Statistical and Evolutionary Analysis of Sequenced DNA from Breast Cancer FFPE Specimens.

Background: Despite the introduction of instant freezing of tumor specimens, formalin-fixed paraffin-embedded (FFPE) blocks of tissue are still commonplace in clinical practice and constitute an important reference for genetic epidemiology of cancer. We carried out a study of a collection of breast tumors paired with lymph-node metastases and analyzed using advanced computational methods, to determine how much information can be obtained from mid-depth whole-exome bulk DNA sequencing. Methods: We gathered 15 paired (primary and an involved lymph node) excised breast tumors of different molecular subtypes (HER2+, triple negative, luminal A and luminal B HER2-), from the National Research Institute of Oncology, Krakow (Poland) Branch. FFPE specimens contained typical artifacts, manifesting themselves in spurious DNA variant calls. We used several bioinformatics tools to remove the artifacts and analyzed the exomic data, using both commercial and original in-house computational techniques. Results: We used several of recent bioinformatics tools to remove the FFPE artifacts and found a serious dispersal of outcomes. After calibration, a series of analyses was performed, including copy number study, resulting in ploidy levels ranging from 1 to 5 (average of 2.5). Positive association was found between the frequency of oncogenes relative to tumor suppressor genes and DNA copy number. In addition, we carried out analyses of the clonal structure of the data using original computational methods based on evolutionary modeling. Interesting results concerning clonal structure, early tumor expansion, and interdependence of the primary tumor and lymph node metastases have been obtained. Conclusions: Despite the imperfections of the FFPE data, many important features of molecular evolution of tumor DNA can be recovered from routine clinical samples.