scholarly journals Insulin Resistance and Inflammation in Black Women with and without Breast Cancer: Cause for Concern

2016 ◽  
Vol 26 (4) ◽  
pp. 513 ◽  
Author(s):  
Kathleen A. Griffith ◽  
Seon Yoon Chung ◽  
Shijun Zhu ◽  
Alice S. Ryan
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Black Women ◽  
White Women ◽  
Cancer Recurrence ◽  
Control Group ◽  
Study Objective ◽  
Increased Risk ◽  
Tnf Α ◽  
History Of

<p class="Pa7"><strong>Objective: </strong>After chemotherapy for breast cancer, Black women gain more weight and have an increased mortality rate compared with White women. Our study objective was to compare biomarkers associated with obesity in Black women with and without a history of breast cancer.</p><p class="Pa7"><strong>Design: </strong>Case-control</p><p class="Pa7"><strong>Setting: </strong>Academic/federal institution</p><p class="Pa7"><strong>Participants: </strong>Black women with a history of breast cancer (cases) and age-matched controls.</p><p class="Pa7"><strong>Methods: </strong>We compared insulin resistance, inflammation, and lipids in overweight and obese Black women with a history of breast cancer (n=19), age similar controls (n=25), and older controls (n=32). Groups did not differ on mean body mass index (BMI), which was 35.4 kg/m2, 36.0 kg/m2, and 33.0 kg/m2, respectively.</p><p class="Default"><strong>Main Outcome Measures: </strong>Insulin resis­tance (HOMA-IR); inflammation (TNF-α, IL-1b, IL-6, IL-8, CRP); lipids (cholesterol, triglycerides).</p><p class="Pa7"><strong>Results: </strong>Cases had 1.6 and 1.38 times higher HOMA-IR values compared with age similar and older controls, respectively (P≤.001 for both). TNF-α and IL-1b were significantly higher in cases compared with both control groups (P&lt;.001 for both). IL-6 was also higher in cases compared with age-similar controls (P=.007), and IL-8 was lower in cases compared with older controls (P&lt;.05). Lipids did not differ between cases and either control group.</p><p class="Default"><strong>Conclusions: </strong>Black women with breast cancer were significantly more insulin resis­tant with increased inflammation compared not only with age similar controls but with women who were, on average, a decade older. These biomarkers of insulin resistance and inflammation may be associated with increased risk of breast cancer recurrence and require ongoing evaluation, especially given the relatively abnormal findings com­pared with the controls in this underserved group. <em></em></p><p class="Default"><em>Ethn Dis. </em>2016;26(4):513-520; doi:10.18865/ed.26.4.513</p>

Abstract 16083: Risk of Preserved versus Reduced Ejection Fraction in Women With and Without History of Breast Cancer: The Pathways Heart Study

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Jamal S Rana ◽  
Heather Greenlee ◽  
Richard Cheng ◽  
Cecile A Laurent ◽  
Hanjie Shen ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Radiation Therapy ◽  
Ejection Fraction ◽  
Endocrine Therapy ◽  
White Women ◽  
Cox Regression ◽  
Prior History ◽  
Reduced Ejection Fraction ◽  
Increased Risk ◽  
History Of

Introduction: Incidence of heart failure (HF), specifically with preserved ejection fraction (HFpEF), is rising in the general population, yet is understudied. To provide a population-based estimate of HF in breast cancer (BC) survivors, we compared risk of HF in women with and without BC history in the Kaiser Permanente Northern California (KPNC) integrated health system. Methods: Data were extracted from KPNC electronic health records. All invasive BC cases diagnosed from 2005-2013 were identified and matched 1:5 with non-BC controls on birth year, race/ethnicity, and KPNC membership at BC diagnosis. Cox regression models assessed the hazard of HF by EF status: HFpEF (EF ≥ 45%), HF with reduced EF (HFrEF; EF < 45%), and unknown EF. Women with prior history of HF were excluded. Models were adjusted for factors known to affect BC risk or CVD and for prevalent CVD at BC diagnosis. We also examined case subgroups who received cardiotoxic chemotherapy, left-sided radiation therapy, and/or endocrine therapy, versus their controls. Results: A total of 14,804 women diagnosed with invasive BC and with no history of HF were identified and matched to 74,034 women without BC history. Women were on average 61 years at BC diagnosis and 65% white. Women with HFpEF were older and more likely to have hypertension (p<0.05). Among all cases vs. controls, there was increased risk of HFrEF (HR: 1.5, 95% CI: 1.18, 1.98) but not HFpEF or unknown EF (figure). Compared to their controls, women treated with chemotherapy were more than 3-times likely to develop HFrEF (HR: 3.26, 95% CI: 2.2, 4.8) and more than 1.5-times likely to develop HFpEF (HR=1.61, 95% CI: 1.15, 2.24). Women who received left-sided radiation therapy had nearly double the risk of developing HFrEF (HR=1.85, 95% CI: 1.20, 2.84). No associations were found among women who received endocrine therapy. Conclusions: Increased surveillance is warranted for women with BC receiving cardiotoxic chemotherapy for development of both HFrEF and HFpEF.

