of disease.

N-glycolylneuraminic acid (Neu5Gc) is an aberrant glycosylation that has been proposed as a cancer biomarker. Using a Neu5Gc-specific lectin called SubB2M in a Surface Plasmon Resonance (SPR)-based assay, we previously reported elevated Neu5Gc biomarkers in serum from ovarian cancer patients. Here we report an optimized SubB2M SPR-based assay to enhance specificity with a non-sialic acid binding version of SubB2M, SubBA12, to control for any non-specific binding to SubB2M, which improved discrimination of cancer-free controls from early-stage ovarian cancer. Using this new assay, sera from breast cancer cases were analysed, revealing significantly elevated levels of Neu5Gc biomarkers at all stages of breast cancer. We show that Neu5Gc serum biomarker levels can discriminate breast cancer patients from cancer-free individuals with high sensitivity and specificity. Analysis of serum collected prospectively, post-diagnosis, from breast cancer patients at high risk for disease recurrence showed a trend for a decrease in Neu5Gc levels immediately following treatment for those in remission. Neu5Gc serum biomarkers are a promising new tool for early detection and disease monitoring for breast cancer that may complement current imaging- and biopsy-based approaches.

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Timing of referral to genetic counseling among women with gynecologic or breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.1545 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. 1545-1545

Author(s):

Amy J Bregar ◽

Terri Febbraro ◽

Katina Robison ◽

Jennifer Scalia Wilbur ◽

Jessica Kent Laprise ◽

...

Keyword(s):

Breast Cancer ◽

Ovarian Cancer ◽

Genetic Counseling ◽

Cancer Patients ◽

Early Stage ◽

Treatment Decisions ◽

Genetic Evaluation ◽

Early Stage Breast Cancer ◽

Breast Cancer Patients ◽

Late Stages

1545 Background: The National Comprehensive Cancer Network (NCCN) has established guidelines delineating appropriate candidates for genetic counseling. While genetic predisposition is responsible for a small percentage of cancer, genetic referral at diagnosis may effect treatment decisions. We aim to determine factors associated with timing of referral in women with breast and gynecologic cancers. Methods: Patients from an academic women’s oncology program were identified who met a subset of NCCN referral criteria for genetic evaluation between 2004-2010 (ovarian cancer at any age, breast cancer ≤ 50 years of age, or uterine cancer < 50 years of age). A retrospective chart review was conducted. Statistics were analyzed using SAS v. 9.2 (SAS Institute, Cary, NC); categorical variables were compared by chi-square or Fisher's exact test and continuous variables were compared by ANOVA. The study was approved by the hospital Institutional Review Board. Results: 820 women with cancer (26% uterine, 38% breast, 35% ovarian) were included. The overall referral rate was 22%; more breast than gynecologic cancer patients were referred (34% vs. 28%, p<0.0001). Breast cancer patients were more often referred at diagnosis compared to women with uterine (p<0.0001) and ovarian cancer (p=0.007). Early stage breast cancer patients were more often referred at diagnosis compared to women with late stages (p=0.03). Among ovarian cancer patients, those with late stages were more often referred at diagnosis compared to women with early stages (p=0.02). Age at diagnosis, family history, and parity were not associated with timing of referral. Among women with breast cancer, 26% of referred patients had a prophylactic contralateral mastectomy compared to 8% of those not referred (p<0.0001). Conclusions: Genetic counseling is underutilized in breast and gynecologic malignancies. The timing of referral varies widely and genetic counseling may impact treatment decisions. Breast cancer diagnosis, early stage breast cancer, and late stage ovarian cancer are associated with earlier referral for genetic evaluation. Further research is needed to determine additional factors that may increase referral rates and impact timing of referral.

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