- Nee, Kevin;
- Ma, Dennis;
- Nguyen, Quy H;
- Pein, Maren;
- Pervolarakis, Nicholas;
- Insua-Rodríguez, Jacob;
- Gong, Yanwen;
- Hernandez, Grace;
- Alshetaiwi, Hamad;
- Williams, Justice;
- Rauf, Maha;
- Dave, Kushal Rajiv;
- Boyapati, Keerti;
- Hasnain, Aliza;
- Calderon, Christian;
- Markaryan, Anush;
- Edwards, Robert;
- Lin, Erin;
- Parajuli, Ritesh;
- Zhou, Peijie;
- Nie, Qing;
- Shalabi, Sundus;
- LaBarge, Mark A;
- Kessenbrock, Kai
Women with germline BRCA1 mutations (BRCA1+/mut) have increased risk for hereditary breast cancer. Cancer initiation in BRCA1+/mut is associated with premalignant changes in breast epithelium; however, the role of the epithelium-associated stromal niche during BRCA1-driven tumor initiation remains unclear. Here we show that the premalignant stromal niche promotes epithelial proliferation and mutant BRCA1-driven tumorigenesis in trans. Using single-cell RNA sequencing analysis of human preneoplastic BRCA1+/mut and noncarrier breast tissues, we show distinct changes in epithelial homeostasis including increased proliferation and expansion of basal-luminal intermediate progenitor cells. Additionally, BRCA1+/mut stromal cells show increased expression of pro-proliferative paracrine signals. In particular, we identify pre-cancer-associated fibroblasts (pre-CAFs) that produce protumorigenic factors including matrix metalloproteinase 3 (MMP3), which promotes BRCA1-driven tumorigenesis in vivo. Together, our findings demonstrate that precancerous stroma in BRCA1+/mut may elevate breast cancer risk through the promotion of epithelial proliferation and an accumulation of luminal progenitor cells with altered differentiation.