Accuracy of telomerase in estimating breast cancer risk: a systematic review and meta-analysis.

OBJECTIVE To determine the accuracy of telomerase activity in predicting a higher risk for breast cancer. STUDY DESIGN A quantitative systematic review was performed. Studies that detected telomerase activities in breast tissue were included. RESULTS Twenty-five primary studies were analyzed, which included 2395 breast lesions. The proportion of breast cancer was 60.8%. Eighty-two percent (1193/1455) of breast cancer cases and 18% (169/940) of benign lesions cases were positive for telomerase activity. For breast cancer vs benign or normal breast tissue, the pooled likelihood ratio for the presence of telomerase activity was 4.5 (95% confidence interval [CI], 3.1-6.5) and the post-test probability was 88% (95% CI, 83-91). For breast cancer vs benign or normal tissue, the area under the summary receiver operating characteristic (SROC) curve was 0.89 with the Q* point value of 0.82. CONCLUSION Our systematic review showed that telomerase activity was significantly present in breast cancer when compared with normal breast tissue or benign breast lesions.