PURPOSE
Systemic oxidative stress has been implicated in the pathogenesis and progression of many chronic diseases, including breast cancer. No studies have investigated F2-isoprostanes (F2-IsoPs), valid biomarkers of systemic oxidative stress, in association with breast cancer prognosis. We conducted a nested case-control study in a prospective breast cancer survivor cohort to investigate systemic oxidative stress and survival.
METHODS
Urinary levels of F2-IsoPs and its major urinary metabolite (2,3-dinor-5,6-dihydro-15-F2t-IsoP, F2-IsoP-M) were measured post-cancer treatment using gas chromatography/negative ion chemical ionization mass spectrometry for 57 deceased breast cancer patients (cases) and 103 surviving patients (controls) matched 1:2 on age at diagnosis, stage, and diagnosis year. Odds ratios (ORs) and 95% confidence intervals (CIs) were derived from conditional logistic regression models.
RESULTS
In unadjusted models, elevated F2-IsoP levels categorized based on the median value (≥1.73;<1.73 (reference)) were non-significantly inversely associated with mortality (OR:0.51, 95% CI:0.24–1.10). After adjustment for potential confounders, elevated F2-IsoP levels were significantly associated with mortality (OR:0.36, 95% CI:0.14–0.96). The inverse association was marginally significant when F2-IsoP was categorized based on tertiles (Ptrend=0.08). In contrast, elevated F2-IsoP-M levels, categorized based on the median level (≥0.91;<0.91(reference)), were associated with a statistically non-significant increased risk of mortality in both unadjusted and adjusted models (adjusted OR:1.39, 95% CI:0.62–3.09).
CONCLUSION
Results suggest a role for oxidative stress biomarkers in breast cancer survival; however, as this is the first study to date, additional larger studies are needed.