Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival
dc.contributor.author | Morra, A. | * |
dc.contributor.author | Schreurs, M.A.C. | * |
dc.contributor.author | Andrulis, I.L. | * |
dc.contributor.author | Anton-Culver, H. | * |
dc.contributor.author | Augustinsson, A. | * |
dc.contributor.author | Beckmann, M.W. | * |
dc.contributor.author | Behrens, S. | * |
dc.contributor.author | Bojesen, S.E. | * |
dc.contributor.author | Bolla, M.K. | * |
dc.contributor.author | Brauch, H. | * |
dc.contributor.author | Broeks, A. | * |
dc.contributor.author | Buys, S.S. | * |
dc.contributor.author | Camp, N.J. | * |
dc.contributor.author | Castelao Fernández, José Esteban | * |
dc.contributor.author | Cessna, M.H. | * |
dc.contributor.author | Chang-Claude, J. | * |
dc.contributor.author | Chung, W.K. | * |
dc.contributor.author | Sahlberg, K.K. | * |
dc.contributor.author | Børresen-Dale, A.-L. | * |
dc.contributor.author | Gram, I.T. | * |
dc.contributor.author | Olsen, K.S. | * |
dc.contributor.author | Engebråten, O. | * |
dc.contributor.author | Naume, B. | * |
dc.contributor.author | Geisler, J. | * |
dc.contributor.author | Grenaker Alnæs, G.I. | * |
dc.contributor.author | Colonna, S.V. | * |
dc.contributor.author | Couch, F.J. | * |
dc.contributor.author | Cox, A. | * |
dc.contributor.author | Cross, S.S. | * |
dc.contributor.author | Czene, K. | * |
dc.contributor.author | Daly, M.B. | * |
dc.contributor.author | Dennis, J. | * |
dc.contributor.author | Devilee, P. | * |
dc.contributor.author | Dörk, T. | * |
dc.contributor.author | Dunning, A.M. | * |
dc.contributor.author | Dwek, M. | * |
dc.contributor.author | Easton, D.F. | * |
dc.contributor.author | Eccles, D.M. | * |
dc.contributor.author | Eriksson, M. | * |
dc.contributor.author | Evans, D.G. | * |
dc.contributor.author | Fasching, P.A. | * |
dc.contributor.author | Fehm, T.N. | * |
dc.contributor.author | Figueroa, J.D. | * |
dc.contributor.author | Flyger, H. | * |
dc.contributor.author | Gabrielson, M. | * |
dc.contributor.author | Gago Dominguez, Manuela | * |
dc.contributor.author | García-Closas, M. | * |
dc.contributor.author | García-Sáenz, J.A. | * |
dc.contributor.author | Genkinger, J. | * |
dc.contributor.author | Grassmann, F. | * |
dc.contributor.author | Gündert, M. | * |
dc.contributor.author | Hahnen, E. | * |
dc.contributor.author | Haiman, C.A. | * |
dc.contributor.author | Hamann, U. | * |
dc.contributor.author | Harrington, P.A. | * |
dc.contributor.author | Hartikainen, J.M. | * |
dc.contributor.author | Hoppe, R. | * |
dc.contributor.author | Hopper, J.L. | * |
dc.contributor.author | Houlston, R.S. | * |
dc.contributor.author | Howell, A. | * |
dc.contributor.author | Clarke, C. | * |
dc.contributor.author | Marsh, D. | * |
dc.contributor.author | Scott, R. | * |
dc.contributor.author | Baxter, R. | * |
dc.contributor.author | Yip, D. | * |
dc.contributor.author | Carpenter, J. | * |
dc.contributor.author | Davis, A. | * |
dc.contributor.author | Pathmanathan, N. | * |
dc.contributor.author | Simpson, P. | * |
dc.contributor.author | Graham, J.D. | * |
dc.contributor.author | Sachchithananthan, M. | * |
dc.contributor.author | Amor, D. | * |
dc.contributor.author | Andrews, L. | * |
dc.contributor.author | Antill, Y. | * |
dc.contributor.author | Balleine, R. | * |
dc.contributor.author | Beesley, J. | * |
