Methionine synthase A2756G polymorphism and breast cancer risk: An up-to-date meta-analysis

• It is an up-to-date meta-analysis including 16 studies with 9866 cases and 11,702 controls.
• We evaluate study quality using the Newcastle–Ottawa Scale.
• The heterogeneity is explored by ethnicity, source of control, study quality and sample size.
• Sample size contributes to the heterogeneity.
• MTR A2756G polymorphism may be not associated with breast cancer risk.

The methionine synthase (MTR) gene polymorphism A2756G has been linked to the risk of developing breast cancer, but the available results were inconsistent and underpowered. To derive a more precise estimation of the association between A2756G and breast cancer risk, an updated meta-analysis of 16 available studies with 9866 cases and 11,702 controls estimating the association between MTR A2756G and breast cancer risk was conducted. The quality of these studies was generally good except 2 studies with a lowest score 4 according to the Newcastle–Ottawa Scale (NOS). The results suggested that there is no significant association between A2756G and breast cancer risk in overall results. In the stratified analysis by ethnicity, source of controls (population or hospital-based), Hardy–Weinberg equilibrium (HWE) in controls, sample size (≥ 1000 and < 1000 subjects), and menopausal status, the 2756G allele was associated with a decreased risk in Caucasians, PB (population-based) subgroup, and large studies. But the associations disappeared after removing the studies not in HWE. On the contrary, an increased risk was found in small studies. In conclusion, the findings suggest that MTR A2756G polymorphism is not associated with altered susceptibility to breast cancer, while the observed decreased risk in Caucasians, PB subgroup, and large studies and increased risk in small studies may be due to selection bias or other unknown factors.