Telomere Length and Breast Cancer Prognosis: A Systematic Review

Telomeres ensure genome integrity during replication. Loss of telomeric function leads to cell immortalization and accumulation of genetic alterations. The association of telomere length (TL) with breast cancer prognosis is examined through a systematic review. Electronic databases (MEDLINE, EMBASE,...

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Bibliographic Details
Published in:Cancer epidemiology, biomarkers & prevention biomarkers & prevention, 2017-01, Vol.26 (1), p.3-10
Main Authors: Ennour-Idrissi, Kaoutar, Maunsell, Elizabeth, Diorio, Caroline
Format: Article
Language:English
Subjects:
Blood
Breast cancer
Breast Neoplasms - genetics
Breast Neoplasms - mortality
Breast Neoplasms - therapy
Cell immortalization
Chemotherapy
Female
Genetic Markers
Genetics
Genomes
Humans
Immortalization
Medical prognosis
Observational Studies as Topic
Physical activity
Predictive Value of Tests
Prognosis
Retrospective Studies
Studies
Systematic review
Telomerase
Telomere - genetics
Telomere - pathology
Telomere Shortening - genetics
Telomeres
Treatment Outcome
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Summary:Telomeres ensure genome integrity during replication. Loss of telomeric function leads to cell immortalization and accumulation of genetic alterations. The association of telomere length (TL) with breast cancer prognosis is examined through a systematic review. Electronic databases (MEDLINE, EMBASE, CENTRAL), from inception to December 2015, and relevant reviews were searched. Studies that evaluated TL (blood and/or tumor) in association with breast cancer survival or prognostic factor were included. Thirty-six studies met inclusion criteria. Overall risk of bias was critical. Eight studies reported survival outcomes. Overall, there was a trend toward an association of longer telomeres with better outcomes (tumor, not blood). Of the 33 studies reporting associations with prognostic factors, nine adjusted for potential confounders. Among the latter, shorter telomeres were associated with older age (blood, not tumor), higher local recurrence rates (normal tissue), higher tumor grade (tumor), and lower physical activity (blood), which were reported in one study each. TL was not associated with molecular subtype (blood, one study), family history (tumor, one study), chemotherapy (blood, three of four studies), and stress reduction interventions (blood, two of two studies). Although major methodologic differences preclude from drawing conclusive results, TL could be a valuable breast cancer prognostic marker. Cancer Epidemiol Biomarkers Prev; 26(1); 3-10. ©2016 AACR.
ISSN:1055-9965
1538-7755
DOI:10.1158/1055-9965.epi-16-0343