dc.contributor.author | Bennett, I. | * |
dc.contributor.author | Bogwitz, M. | * |
dc.contributor.author | Botes, L. | * |
dc.contributor.author | Brennan, M. | * |
dc.contributor.author | Brown, M. | * |
dc.contributor.author | Buckley, M. | * |
dc.contributor.author | Burke, J. | * |
dc.contributor.author | Butow, P. | * |
dc.contributor.author | Caldon, L. | * |
dc.contributor.author | Campbell, I. | * |
dc.contributor.author | Cao, M. | * |
dc.contributor.author | Chakrabarti, A. | * |
dc.contributor.author | Chauhan, D. | * |
dc.contributor.author | Chauhan, M. | * |
dc.contributor.author | Chenevix-Trench, G. | * |
dc.contributor.author | Christian, A. | * |
dc.contributor.author | Cohen, P. | * |
dc.contributor.author | Colley, A. | * |
dc.contributor.author | Crook, A. | * |
dc.contributor.author | Cui, J. | * |
dc.contributor.author | Courtney, E. | * |
dc.contributor.author | Cummings, M. | * |
dc.contributor.author | Dawson, S.-J. | * |
dc.contributor.author | DeFazio, A. | * |
dc.contributor.author | Delatycki, M. | * |
dc.contributor.author | Dickson, R. | * |
dc.contributor.author | Dixon, J. | * |
dc.contributor.author | Edkins, T. | * |
dc.contributor.author | Edwards, S. | * |
dc.contributor.author | Farshid, G. | * |
dc.contributor.author | Fellows, A. | * |
dc.contributor.author | Fenton, G. | * |
dc.contributor.author | Field, M. | * |
dc.contributor.author | Flanagan, J. | * |
dc.contributor.author | Fong, P. | * |
dc.contributor.author | Forrest, L. | * |
dc.contributor.author | Fox, S. | * |
dc.contributor.author | French, J. | * |
dc.contributor.author | Friedlander, M. | * |
dc.contributor.author | Gaff, C. | * |
dc.contributor.author | Gattas, M. | * |
dc.contributor.author | George, P. | * |
dc.contributor.author | Greening, S. | * |
dc.contributor.author | Harris, M. | * |
dc.contributor.author | Hart, S. | * |
dc.contributor.author | Hayward, N. | * |
dc.contributor.author | Hopper, J. | * |
dc.contributor.author | Hoskins, C. | * |
dc.contributor.author | Hunt, C. | * |
dc.contributor.author | James, P. | * |
dc.contributor.author | Jenkins, M. | * |
dc.contributor.author | Kidd, A. | * |
dc.contributor.author | Kirk, J. | * |
dc.contributor.author | Koehler, J. | * |
dc.contributor.author | Kollias, J. | * |
dc.contributor.author | Lakhani, S. | * |
dc.contributor.author | Lawrence, M. | * |
dc.contributor.author | Lee, J. | * |
dc.contributor.author | Li, S. | * |
dc.contributor.author | Lindeman, G. | * |
dc.contributor.author | Lipton, L. | * |
dc.contributor.author | Lobb, L. | * |
dc.contributor.author | Loi, S. | * |
dc.contributor.author | Mann, G. | * |
dc.contributor.author | Marsh, D. | * |
dc.contributor.author | McLachlan, S.A. | * |
dc.contributor.author | Meiser, B. | * |
dc.contributor.author | Milne, R. | * |
dc.contributor.author | Nightingale, S. | * |
dc.contributor.author | O'Connell, S. | * |
dc.contributor.author | O'Sullivan, S. | * |
dc.contributor.author | Ortega, D.G. | * |
dc.contributor.author | Pachter, N. | * |
dc.contributor.author | Pang, J.-M. | * |
dc.contributor.author | Pathak, G. | * |
dc.contributor.author | Patterson, B. | * |
dc.contributor.author | Pearn, A. | * |
dc.contributor.author | Phillips, K. | * |
dc.contributor.author | Pieper, E. | * |
dc.contributor.author | Ramus, S. | * |
