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Previous studies have suggested that polymorphisms in  CASP8  on chromosome 2 are associated with breast cancer risk. To clarify the role of  CASP8  in breast cancer susceptibility, we carried out dense genotyping of this region in the Breast Cancer Association Consortium (BCAC). Single-nucleotide polymorphisms (SNPs) spanning a 1 Mb region around  CASP8  were genotyped in 46 450 breast cancer cases and 42 600 controls of European origin from 41 studies participating in the BCAC as part of a custom genotyping array experiment (iCOGS). Missing genotypes and SNPs were imputed and, after quality exclusions, 501 typed and 1232 imputed SNPs were included in logistic regression models adjusting for study and ancestry principal components. The SNPs retained in the final model were investigated further in data from nine genome-wide association studies (GWAS) comprising in total 10 052 case and 12 575 control subjects. The most significant association signal observed in European subjects was for the imputed intronic SNP rs1830298 in  ALS2CR12  (telomeric to  CASP8 ), with per allele odds ratio and 95% confidence interval [OR (95% confidence interval, CI)] for the minor allele of 1.05 (1.03–1.07),  P  = 1 × 10 −5 . Three additional independent signals from intronic SNPs were identified, in  CASP8  (rs36043647),  ALS2CR11  (rs59278883) and  CFLAR  (rs7558475). The association with rs1830298 was replicated in the imputed results from the combined GWAS ( P  = 3 × 10 −6 ), yielding a combined OR (95% CI) of 1.06 (1.04–1.08),  P  = 1 × 10 −9 . Analyses of gene expression associations in peripheral blood and normal breast tissue indicate that  CASP8  might be the target gene, suggesting a mechanism involving apoptosis.

Identification and characterization of novel associations in the CASP8/ALS2CR12 region on chromosome 2 with breast cancer risk