Characterizing Pathogenic Risk Factors Associated with Breast Cancer in Ghanaian Women

Abstract

Globally, the second leading cause of cancer death in women is breast cancer. It is responsible for 16% of all cancer cases and the most common cancer in Ghana. Breast cancer pathogenesis has not been fully elucidated but is however known to have a complex aetiology involving both genetic and environmental factors. Pathogens are one of the environmental factors that have been linked with breast cancer development. Epstein-Barr Virus (EBV), Human Papilloma Virus (HPV) and Mouse Mammary Tumour virus (MMTV) have been implicated in breast cancer. Research has showed that the local microbiome of the host could modulate breast cancer risk, yet it is unknown what microbes (pathogenic or probiotic) inhabit breast tumour tissues in Ghana. The objectives of this study were to detect the presence of HPV, EBV, MMTV and bacteria in breast tumour tissues from Ghanaian women and determine the effect of bacteria on DNA in HeLa and MCF-7 cells. Formalin-Fixed Paraffin-Embedded (FFPE) tissues and fresh breast cancer tissues were obtained from 204 breast cancer patients at the Department of Surgery, Korle-bu Teaching Hospital. Nucleic acid was extracted from the samples and amplified using standard Polymerase Chain Reaction (PCR) to detect the viruses. HPV-positive tumours were sequenced using the Sanger sequencing method. EBV typing of EBV positive samples was done by a nested PCR reaction using EBV-1 and EBV-2 specific primers. Bacteria from fresh breast cancer tissues were obtained and identified using basic biochemical tests and Sanger sequencing. The DNA damage potential of the isolates was tested on HeLa and MCF-7 cells using the histone-2AX phosphorylation assay. HPV was detected in 27 (13.2%) of the 204 cases analyzed. EBV was identified in 66 (32.4%) of the samples. Out of the EBV positive cases, 2 (1%) were positive for EBV-1, 30 (14.7%) were positive for EBV-2, 26 (12.7%) were positive for both EBV-1 and EBV-2 and 8 (3.9%) could not be genotyped using available methods. Co-infection of both HPV and EBV was detected in 11 (5.4%) of the cases. MMTV was not detected in any of the samples analyzed. Microbiome analysis showed relatively high evidence of bacteria belonging to the Staphylococcus and Bacillus species. Staphylococcus sciuri, Staphylococcus epidermidis, Staphylococcus lugdunensis obtained from breast tumours induced DNA double-strand breaks in MCF-7 cells. The diversity and the probable role of the microbiome in breast cancer were also identified. Therefore, the presence of these pathogens showed probable involvement in breast cancer carcinogenesis.