dc.contributor.author | Rickard, E. | * |
dc.contributor.author | Robinson, B. | * |
dc.contributor.author | Saleh, M. | * |
dc.contributor.author | Skandarajah, A. | * |
dc.contributor.author | Salisbury, E. | * |
dc.contributor.author | Saunders, C. | * |
dc.contributor.author | Saunus, J. | * |
dc.contributor.author | Scott, R. | * |
dc.contributor.author | Scott, C. | * |
dc.contributor.author | Sexton, A. | * |
dc.contributor.author | Shelling, A. | * |
dc.contributor.author | Simpson, P. | * |
dc.contributor.author | Southey, M. | * |
dc.contributor.author | Spurdle, A. | * |
dc.contributor.author | Taylor, J. | * |
dc.contributor.author | Taylor, R. | * |
dc.contributor.author | Thorne, H. | * |
dc.contributor.author | Trainer, A. | * |
dc.contributor.author | Tucker, K. | * |
dc.contributor.author | Visvader, J. | * |
dc.contributor.author | Walker, L. | * |
dc.contributor.author | Williams, R. | * |
dc.contributor.author | Winship, I. | * |
dc.contributor.author | Young, M.A. | * |
dc.contributor.author | Zaheed, M. | * |
dc.contributor.author | Jakubowska, A. | * |
dc.contributor.author | Janni, W. | * |
dc.contributor.author | Jernström, H. | * |
dc.contributor.author | John, E.M. | * |
dc.contributor.author | Johnson, N. | * |
dc.contributor.author | Jones, M.E. | * |
dc.contributor.author | Kristensen, V.N. | * |
dc.contributor.author | Kurian, A.W. | * |
dc.contributor.author | Lambrechts, D. | * |
dc.contributor.author | Le Marchand, L. | * |
dc.contributor.author | Lindblom, A. | * |
dc.contributor.author | Lubi?ski, J. | * |
dc.contributor.author | Lux, M.P. | * |
dc.contributor.author | Mannermaa, A. | * |
dc.contributor.author | Mavroudis, D. | * |
dc.contributor.author | Mulligan, A.M. | * |
dc.contributor.author | Muranen, T.A. | * |
dc.contributor.author | Nevanlinna, H. | * |
dc.contributor.author | Nevelsteen, I. | * |
dc.contributor.author | Neven, P. | * |
dc.contributor.author | Newman, W.G. | * |
dc.contributor.author | Obi, N. | * |
dc.contributor.author | Offit, K. | * |
dc.contributor.author | Olshan, A.F. | * |
dc.contributor.author | Park-Simon, T.-W. | * |
dc.contributor.author | Patel, A.V. | * |
dc.contributor.author | Peterlongo, P. | * |
dc.contributor.author | Phillips, K.-A. | * |
dc.contributor.author | Plaseska-Karanfilska, D. | * |
dc.contributor.author | Polley, E.C. | * |
dc.contributor.author | Presneau, N. | * |
dc.contributor.author | Pylkäs, K. | * |
dc.contributor.author | Rack, B. | * |
dc.contributor.author | Radice, P. | * |
dc.contributor.author | Rashid, M.U. | * |
dc.contributor.author | Rhenius, V. | * |
dc.contributor.author | Robson, M. | * |
dc.contributor.author | Romero, A. | * |
dc.contributor.author | Saloustros, E. | * |
dc.contributor.author | Sawyer, E.J. | * |
dc.contributor.author | Schmutzler, R.K. | * |
dc.contributor.author | Schuetze, S. | * |
dc.contributor.author | Scott, C. | * |
dc.contributor.author | Shah, M. | * |
dc.contributor.author | Smichkoska, S. | * |
dc.contributor.author | Southey, M.C. | * |
dc.contributor.author | Tapper, W.J. | * |
dc.contributor.author | Teras, L.R. | * |
dc.contributor.author | Tollenaar, R.A.E.M. | * |
dc.contributor.author | Tomczyk, K. | * |
dc.contributor.author | Tomlinson, I. | * |
dc.contributor.author | Troester, M.A. | * |
dc.contributor.author | Vachon, C.M. | * |
