Association of adiposity, dysmetabolisms, and inflammation with aggressive breast cancer subtypes: a cross-sectional study

Abstract

Obesity and metabolic syndrome are risk and prognostic factors for breast cancer (BC) and are associated with chronic inflammation. We investigated the association between distinct BC subtypes and markers of adiposity, dysmetabolisms, and inflammation. We analyzed 1779 patients with primary invasive BC treated at a single institution, for whom anthropometric and clinical-pathological data were archived. BC subtypes were classified by immunohistochemical staining of ER, PR, HER2, and Ki67, and their relations with the study markers were assessed by multinomial logistic regression. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) were calculated taking luminal A as reference. All subtypes more aggressive than luminal A were significantly more frequent in younger (<45 years) than older women. Before menopause, luminal B HER2-negative tumors were positively associated with large waist (OR 2.55, 95 % CI 1.53-4.24) and insulin resistance (OR 1.90, 95 % CI 1.05-3.41); luminal B HER2-positive tumors with large waist (OR 2.11, 95 % CI 1.03-4.35) and triple-negative tumors with overweight (OR 3.04, 95 % CI 1.43-6.43) and high C-reactive protein (p trend = 0.026). In postmenopausal women aged <65, luminal B HER2-negative (OR 1.94, 95 % CI 1.16-3.24) and luminal B HER2-positive tumors (OR 2.48, 95 % CI 1.16-5.27) were positively related with metabolic syndrome. Dysmetabolisms and inflammation may be related to different BC subtypes. Before menopause, triple-negative cancers were related to obesity and chronic inflammation, and aggressive luminal subtypes to abdominal adiposity. After menopause, in women aged <65 these latter subtypes were related to metabolic syndrome. Control of adiposity and dysmetabolism can reduce the risk of aggressive BC subtypes, improving the prognosis.

Adipose-Derived Fatty Acid-Binding Proteins Plasma Concentrations Are Increased in Breast Cancer Patients

“…There are some controversial results regarding the levels and the possible role of CRP in breast cancer. In fact, the CRP levels are elevated under specific conditions in breast cancer patients, but the results are not conclusive . In our population, we found that the CRP levels are higher in breast cancer patients, implicating a role of inflammation in this pathology.…”

Association of 15-hydroxyprostaglandin dehydrogenate and poor prognosis of obese breast cancer patients

“…Hong et al provided epidemiological evidence that chronic inflammation might mediate the association between obesity and breast cancer [19]. Agresti et al also reported that serum C-reactive protein(CRP), a sensitive marker of systemic inflammation, was higher in overweight or obese breast cancer [20]. Similarly, Wulaningsih et al suggested that CRP was associated with mortality from breast cancer [21].…”

Increased Lipids Levels and Breast Cancer

“…5 Recently, the body mass index (BMI) has been shown to be distributed differently to the breast cancer molecular subtypes, 6 and has also been supported by others. 7,8 Triglycerides serve as an independent source for fatty acid oxidation, 9 an important process that supports the carcinogenic potential of triglycerides and promotes cell proliferation and tumor growth. 10 However, the relationship between pre-diagnostic triglycerides and breast cancer development remains unclear as a molecular subtype.…”