Abstract

PurposeThe fragile-site associated tumor suppressor (FATS) is a newly identified tumor suppressor involved in radiation-induced tumorigenesis. The purpose of this study was to characterize FATS expression in breast cancers about radiotherapy benefit, patient characteristics, and prognosis.ResultsThe expression of FATS mRNA was silent or downregulated in 95.2% of breast cancer samples compared with paired normal controls (P < .0001). Negative status of FATS was correlated with higher nuclear grade (P = .01) and shorter disease-free survival (DFS) of breast cancer (P = .036). In a multivariate analysis, FATS expression showed favorable prognostic value for DFS (odds ratio, 0.532; 95% confidence interval, 0.299 to 0.947; (P = .032). Furthermore, improved survival time was seen in FATS-positive patients receiving radiotherapy (P = .006). The results of multivariate analysis revealed independent prognostic value of FATS expression in predicting longer DFS (odds ratio, 0.377; 95% confidence interval, 0.176 to 0.809; P = 0.012) for patients receiving adjuvant radiotherapy. In support of this, reduction of FATS expression in breast cancer cell lines, FATS positive group significantly sensitized than Knock-down of FATS group.Materials and MethodsTissue samples from 156 breast cancer patients and 42 controls in tumor bank were studied. FATS gene expression was evaluated using quantitative reverse transcription polymerase chain reaction (qRT-PCR). FATS function was examined in breast cancer cell lines using siRNA knock-downs and colony forming assays after irradiation.ConclusionsFATS status is a biomarker in breast cancer to identify individuals likely to benefit from radiotherapy.

Highlights

  • Breast cancer is a leading cause of cancer death among women, second only to lung cancer

  • fragile-site associated tumor suppressor (FATS) expression showed favorable prognostic value for disease-free survival (DFS) (odds ratio, 0.532; 95% confidence interval, 0.299 to 0.947; (P = .032)

  • The results of multivariate analysis revealed independent prognostic value of FATS expression in predicting longer DFS for patients receiving adjuvant radiotherapy

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Summary

Introduction

Breast cancer is a leading cause of cancer death among women, second only to lung cancer. Mammography has improved early detection and increased the 5-year survival rate to 98% for breast cancer, the survival rate drops dramatically to 83% for patients initially diagnosed with regional spread and to 26% for www.impactjournals.com/oncotarget those with distant metastases [1]. Radiotherapy continues to play a key role in the management of breast cancer. Increased risk for second malignant neoplasms (SMNs) after relative lose-dose radiation is raising more and more concern [3,4,5,6]. Given that there is no threshold dose below which no increase in risk to health is posed [5]. Little is known about reliable molecular tumor markers to identify individuals likely to benefit from radiotherapy

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