dc.contributor.author | van Veen, E.M. | * |
dc.contributor.author | Wang, Q. | * |
dc.contributor.author | Wendt, C. | * |
dc.contributor.author | Wildiers, H. | * |
dc.contributor.author | Winqvist, R. | * |
dc.contributor.author | Ziogas, A. | * |
dc.contributor.author | Hall, P. | * |
dc.contributor.author | Pharoah, P.D.P. | * |
dc.contributor.author | Adank, M.A. | * |
dc.contributor.author | Hollestelle, A. | * |
dc.contributor.author | Schmidt, M.K. | * |
dc.contributor.author | Hooning, M.J. | * |
dc.date.accessioned | 2025-09-08T09:19:04Z | |
dc.date.available | 2025-09-08T09:19:04Z | |
dc.date.issued | 2023 | |
dc.identifier.citation | Morra A, Schreurs MAC, Andrulis IL, Anton-Culver H, Augustinsson A, Beckmann MW, et al. Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival. Cancer Medicine. 2023;12(15):16142-62. | |
dc.identifier.issn | 2045-7634 | |
dc.identifier.other | https://portalcientifico.sergas.gal//documentos/65c35cbbd2edca1267d6a0f9 | |
dc.identifier.uri | http://hdl.handle.net/20.500.11940/21123 | |
dc.description.abstract | Background: Breast cancer (BC) patients with a germline CHEK2 c.1100delC variant have an increased risk of contralateral BC (CBC) and worse BC-specific survival (BCSS) compared to non-carriers. Aim: To assessed the associations of CHEK2 c.1100delC, radiotherapy, and systemic treatment with CBC risk and BCSS. Methods: Analyses were based on 82,701 women diagnosed with a first primary invasive BC including 963 CHEK2 c.1100delC carriers; median follow-up was 9.1 years. Differential associations with treatment by CHEK2 c.1100delC status were tested by including interaction terms in a multivariable Cox regression model. A multi-state model was used for further insight into the relation between CHEK2 c.1100delC status, treatment, CBC risk and death. Results: There was no evidence for differential associations of therapy with CBC risk by CHEK2 c.1100delC status. The strongest association with reduced CBC risk was observed for the combination of chemotherapy and endocrine therapy [HR (95% CI): 0.66 (0.55-0.78)]. No association was observed with radiotherapy. Results from the multi-state model showed shorter BCSS for CHEK2 c.1100delC carriers versus non-carriers also after accounting for CBC occurrence [HR (95% CI): 1.30 (1.09-1.56)]. Conclusion: Systemic therapy was associated with reduced CBC risk irrespective of CHEK2 c.1100delC status. Moreover, CHEK2 c.1100delC carriers had shorter BCSS, which appears not to be fully explained by their CBC risk. | |
dc.description.sponsorship | Canadian Institutes of Health Research, Grant/Award Number: GPH-129344; Cancer Research UK, Grant/Award Number: C12292/A11174, C1281/A12014, C1287/A10118, C1287/A10710, C1287/A16563, C5047/A10692, C5047/A15007, C5047/A8384 and C8197/A16565; US Department of Defence, Grant/Award Number: W81XWH-10-1-0341; European Union's Horizon 2020 Research and Innovation Programme, Grant/Award Number: 633784 and 634935; Fondation du cancer du sein du Quebec; FP7 Ideas: European Research Council, Grant/Award Number: HEALTH-F2-2009-223175; Genome Canada; Genome Quebec; Government of Canada; National Institutes of Health, Grant/Award Number: CA128978 and U19 CA148065; Post-Cancer GWAS initiative, Grant/Award Number: 1U19 CA148065, 1U19 CA148112 - the GAME-ON initiative and 1U19 CA148537; Wellcome Trust, Grant/Award Number: v203477/Z/16/Z | |
