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Carvalho, B. S. & Irizarry, R. A. A framework for oligonucleotide microarray preprocessing. Bioinformatics 26, 2363–2367 (2010). Tepper, O.M., Unger, J.G., Small, K.H., Feldman, D., Kumar, N., Choi, M. and Karp, N.S. (2010) Mammometrics: The Standardization of Aesthetic and Reconstructive Breast Surgery. Plastic and Reconstructive Surgery, 125, 393-400. Moreno-Estrada, A. et al. Human genetics. The genetics of Mexico recapitulates Native American substructure and affects biomedical traits. Science 344, 1280–1285 (2014). Plastic Surgery can be defined as the medical specialty where the artistic design and the surgical execution coexist in balance [2]. Therefore, to obtain optimal results, surgical techniques must be based on anthropometric measurements according to race, geographic location, and body mass index. Ciriello, G., Cerami, E., Sander, C. & Schultz, N. Mutual exclusivity analysis identifies oncogenic network modules. Genome Res. 22, 398–406 (2012).

I.S-G., R.R-V., and S.L.R.-C. contributed equally to this work. S.L.R.-C. and A.H.-M. conceived and designed the study. R.R.-V., S.L.R.-C., and L.A.-R. collected tumoral specimens (Fresh-frozen and formalin-fixed paraffin-embedded tumor tissue). I.S.-G., R.R.-V., S.L.R.-C., and A.H.-M. designed the pipeline-analysis. R.R.-V., L.A.-R., and L.U.F. performed nucleic acid extraction and sample preparation for microarray analysis. I.S.-G. and S.L.R.-C. performed all the genomic analysis. I.S.-G. and S.L.R.-C. wrote the paper. R.R.-V., A.H.-M. and L.U.F. drafted, edit, discuss, and finalized the paper. I.S.-G., S.L.R.-C. and J.C.F.-L. provided bioinformatics support. V.B.-P., F.V.C., A.T.-T., C.D.-R. procured patient tumoral specimens, assisted the pathological assessment, and immunochemistry evaluation, and provided clinical features of analyzed samples. R.R.-V. performed immunohistochemical evaluation for triple-negative tumors (extended markers). R.R.-V. and L.A.-R. managed the clinical data bases. J.C.F.-L. performed ancestry analysis of HM tumors. All authors reviewed and approved the final manuscript. Corresponding authors Mayakonda, A., Lin, D. C., Assenov, Y., Plass, C. & Koeffler, H. P. Maftools: efficient and comprehensive analysis of somatic variants in cancer. Genome Res 28, 1747–1756 (2018). Mexican patients diagnosed with primary breast cancer, without a second tumor and treated with adjuvant therapy at the Institute of Breast Diseases (FUCAM) from 2008–2012 were convenient collected. Tumor and adjacent non-tumoral tissue, as well as peripheral blood were obtained (EDTA Vacutainer tubes, BD, 6 ml) from each patient after informed consent was obtained. After macroscopic inspection by the pathologist, sections of tumor and normal tissue were frozen in liquid nitrogen and store at −80 °C until further processing. A section of the tissue was formalin fixed and embedded in paraffin (FFPE) to confirm pathological diagnosis, as well as to assess tumor cell content and grade by hematoxylin eosin (H&E) staining. Only samples with tumor content values >60% were further analyzed. Blood samples were centrifuged to separate and isolate buffy and plasma components. Additionally, one hundred consecutive FFPE specimens with adjuvant surgical resection (2012–2016) were convenient collected at Anatomic Pathology Department of FUCAM fulfilling the inclusion criteria described above. Tumor specimens were evaluated by a pathologist to determine their histotype and evaluate cellularity, to then macrodisected the most enriched area with tumoral cells (>60% of tumor cells). The clinical characteristics of the HM in-house-profiled samples are shown in Supplementary Data 1. The protocol was reviewed and approved by the Ethics and Research committees of the National Institute of Genomic Medicine and FUCAM Institute in Mexico City (CE2009/11). All the studies were conducted in accordance with the Declaration of Helsinki. Immunohistochemistry The heterogeneous transcriptional phenotypes observed in women with BC belonging to different ancestries, is in part influenced by the alterations in cancer genomes such as mutations and SCNV. Even when a well concordance of SCNA profiles were observed with other ancestries, differences exist in the frequencies of these genomic alterations alongside the detection of unique SCNA in tumors from HM women.Kresovich, J. K. et al. Methylation-based biological age and breast cancer risk. J. Natl Cancer Inst. 111, 1051–1058 (2019). We believe that the findings of this study should be mentioned in the preoperative consultations, for the patient to be aware of what are the reconstructive needs to achieve the best result ( Figure 9). This study evaluates the mean values of breast anthropometric measurements in a sample of Healthy Mexican Female volunteers, with the objective of establishing reference values for our patient population. Adequate proportions play an important role in the aesthetic aspect of the breast, therefore a proper analysis and planning must be done for surgeons to obtain better results. Silva-Zolezzi, I. et al. Analysis of genomic diversity in Mexican Mestizo populations to develop genomic medicine in Mexico. Proc. Natl Acad. Sci. USA 106, 8611–8616 (2009).

