Prospective study of trace elements in breast cancer risk and treatment response

Breast cancer (BC), the most common cancer in women, affects over 2M annually, with 500K+ deaths. BC risk in BRCA1 mutation carriers varies (49%-72%), suggesting environmental influences. Some studies have reported TE impact on BC risk/survival, with optimal levels improving outcomes, but data is limited to few European populations.

Aim

To prospectively measure trace element (TE) Se, Cu, Zn, As, Pb and Cd plasma levels in 400 unselected BC cases at diagnosis, 400 healthy controls and 200 unaffected BRCA1/2 pathogenic variant (PV) carriers and to determine their association with BC risk and treatment outcomes.

Endpoints

In BC group overall/BC-specific survival, event-free survival; pathological complete response after preoperative systemic therapy. In control group - cancer events.

Hypothesis

Abnormal TE levels are significantly associated with BC risk and treatment outcome.

Modulation

TE like Zn is lower, while Cu, Pb, Cd is higher in BC cases. Cd links to higher risk of distant metastasis. Optimal Se level may reduce BC risk.

TE Mechanisms

TE cause oxidative damage, altering gene expression and cancer risk.

Novelty

Prospective study in Latvia to confirm TE levels in BC and unaffected controls, including subgroup of BRCA1/2 PV carriers. Lifestyle/nutritional confounders will be addressed as a part of comprehensive analysis.

Impact

Results could shift BC risk reduction/treatment globally, leveraging European project synergies.

Planned results

• Original research articles published in the Q1 or Q2 publications listed in the Web of Science or SCOPUS databases – 2
• Scientific databases and datasets prepared according to the FAIR principles – 1
• Policy recommendations and reports on the impact of policies – 1
• Project proposal submitted in an international call for research and development projects (competition abroad or submitted by an international consortium) – 1
• Project proposal submitted in a Latvian call for research and development projects – 1

Project-related activities

• Recruitment of study participants and sample collection are ongoing. Recruitment of participants in the breast cancer patient group continued, while recruitment for the control group was launched in cooperation with the Ophthalmology Clinic of Pauls Stradiņš Clinical University Hospital (PSKUS). By 10 September 2026, 166 of the planned 1,000 samples had been collected (Q3 2026)
• Recruitment of study participants and sample collection commenced. Recruitment of participants in the breast cancer patient group was launched to build the sample and data set required to investigate trace element levels and their association with breast cancer risk and treatment response. An agreement was concluded with Pauls Stradiņš Clinical University Hospital (PSKUS) for the implementation of the study, with patient recruitment taking place at the hospital (Q2 2026)
• The documentation required for conducting the study was prepared and ethical approval was obtained. A data management plan was developed, an informed consent form was prepared, and the study participant questionnaire was refined. An application was submitted to the Ethics Committee, and approval for the study protocol was obtained (Q1–Q2 2026)
• Collaboration with researchers from the Pomeranian Medical University in Szczecin was initiated. An agreement was reached with Prof. Jan Lubiński and the project partners on regular exchange of experience and review of project progress. Joint project meetings are held monthly to discuss technical and scientific aspects of the study (Q1–Q2 2026)
• The study workflow and standardised procedures were established. Tasks were defined within the project team, and standard operating procedures (SOPs) were developed in collaboration with colleagues from the RSU Institute of Oncology and Molecular Genetics, and from RSU Institute of Occupational Safety and Environmental Health thus providing a consistent framework for conducting the study and recruiting participants (Q1–Q2 2026) 

Scientific Team

• Arvīds Irmejs – lead researcher, principal investigator
• Ivars Vanadziņš – lead researcher
• Andrejs Šķesters – lead researcher
• Ieva Strēle – lead researcher
• Diāna Inga Paegle – researcher
• Lauma Ilsuma – senior laboratory technician
• Dace Lapiņa – laboratory technician
• Laura Rasa Rotberga – acting research assistant