scholarly journals Health Care Segregation, Physician Recommendation, and Racial Disparities in BRCA1/2 Testing Among Women With Breast Cancer

2016 ◽  
Vol 34 (22) ◽  
pp. 2610-2618 ◽  
Author(s):  
Anne Marie McCarthy ◽  
Mirar Bristol ◽  
Susan M. Domchek ◽  
Peter W. Groeneveld ◽  
Younji Kim ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Racial Disparities ◽  
Racial Differences ◽  
White Women ◽  
Physician Recommendation ◽  
Study Objective ◽  
Black And White ◽  
Physician Characteristics ◽  
White Patients

Purpose Racial disparities in BRCA1/2 testing have been documented, but causes of these disparities are poorly understood. The study objective was to investigate whether the distribution of black and white patients across cancer providers contributes to disparities in BRCA1/2 testing. Patients and Methods We conducted a population-based study of women in Pennsylvania and Florida who were 18 to 64 years old and diagnosed with invasive breast cancer between 2007 and 2009, linking cancer registry data, the American Medical Association Physician Masterfile, and patient and physician surveys. The study included 3,016 women (69% white, 31% black), 808 medical oncologists, and 732 surgeons. Results Black women were less likely to undergo BRCA1/2 testing than white women (odds ratio [OR], 0.40; 95% CI, 0.34 to 0.48; P < .001). This difference was attenuated but not eliminated by adjustment for mutation risk, clinical factors, sociodemographic characteristics, and attitudes about testing (OR, 0.66; 95% CI, 0.53 to 0.81; P < .001). The care of black and white women was highly segregated across surgeons and oncologists (index of dissimilarity 64.1 and 61.9, respectively), but adjusting for clustering within physician or physician characteristics did not change the size of the testing disparity. Black women were less likely to report that they had received physician recommendation for BRCA1/2 testing even after adjusting for mutation risk (OR, 0.66; 95% CI, 0.54 to 0.82; P < .001). Adjusting for physician recommendation further attenuated the testing disparity (OR, 0.76; 95% CI, 0.57 to 1.02; P = .06). Conclusion Although black and white patients with breast cancer tend to see different surgeons and oncologists, this distribution does not contribute to disparities in BRCA1/2 testing. Instead, residual racial differences in testing after accounting for patient and physician characteristics are largely attributable to differences in physician recommendations. Efforts to address these disparities should focus on ensuring equity in testing recommendations.

scholarly journals Genetic Variants in COX2 and ALOX Genes and Breast Cancer Risk in White and Black Women

2021 ◽  
Vol 11 ◽  
Author(s):  
Jennifer M. Mongiovi ◽  
Chi-Chen Hong ◽  
Gary R. Zirpoli ◽  
Thaer Khoury ◽  
Angela R. Omilian ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Black Women ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Postmenopausal Women ◽  
Genetic Variants ◽  
White Women ◽  
Dominant Model ◽  
Increased Risk ◽  
Reduced Risk

COX and ALOX genes are involved in inflammatory processes and that may be related to breast cancer risk differentially between White and Black women. We evaluated distributions of genetic variants involved in COX2 and ALOX-related pathways and examined their associations with breast cancer risk among 1,275 White and 1,299 Black cases and controls who participated in the Women’s Circle of Health Study. Odds ratios (ORs) and 95% confidence intervals (CIs) were estimated using multivariable-adjusted logistic regression models. Our results showed differential associations of certain genetic variants with breast cancer according to menopausal and ER status in either White or Black women. In White women, an increased risk of breast cancer was observed for COX2-rs689470 (OR: 2.02, P = 0.01) in the dominant model, and was strongest among postmenopausal women (OR: 2.72, P = 0.02) and for estrogen receptor positive (ER+) breast cancers (OR: 2.60, P = 0.001). A reduced risk was observed for ALOX5-rs7099874 (OR: 0.75, P = 0.01) in the dominant model, and was stronger among postmenopausal women (OR: 0.68, P = 0.03) and for ER+ cancer (OR: 0.66, P = 0.001). Four SNPs (rs3840880, rs1126667, rs434473, rs1042357) in the ALOX12 gene were found in high LD (r2 &gt;0.98) in White women and were similarly associated with reduced risk of breast cancer, with a stronger association among postmenopausal women and for ER− cancer. Among Black women, increased risk was observed for ALOX5-rs1369214 (OR: 1.44, P = 0.003) in the recessive model and was stronger among premenopausal women (OR: 1.57, P = 0.03) and for ER+ cancer (OR: 1.53, P = 0.003). Our study suggests that genetic variants of COX2 and ALOX genes are associated with breast cancer, and that these associations and genotype distributions differ in subgroups defined by menopausal and ER status between White and Black women. Findings may provide insights into the etiology of breast cancer and areas for further research into reasons for breast cancer differences between races.