dc.language | eng | |
dc.rights | Attribution 4.0 International (CC BY 4.0) | * |
dc.rights.uri | http://creativecommons.org/licenses/by/4.0/ | * |
dc.subject.mesh | Female | * |
dc.subject.mesh | Humans | * |
dc.subject.mesh | Breast Neoplasms | * |
dc.subject.mesh | Checkpoint Kinase 2 | * |
dc.subject.mesh | Genetic Predisposition to Disease | * |
dc.subject.mesh | Germ-Line Mutation | * |
dc.subject.mesh | Heterozygote | * |
dc.subject.mesh | Proportional Hazards Models | * |
dc.title | Association of the CHEK2 c.1100delC variant, radiotherapy, and systemic treatment with contralateral breast cancer risk and breast cancer-specific survival | |
dc.type | Artigo | |
dc.authorsophos | Morra, A.; Schreurs, M.A.C.; Andrulis, I.L.; Anton-Culver, H.; Augustinsson, A.; Beckmann, M.W.; Behrens, S.; Bojesen, S.E.; Bolla, M.K.; Brauch, H.; Broeks, A.; Buys, S.S.; Camp, N.J.; Castelao, J.E.; Cessna, M.H.; Chang-Claude, J.; Chung, W.K.; Sahlberg, K.K.; Børresen-Dale, A.-L.; Gram, I.T.; Olsen, K.S.; Engebråten, O.; Naume, B.; Geisler, J.; Grenaker Alnæs, G.I.; Colonna, S.V.; Couch, F.J.; Cox, A.; Cross, S.S.; Czene, K.; Daly, M.B.; Dennis, J.; Devilee, P.; Dörk, T.; Dunning, A.M.; Dwek, M.; Easton, D.F.; Eccles, D.M.; Eriksson, M.; Evans, D.G.; Fasching, P.A.; Fehm, T.N.; Figueroa, J.D.; Flyger, H.; Gabrielson, M.; Gago-Dominguez, M.; García-Closas, M.; García-Sáenz, J.A.; Genkinger, J.; Grassmann, F.; Gündert, M.; Hahnen, E.; Haiman, C.A.; Hamann, U.; Harrington, P.A.; Hartikainen, J.M.; Hoppe, R.; Hopper, J.L.; Houlston, R.S.; Howell, A.; Clarke, C.; Marsh, D.; Scott, R.; Baxter, R.; Yip, D.; Carpenter, J.; Davis, A.; Pathmanathan, N.; Simpson, P.; Graham, J.D.; Sachchithananthan, M.; Amor, D.; Andrews, L.; Antill, Y.; Balleine, R.; Beesley, J.; Bennett, I.; Bogwitz, M.; Botes, L.; Brennan, M.; Brown, M.; Buckley, M.; Burke, J.; Butow, P.; Caldon, L.; Campbell, I.; Cao, M.; Chakrabarti, A.; Chauhan, D.; Chauhan, M.; Chenevix-Trench, G.; Christian, A.; Cohen, P.; Colley, A.; Crook, A.; Cui, J.; Courtney, E.; Cummings, M.; Dawson, S.-J.; DeFazio, A.; Delatycki, M.; Dickson, R.; Dixon, J.; Edkins, T.; Edwards, S.; Farshid, G.; Fellows, A.; Fenton, G.; Field, M.; Flanagan, J.; Fong, P.; Forrest, L.; Fox, S.; French, J.; Friedlander, M.; Gaff, C.; Gattas, M.; George, P.; Greening, S.; Harris, M.; Hart, S.; Hayward, N.; Hopper, J.; Hoskins, C.; Hunt, C.; James, P.; Jenkins, M.; Kidd, A.; Kirk, J.; Koehler, J.; Kollias, J.; Lakhani, S.; Lawrence, M.; Lee, J.; Li, S.; Lindeman, G.; Lipton, L.; Lobb, L.; Loi, S.; Mann, G.; Marsh, D.; McLachlan, S.A.; Meiser, B.; Milne, R.; Nightingale, S.; O'Connell, S.; O'Sullivan, S.; Ortega, D.G.; Pachter, N.; Pang, J.-M.; Pathak, G.; Patterson, B.; Pearn, A.; Phillips, K.; Pieper, E.; Ramus, S.; Rickard, E.; Robinson, B.; Saleh, M.; Skandarajah, A.; Salisbury, E.; Saunders, C.; Saunus, J.; Scott, R.; Scott, C.; Sexton, A.; Shelling, A.; Simpson, P.; Southey, M.; Spurdle, A.; Taylor, J.; Taylor, R.; Thorne, H.; Trainer, A.; Tucker, K.; Visvader, J.; Walker, L.; Williams, R.; Winship, I.; Young, M.A.; Zaheed, M.; Jakubowska, A.; Janni, W.; Jernström, H.; John, E.M.; Johnson, N.; Jones, M.E.; Kristensen, V.N.; Kurian, A.W.; Lambrechts, D.; Le Marchand, L.; Lindblom, A.; Lubi?ski, J.; Lux, M.P.; Mannermaa, A.; Mavroudis, D.; Mulligan, A.M.; Muranen, T.A.; Nevanlinna, H.; Nevelsteen, I.; Neven, P.; Newman, W.G.; Obi, N.; Offit, K.; Olshan, A.F.; Park-Simon, T.