The female breast represents the center of femininity and constitutes one of the most important physical and psychological elements in a woman. It is characterized by a diverse anatomy that comprises different volumes, width, height, projection, composition, shape, and position in the chest wall. group were: 3rd decade of life (R 20.4 cm, L 20.5 cm), Fourth decade of life (R 21.9 cm, L 22.1 cm), Fifth decade of life (R 23.9 cm, L 23.8 cm), >6 th decade of life (R 24.6 cm, L 24.9 cm) ( Figure 3). There was no statistically significant difference between right and left breasts (p < 0.419) ( Table 4). An average increase of 1cm in SSN:N per every 10 years was observed, which correlates with the decrease in strength of Cooper ligaments, increase in weight and fatty changes of the gland associated with age. Tfayli, A., Temraz, S., Abou Mrad, R. & Shamseddine, A. Breast cancer in low- and middle-income countries: an emerging and challenging epidemic. J. Oncol. 2010, 490631 (2010). Spratt, D. E. et al. Racial/ethnic disparities in genomic sequencing. JAMA Oncol. 2, 1070–1074 (2016).Biochemistry Department, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico Ruiz-Saenz, A. et al. HER2 Amplification in Tumors Activates PI3K/Akt Signaling Independent of HER3. Cancer Res. 78, 3645–3658 (2018). Liu, Y.-J. and Thomson, J.G. (2011) Ideal Anthropomorphic Values of the Female Breast: Correlation of Pluralistic Aesthetic Evaluations with Objective Measurements. Annals of Plastic Surgery, 67, 7-11.

After correlating the demographic characteristics (age, weight, BMI, height) with the anthropometric measurements, a positive medium and high correlation was found between weight/BMI and SNN:N, BV and BB. A Low correlation was found between weight/BMI and, ML:N and LBPL. We also found a correlation between age and SSN:N, LBPL, BV and BB. In contrast, no correlation was found between any age and ML:N, or height and any anthropometric measurement ( Table 5). breast (58.9/41.1), Left breast (58.9/41.0). Then expressed by decade of life were: 3rd decade of life (57.8:42.1), Fourth decade of life (59.6:40.3), Fifth decade of life (57.9:42), >6 th decade of life (61.5:38.4). And for the left breast were: 3rd decade of life (57.7:42.2), Fourth decade of life (59.2:40.7), Fifth decade of life (58.3:41.6), >6 th decade of life (62.1:37.8) ( Figure 8). After tumor cell content evaluation, DNA and RNA were extracted from tumor tissue using the AllPrep DNA/RNA mini kit (Qiagen, Valencia, CA), while DNA from peripheral blood lymphocytes was extracted with the QIAamp DNA Blood Maxi Kit (Qiagen, Valencia, CA), according to manufacturer’s instructions. DNA integrity was evaluated by 1% agarose gel electrophoresis and RNA integrity by capillary electrophoresis using the Bionalyzer system (Agilent, Santa Clara, CA). Only samples with RNA integrity number (RIN) >6.0 were used for microarrays analysis. mRNA expression profilesWhile comparing the measurements of our population with those published of other nations and ethnicities, we found differences and similarities. The Nipple Areola Complex diameter was similar to Saudi Arabia and Turkey, but statistically different from Asian and Caucasian patients [3] [4] ( Table 8). Recent studies have shown that breast tumors in young women exhibit more aggressive characteristics than those occurring in older patients 37. Public systems need to face this growing health problem, mainly in developing countries where the incidence of BC is rising 38 and a higher proportion of women debuts at younger stages 37. In our analysis, younger women (<45 years of age) from Hispanic datasets accounted for a higher proportion compared with Caucasian patients. In accordance with the reported average age at diagnosis in Mexican women, that occurs a decade less than in the Caucasian population 39. Notably, aggressive basal-like tumors, that are mainly composed by TN tumors, and HR + /HER2 + cancers are enriched in younger HM and Hispanic non-Mexican patients in comparison with patients from non-Hispanic ancestry. In accordance, it has been reported that Mexican young patients have a larger proportion of TN tumors than their counterparts in Europe, US and Asia 40.

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