Genetic , Hormonal and cultural determinants of breast cancer risk in Egyptian women under 50
Breast cancer, in Egyptian populations occurs at a relatively earlier age compared with other populations. The median age of breast cancer in NCI series is 46 years, a full decade below Caucasian populations.
Clinical observation supports the possibility that circulating estrogen levels may be higher in this group of patients. It may be hypothesized that Egyptian women have a higher lifetime exposure to Estrogen as a result of early menarche and delayed start of sexual activity due to cultural and religious traditions.
This may be translating as the appearance of the disease in lower age groups. In addition, there is currently no data regarding this population's prevalence of the functional polymorphisms in the low penetrance genes associated with the biosynthesis and metabolism of Estrogen, which may offer an alternative explanation for the clinically observed estrogen levels.
To investigate the role of hormonal, genetic and cultural factors contributing to the risk of early breast cancer in Egyptian women
A prospective case-control study is proposed, where cases are defined as premenopausal women diagnosed with breast cancer. Controls will be matched by age and social class and will be ascertained as disease free using digital mammography.
The risk factors that will be examined are: serum estradiol, pattern and age of start of sexual activity, oxytocin level and functional polymorphisms in the CYP17 and CYP19 genes involved in Estrogen biosynthesis and metabolism.
Results will be expressed in terms of odds ratio representing the risk incurred with each examined variable with 95% confidence interval. In addition, multivariate analysis will be performed adjusting for multiple testing.