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@ARTICLE{Sarink:141336,
      author       = {D. Sarink$^*$ and H. Schock$^*$ and T. S. Johnson$^*$ and
                      J. Chang-Claude$^*$ and K. Overvad and A. Olsen and A.
                      Tjønneland and P. Arveux and A. Fournier and M. Kvaskoff
                      and H. Boeing and A. Karakatsani and A. Trichopoulou and C.
                      La Vecchia and G. Masala and C. Agnoli and S. Panico and R.
                      Tumino and C. Sacerdote and C. H. van Gils and P. H. M.
                      Peeters and E. Weiderpass and A. Agudo and M.
                      Rodríguez-Barranco and J. M. Huerta and E. Ardanaz and L.
                      Gil and K. T. Kaw and J. A. Schmidt and L. Dossus and M. His
                      and D. Aune and E. Riboli and R. Kaaks$^*$ and R.
                      Turzanski-Fortner$^*$},
      title        = {{R}eceptor activator of nuclear factor k{B} ligand,
                      osteoprotegerin, and risk of death following a breast cancer
                      diagnosis: results from the {EPIC} cohort.},
      journal      = {BMC cancer},
      volume       = {18},
      number       = {1},
      issn         = {1471-2407},
      address      = {Heidelberg},
      publisher    = {Springer},
      reportid     = {DKFZ-2018-01855},
      pages        = {1010},
      year         = {2018},
      abstract     = {Receptor activator of nuclear factor kappa-B
                      (RANK)-signaling is involved in tumor growth and spread in
                      experimental models. Binding of RANK ligand (RANKL) to RANK
                      activates signaling, which is inhibited by osteoprotegerin
                      (OPG). We have previously shown that circulating soluble
                      RANKL (sRANKL) and OPG are associated with breast cancer
                      risk. Here we extend these findings to provide the first
                      data on pre-diagnosis concentrations of sRANKL and OPG and
                      risk of breast cancer-specific and overall mortality after
                      a breast cancer diagnosis.Two thousand six pre- and
                      postmenopausal women with incident invasive breast cancer
                      (1620 $(81\%)$ with ER+ disease) participating in the
                      European Prospective Investigation into Cancer and Nutrition
                      (EPIC) cohort were followed-up for mortality. Pre-diagnosis
                      concentrations of sRANKL and OPG were quantified in baseline
                      serum samples using an enzyme-linked immunosorbent assay and
                      electrochemiluminescent assay, respectively. Hazard ratios
                      (HRs) and $95\%$ confidence intervals (CIs) for breast
                      cancer-specific and overall mortality were calculated using
                      Cox proportional hazards regression models.Especially in
                      women with ER+ disease, higher circulating OPG
                      concentrations were associated with higher risk of breast
                      cancer-specific (quintile 5 vs 1 HR 1.77 [CI 1.03, 3.04];
                      ptrend 0.10) and overall mortality (q5 vs 1 HR 1.39 [CI
                      0.94, 2.05]; ptrend 0.02). sRANKL and the sRANKL/OPG ratio
                      were not associated with mortality following a breast cancer
                      diagnosis.High pre-diagnosis endogenous concentrations of
                      OPG, the decoy receptor for RANKL, were associated with
                      increased risk of death after a breast cancer diagnosis,
                      especially in those with ER+ disease. These results need to
                      be confirmed in well-characterized patient cohorts.},
      cin          = {C020},
      ddc          = {610},
      cid          = {I:(DE-He78)C020-20160331},
      pnm          = {313 - Cancer risk factors and prevention (POF3-313)},
      pid          = {G:(DE-HGF)POF3-313},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {pmid:30348163},
      pmc          = {pmc:PMC6196438},
      doi          = {10.1186/s12885-018-4887-3},
      url          = {https://inrepo02.dkfz.de/record/141336},
}