Abstract
BackgroundMolecular classification of tumour clonality is currently not evaluated in multiple invasive breast carcinomas, despite evidence suggesting common clonal origins. There is no consensus about which type of data (e.g. copy number, mutation, histology) and especially which statistical method is most suitable to distinguish clonal recurrences from independent primary tumours.MethodsThirty-seven invasive breast tumour pairs were stratified according to laterality and time interval between the diagnoses of the two tumours. In a multi-omics approach, tumour clonality was analysed by integrating clinical characteristics (n = 37), DNA copy number (n = 37), DNA methylation (n = 8), gene expression microarray (n = 7), RNA sequencing (n = 3), and SNP genotyping data (n = 3). Different statistical methods, e.g. the diagnostic similarity index (SI), were used to classify the tumours as clonally related recurrences or independent primary tumours.ResultsThe SI and hierarchical clustering showed similar tendencies and the highest concordance with the other methods. Concordant evidence for tumour clonality was found in 46% (17/37) of patients. Notably, no association was found between the current clinical guidelines and molecular tumour features.ConclusionsA more accurate classification of clonal relatedness between multiple breast tumours may help to mitigate treatment failure and relapse by integrating tumour-associated molecular features, clinical parameters, and statistical methods. Guidelines need to be defined with exact thresholds to standardise clonality testing in a routine diagnostic setting.
Highlights
Molecular classification of tumour clonality is currently not evaluated in multiple invasive breast carcinomas, despite evidence suggesting common clonal origins
Most changes were found in the histological subtypes (35%; 6/17 patients), while the molecular subtype differed in 25% (2/8 patients), Oestrogen receptor status (ER) status in 11% (4/35 patients), and Human epidermal growth factor receptor 2 status (HER2) status in 8% (3/37 patients)
The discordant changes were distributed between the different clinical groups and showed no significance when stratified by group
Summary
Molecular classification of tumour clonality is currently not evaluated in multiple invasive breast carcinomas, despite evidence suggesting common clonal origins. The risk of developing a breast tumour in the contralateral breast is 2ā6-fold higher in breast cancer patients than the risk of developing a first primary breast cancer in the general population [2]. These findings indicate a clonal relationship between bilateral breast cancers as well as a consequence of genetic predisposition and treatment [2, 3]. Two independent tumours with the same clinical features can be treated since the treatment was successful for the first tumour
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