Are racial differences in obesity and insulin resistance related to aggressive breast cancer?

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e18157-e18157
Author(s):  
Emily Gallagher ◽  
Derek Leroith ◽  
Sheldon M. Feldman ◽  
Elisa R. Port ◽  
Neil B Friedman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Insulin Resistance ◽  
Black Women ◽  
Racial Differences ◽  
White Women ◽  
Fasting Blood Glucose ◽  
Prognostic Index ◽  
Nottingham Prognostic Index ◽  
Insulin Resistant ◽  
Aggressive Breast Cancer

e18157 Background: Black women are more likely to die of breast cancer and develop more aggressive subtypes than white women. Black women are also more likely to be obese and have insulin resistance than white women. Insulin resistance has been associated with faster tumor growth but has not been studied as a potential mediator of racial disparities in women with breast cancer. We hypothesized that black women would present with more aggressive breast cancer and this would be associated with obesity and insulin resistance. Methods: We recruited 1017 (80% white, 20% black) women with new primary breast cancer, measured fasting blood glucose and insulin, body mass index (BMI), triple negative breast cancer (TNBC) & Nottingham prognostic index (NPI). We classified aggressive breast cancer as NPI > 4.4. We calculated insulin resistance scores (HOMA) and classified insulin resistance as HOMA > 2.8. Patients self-identified race. Results: Of 1017 women, average age was 58 years (SD = 12.0). 373 (37%) were stage 2+ at time of diagnosis; 19% had an NPI > 4.4. Black women presented with higher stage of cancer than white women (stage 2+: 45% vs 35%; p = 0.01), more TNBC than white women (10% vs 5%, p = 0.01), were more insulin resistant (24% vs 11%, p < .0001), had higher BMI (31.4kg/m2 vs 26.6 kg/m2; p < .0001) and NPI > 4.4 (29% vs. 17%, p = 0.0002) than white women. HOMA score was positively but not significantly associated with NPI score (r = 0.05; p = 0.1). Multivariate mediation regression model suggested that HOMA_IR does not mediate the effect from black race to higher NPI score (β = 0.01; 95%CI: -0.017 to 0.039). Conclusions: In women with newly diagnosed breast cancer, black women are more likely to be obese, have higher HOMA & NPI scores than white women. While these data are consistent with the hypothesized relationship of hyperinsulinemia promoting more aggressive breast cancer, to date, insulin resistance does not appear to mediate the effect of race and poor prognostic breast cancer.

Antibiotic exposure and risk of breast cancer: A causal association or a skyfall?

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e12524-e12524
Author(s):  
Anna Koumarianou ◽  
Efrosyni D Manali ◽  
Archontoula Fragou ◽  
Panagiotis Katsaounis ◽  
Georgia Bouga ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Conditional Logistic Regression ◽  
Control Group ◽  
Logistic Regression Models ◽  
Increased Risk ◽  
History Of ◽  
Single Cancer ◽  
Matched Case ◽  
Sparse Methods ◽  
Age Of Menarche

e12524 Background: Although it has long been hypothesized that the use of antibiotics may increase the risk of breast cancer, through effects on inflammation, immunity and gastrointestinal microflora that alter the metabolism of phytochemicals, clinical data on this association are sparse. Methods: Matched case-control study among 158 women with newly diagnosed primary invasive breast cancer from a single cancer unit and 158 age-matched controls (± 12 months) from healthy individuals accompanying patients to the outpatient clinics between January 1, 2006 and December 30, 2007. Clinical examination and a standard questionnaire for the collection of baseline characteristics and known aggravating factors, such as body mass index, smoking, age of menarche and menopause, parity, breastfeeding, history of respiratory, urinary or other infections and previous estrogen use, were carried out in all individuals. All antibiotic classes, such as β-lactams, amoxyl and clavulanic acid, cephalosporins, macrolides, quinolones, tetracyclines, trimethoprim, clindamycin and imidazoles, were recorded. Type of antibiotic and dose was ascertained from health insurance’s pharmacy records. Data were analyzed using multivariable conditional logistic regression models including adjustments for potential confounding factors. Results: The age matched groups of patients and controls were found to have statistically significant differences in the considered parameters such as delayed age of menopause, less parity and less smoking in the control group and more antibiotic intake in the patient population. The cumulative use for more than 21 days of any antibiotic classes were found to statistically significant correlate with increased risk of breast cancer [odds ratio(OR):3.5, 95%confidence interval(CI):1.7-7.3, p=0.001]. By subanalyses according to antibiotic class this increased risk was mainly associated with β-lactams (OR:11.4, 95%CI:3.8, 34.1, p<0.001) and less with macrolides (OR:2.8, 95%CI:1.1-7.5, p=0.039). Conclusions: Our study links β-lactam and macrolide consumption with increased breast cancer risk but further investigation of this association in large cohorts together with exploration of the underlying cause are needed.