-W.; Patel, A.V.; Peterlongo, P.; Phillips, K.-A.; Plaseska-Karanfilska, D.; Polley, E.C.; Presneau, N.; Pylkäs, K.; Rack, B.; Radice, P.; Rashid, M.U.; Rhenius, V.; Robson, M.; Romero, A.; Saloustros, E.; Sawyer, E.J.; Schmutzler, R.K.; Schuetze, S.; Scott, C.; Shah, M.; Smichkoska, S.; Southey, M.C.; Tapper, W.J.; Teras, L.R.; Tollenaar, R.A.E.M.; Tomczyk, K.; Tomlinson, I.; Troester, M.A.; Vachon, C.M.; van Veen, E.M.; Wang, Q.; Wendt, C.; Wildiers, H.; Winqvist, R.; Ziogas, A.; Hall, P.; Pharoah, P.D.P.; Adank, M.A.; Hollestelle, A.; Schmidt, M.K.; Hooning, M.J. | |
dc.identifier.doi | 10.1002/cam4.6272 | |
dc.identifier.sophos | 65c35cbbd2edca1267d6a0f9 | |
dc.issue.number | 15 | |
dc.journal.title | Cancer Medicine | * |
dc.organization | Servizo Galego de Saúde::Áreas Sanitarias (A.S.) - Complexo Hospitalario Universitario de Vigo | |
dc.organization | Servizo Galego de Saúde::Áreas Sanitarias (A.S.) - Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS)::Xenética | |
dc.page.initial | 16142 | |
dc.page.final | 16162 | |
dc.relation.projectID | Canadian Institutes of Health Research | |
dc.relation.projectID | Cancer Research UK | |
dc.relation.projectID | US Department of Defence | |
dc.relation.projectID | European Union | |
dc.relation.projectID | Fondation du cancer du sein du Quebec | |
dc.relation.projectID | FP7 Ideas: European Research Council | |
dc.relation.projectID | Genome Canada | |
dc.relation.projectID | Genome Quebec | |
dc.relation.projectID | Government of Canada | |
dc.relation.projectID | National Institutes of Health | |
dc.relation.projectID | Post-Cancer GWAS initiative | |
dc.relation.projectID | Wellcome Trust | |
dc.relation.projectID | [GPH-129344] | |
dc.relation.projectID | [C12292/A11174] | |
dc.relation.projectID | [C1281/A12014] | |
dc.relation.projectID | [C1287/A10118] | |
dc.relation.projectID | [C1287/A10710] | |
dc.relation.projectID | [C1287/A16563] | |
dc.relation.projectID | [C5047/A10692] | |
dc.relation.projectID | [C5047/A15007] | |
dc.relation.projectID | [C5047/A8384] | |
dc.relation.projectID | [C8197/A16565] | |
dc.relation.projectID | [W81XWH-10-1-0341] | |
dc.relation.projectID | [633784] | |
dc.relation.projectID | [634935] | |
dc.relation.projectID | [HEALTH-F2-2009-223175] | |
dc.relation.projectID | [CA128978] | |
dc.relation.projectID | [U19 CA148065] | |
dc.relation.projectID | [1U19 CA148065] | |
dc.relation.projectID | [1U19 CA148112] | |
dc.relation.projectID | [1U19 CA148537] | |
dc.relation.projectID | [v203477/Z/16/Z] | |
dc.relation.projectID | Cancer Research UK [23382] Funding Source: researchfish | |
dc.relation.projectID | Medical Research Council [G1000143, MR/M012190/1] Funding Source: researchfish | |
dc.relation.publisherversion | https://doi.org/10.1002/cam4.6272 | |
dc.rights.accessRights | openAccess | * |
dc.subject.keyword | AS Vigo | |
dc.subject.keyword | CHUVI | |
dc.subject.keyword | AS Santiago | |
dc.subject.keyword | IDIS | |
dc.typefides | Artículo Científico (incluye Original, Original breve, Revisión Sistemática y Meta-análisis) | |
dc.typesophos | Artículo Original | |
dc.volume.number | 12 |
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