Revised 15/08/2008
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A Clear Link Between Inherited Genes and Development of Breast Cancer Established for Malaysians, Kuala Lumpur – 21 July 2008
Cancer Research Initiatives Foundation (CARIF) and University Malaya (UM) recently teamed up to conduct the CARIF-UM Breast Cancer Genetic Study, the largest study of its kind to determine the genes which cause breast cancer, specifically in Malaysian women. While the majority of breast cancers are ‘sporadic’, about 10% are ‘familial’, meaning the condition runs in the same family, and therefore the family members have an inherited risk to breast cancer. This familial breast cancer was the focus of researchers at CARIF and University Malaya for this study.
Funded partly by the Ministry of Science, Technology and Innovation (MOSTI) and by a UM research grant, and supported by other core donors of CARIF, the researchers used data from the CARIF-UM Breast Cancer Genetic Study to examine the genetic factors that increase a woman’s risk to breast cancer in Malaysia. The findings were published recently in July 2008 in an international breast cancer research journal entitled “Breast Cancer Research” |  The Largest Genetic Study on Breast Cancer in Malaysian Women
Commenting on the methodology of the Study, Dr Teo Soo-Hwang (Chief Executive of CARIF) said that the researchers have so far recruited more than 800 Malaysian women with breast cancer. “Of these, the researchers then determined which of the ‘high-risk’ women had inherited a genetic mutation in one of the two breast cancer genes, BRCA1 and BRCA2 (pronounced ‘bra-kah one’ and ‘bra-kah two’).”
“Our researchers then analysed DNA from blood samples of 187 breast cancer patients,” said Dr Teo, adding that each test took more than three months, at an estimated cost of RM6,000 per patient which was paid for by the research grant and donors. | Increased Risk of Breast Cancer Due To Inherited Genetic Mutations
The results of the Study show that up to 9% of Malaysian women who develop breast cancer under the age of 40, up to 14% of breast cancer patients who have family history of breast cancer, and up to 60% of women with both breast and ovarian cancer, had inherited a mutation in one of two specific breast cancer genes, namely BRCA1 and BRCA2.
This genetic change caused each individual to have an 80% lifetime risk of developing breast cancer (compared to less than 5% in the rest of the population), and a 40% lifetime risk of developing ovarian cancer (compared to less than 2% in the rest of the population).
The study showed that a proportion of Malaysian women may have inherited a gene from their mother or their father that increases their risk to breast cancer.
“These findings are significant because our researchers have obtained conclusive evidence on our Malaysian genes, and shown that we carry similar inherited risks to breast cancer as other Caucasian women,” said Dr Teo Soo-Hwang, Chief Executive Officer of CARIF and project leader for the research.
She explains, “When most of us look at global breast cancer statistics, we may take comfort in the fact that the rate of breast cancer is lower amongst Asians compared to Caucasians, and lower in developing countries compared to developed or more affluent countries.”
“For example, one in 20 Malaysians get breast cancer, compared to one in 10 women in Australia, UK or USA. So, we assume, naturally, that we are less likely to get breast cancer because of our ‘good’ Asian genes.”
“However, the CARIF-UM Breast Cancer Genetic Study shows that the BRCA mutations occur at similar frequency in Malaysia as it does in most Caucasian populations,” said Dr Teo. | Expert Panel Expresses Concern About State of Malaysian Genetic Services
The research results of the Study are a bittersweet development to Dr Teo, Professor Yip Cheng Har (Head of Breast Surgery at University Malaya) and Professor Thong Meow Keong (Clinical Geneticist at University Malaya).
“It is important to have this conclusive data about breast cancer predisposition genes in Malaysians. However, we are concerned about the state of genetic testing and counselling services provided in Malaysia at present,” said Professor Thong.
“For example, in the United Kingdom, for a population of 60 million, there are 12 genetic centres with more than 100 clinical geneticists and genetic counsellors, while in Malaysia, for a population of 25 million, there are only a handful of clinical geneticists and genetic counsellors concentrated mainly in the Klang valley”
“Genetic counselling is important because it helps patients and clients to make informed choices. Genetic counselling is a pre-requisite for genetic testing, in view of the many ethical, legal and social issues involved in pre-symptomatic genetic testing,” said Professor Thong.
