Clinical study on the relationship between hepatitis B virus infection and risk of breast cancer: a large sized case-control and single center study in southwest of China

Abstract

PurposeChronic hepatitis C virus (HCV) infection is reported to be associated with early-onset breast cancer, while, as a hepadnavirus, hepatitis B virus(HBV) infection is more common than HCV in China. In this article, it is aimed to study the relationship between HBV infection and risk of breast cancer in China.MethodsThe clinical data of 2452 cases of initially diagnosed breast cancer and 1926 cases of benign breast disease (as controls) with the consecutive reports of HBV serological markers and liver function tests, available in the Electronic Medical Records of the Breast Cancer Center of Chongqing, the southwest of China, from January 2011 to March 2015, were collected for analysis.ResultsThe average age of the initially diagnosed breast cancer patients was 50.3±11.3 years with the age peaking about 40- 49yeaers (39.7%). The positive rate (8.2%) of hepatitis B surface antigen in breast cancer patients was relatively higher than that (7.8%) in controls (P>0.05). While, the positive rate (66.4%)of hepatitis B core antibody in breast cancer patients was significantly higher than that (53.7%) in controls (P<0.05), so were the similar results in the age groups of 40-49 years, after multiple layer analysis stratified by age and compare HBV markers adjusting age with binary logistic regression. Meanwhile, the status of albumin, aminotransferase and aspartate transaminase (41.4 g/L, 22.9 U/L, 22.0 U/L) in breast cancer patients were significantly poorer than those (44.1 g/L,16.8 U/L, 19.2 U/L) in controls (P<0.05).ConclusionsExposure to HBV infection may be a risk factor for breast cancer and may be also related to the earlier age onset of breast cancer (peaked around 40-49 years) among Chinese females.

A nomogram based on clinicopathological features and serological indicators predicting breast pathologic complete response of neoadjuvant chemotherapy in breast cancer

“…In this study, we found that breast cancer patients with hepatitis B surface antibody positivity were more likely to reach bpCR. The mechanism of hepatitis B virus (HBV) and breast cancer progression and prognosis is unclear, but reports have shown that HBV infection is a risk factor for breast cancer 50 . The mechanism may be related to the interference of hepatitis B virus X protein (HBx) on cell repair mechanism, which leads to cell carcinogenesis 51 .…”

“…In addition, HBV infection causes liver dysfunction, which affects estrogen regulation, and estrogen is a known risk factor for breast cancer. Therefore, HBV infection may indirectly induce breast epithelial cells to become cancerous 50 .…”

Could hepatitis B vaccine act as an adjuvant to lower risk and relapses of cancer?

“…Lu et al investigated the data of 2452 mammary carcinoma cases and 1926 benign breast disease cases and analyzed reports of HBV serological markers and hepatic function tests, obtained from the Electronic Medical Records of the Breast Cancer Centre of Chongqing in southwest China. They found that the positive rate (8.2%) of HBsAg in breast cancer patients was slightly higher than that (7.8%) in controls ( P > 0.05) . But two other epidemiological studies – one with a much larger sample population – indicated opposite associations.…”

“…Lu et al 18 Anti-HBs, HBeAg, HBe antibody, and HBcAb). 19 Investigations of the clinical features demonstrated that the axillary lymph node metastases were lower in the case group, as was the ratio of breast cancer patients with pathological T stage ≥T2.…”

HBV Infection Status Does Not Influence the Initial Metastatic Pattern and the Prognosis of Breast Cancer Patients with de novo and Relapsed Metastatic Disease

“… 12–18 Some studies also proposed a hypothetical mechanism for the development of breast cancer as a result of HBV infection: persistence of occult infection and continuous replication of HBV lead to long-term subtle liver damage, and long-term necro-inflammatory damage to the liver may result in persistently high levels of estrogen, which is mainly deactivated in the liver and is a dominant risk factor for breast cancer. 17 , 19 HBV may also directly affect the breast cells through its cis and trans effects of HBx, which may act as oncoprotein. 19 …”