“Even though efforts are underway to train more clinical geneticists and genetic counsellors, there is an obvious gap that we urgently need to address,” Professor Thong added.
In light of these new findings, the expert panel also believes that among the key issues that both private and public sector need to urgently address are the availability of accredited genetic services and the provision of genetic services that are in line with Malaysian Clinical Practice Guidelines for breast cancer, public education and awareness, the implementation of legislation to prevent discrimination based on genetic data, the provision of a psychosocial support needed by high risk families, and so on.
In America, the Senate and Congress have recently passed a new law preventing health insurers and employers from discriminating based on a person’s genetic information. “We think such services and the associated legal framework are important and will no doubt be developed soon,” they add.
“It is critical that we work with the Ministry of Health, doctors, patients and their families, legislators and insurers in order to outline and implement a comprehensive approach towards understanding and managing the link between a person’s genetic profile and their risk of developing specific cancers.”
“Ultimately, we need to provide the most comprehensive genetic testing and counselling services in Malaysia, help people understand and manage their lifestyles according to their risk profiles, and adopt the most appropriate preventative or treatment strategy in order to beat cancer,” said Dr Teo.
CARIF is currently working with several parties and a fully accredited cancer genetic testing laboratory and counselling service are in the pipeline. Through this laboratory service, CARIF will be able to offer individuals at high risk for familial breast cancer the genetic test for BRCA1 and BRCA2 and other validated cancer genes.
In the meantime, the Breast Cancer Genetic Study is still ongoing. Individuals who are interested in taking part in or donating funds towards the research study should contact Miss Yoon Sook-Yee or Dr Teo Soo-Hwang of CARIF at 03-56306774. | | About... | The CARIF-UM Breast Cancer Genetic Study
The CARIF-UM Breast Cancer Genetic Study is an on-going study conducted jointly between CARIF and University Malaya. The study was initiated in 2003 to determine the significance of the Asian genetic background on risk to breast cancer and response to therapies. The Study is funded by the Ministry of Science, Technology and Innovation, Malaysia, University Malaya, and supported by the Terry Fox Run, and the many core donors of CARIF including Sime Darby Berhad, Petronas, Yayasan Lim, the Joseph Eu Foundation, the Lau Gek Poh Foundation and others. | CARIF
The Cancer Research Initiatives Foundation (CARIF) is a cancer charity established in 2000 to work together with others to beat cancer through research. To beat cancer, we must continue to conduct research. To beat cancer in Malaysia, CARIF is focusing on research which we believe will benefit Malaysians. We are using research to fight breast cancer among Asians, using research to fight cancers which are commonly called ‘Asian cancers’ because they are more common here, and using research to maximize the utility of Malaysia’s biodiversity in the search for anti-cancer compounds. CARIF’s research programmes pull together the strengths of local researchers, local resources and international collaborations. CARIF is dependent entirely on donations and grants for research and spends more than 95 percent of funds received into research. We are indebted to the Malaysian Ministry of Science, Technology and Innovation (MOSTI), Sime Darby Berhad, PETRONAS, Yayasan Lim, the Joseph Eu Foundation and a long list of other corporate and individual supporters for our work. For more information on CARIF and its research activities, please visit www.carif.com.my or call Tel: +(603) 5630-6774. | UM
UM prides itself as the first and oldest higher learning institution in Malaysia. It offers a wide selection of programmes at both undergraduate and postgraduate level with distinguished and eminent academicians building the intellectual capital. The mission of UM is to advance knowledge and learning through quality research and education for the nation and for humanity. It endeavours to be an internationally renowned institution of higher learning in research, innovation, publication and teaching. Further information on UM can be found at www.um.edu.my | | |
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 NCR 2003 Report: Breast Cancer is still the top cancer amongst women 
Latest statistics from
the National Cancer Registry (NCR) show
that lung cancer is the most common cancer experienced by men in the country, whilst
breast cancer is the top cancer in women. Lung cancer accounts for 13.8 per cent of cancer cases among men. For women, breast cancer accounts
for 31 per cent of cases. | |
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