scholarly journals Two years' observational study of racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population

2013 ◽  
Vol 11 (2) ◽  
pp. 102-106
Author(s):  
Bishnu P Devkota ◽  
E Armbrecht
Keyword(s):  
Breast Cancer ◽  
White Women ◽  
Racial Difference ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Care Hospital ◽  
Increased Risk ◽  
History Of ◽  
Indigent Population ◽  
Second Degree

Background: Breast cancer is the most common malignancy after non-melanoma skin cancers and second highest cause of cancer deaths (after lung cancer) in females. Objective: To assess racial difference of breast cancer in patients presenting to a tertiary care hospital serving indigent population. Methods: Medical records of 119 Caucasians and 146 African American women with pathologically proven breast cancer who were admitted in a tertiary care hospital serving the indigent population from January 2004 to December 2006 were reviewed retrospectively. Analysis of Variance was performed for within and between group differences using SPSS 19. Results: Our study showed that mean age of cancer diagnosis was much earlier (47.6 years) in white women whose second degree relatives have breast cancer than those women whose first degree relatives have breast cancer (58.6 years). However, in the black women this differencewas not observed (p value for white is 0.002 but for black it was 0 .94). Conclusion: Family history of women with breast cancer in this study showed history of breast cancer in a second degree female relative increased the risk of breast cancer in white women; positive history was associated with earlier age of onset of the disease. We suggest future studies should look into genetic and biological markers in the second generation family members for increased risk of breast cancer. Health Renaissance, January-April 2013; Vol. 11 No.1; 102-106 DOI: http://dx.doi.org/10.3126/hren.v11i2.8215

scholarly journals A Case Report of Germline Compound Heterozygous Mutations in the BRCA1 Gene of an Ovarian and Breast Cancer Patient

2021 ◽  
Vol 22 (2) ◽  
pp. 889
Author(s):  
Ava Kwong ◽  
Cecilia Y. S. Ho ◽  
Vivian Y. Shin ◽  
Chun Hang Au ◽  
Tsun Leung Chan ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Ovarian Cancer ◽  
Brca1 Gene ◽  
Pathogenic Mutation ◽  
Compound Heterozygous ◽  
Strong Family History ◽  
Breast And Ovarian Cancer ◽  
Pathogenic Mutations ◽  
Increased Risk ◽  
History Of

The germline carrier of the BRCA1 pathogenic mutation has been well proven to confer an increased risk of breast and ovarian cancer. Despite BRCA1 biallelic pathogenic mutations being extremely rare, they have been reported to be embryonically lethal or to cause Fanconi anemia (FA). Here we describe a patient who was a 48-year-old female identified with biallelic pathogenic mutations of the BRCA1 gene, with no or very subtle FA-features. She was diagnosed with ovarian cancer and breast cancer at the ages of 43 and 44 and had a strong family history of breast and gynecological cancers.

scholarly journals Estrogens and Progestogens in Triple Negative Breast Cancer: Do They Harm?

Cancers ◽  
2021 ◽  
Vol 13 (11) ◽  
pp. 2506
Author(s):  
Mark van Barele ◽  
Bernadette A. M. Heemskerk-Gerritsen ◽  
Yvonne V. Louwers ◽  
Mijntje B. Vastbinder ◽  
John W. M. Martens ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Triple Negative ◽  
Hormone Replacement ◽  
Breast Cancers ◽  
Younger Women ◽  
Alternative Pathways ◽  
Increased Risk ◽  
History Of ◽  
Hormone Sensitive

Triple-negative breast cancers (TNBC) occur more frequently in younger women and do not express estrogen receptor (ER) nor progesterone receptor (PR), and are therefore often considered hormone-insensitive. Treatment of premenopausal TNBC patients almost always includes chemotherapy, which may lead to premature ovarian insufficiency (POI) and can severely impact quality of life. Hormone replacement therapy (HRT) is contraindicated for patients with a history of hormone-sensitive breast cancer, but the data on safety for TNBC patients is inconclusive, with a few randomized trials showing increased risk-ratios with wide confidence intervals for recurrence after HRT. Here, we review the literature on alternative pathways from the classical ER/PR. We find that for both estrogens and progestogens, potential alternatives exist for exerting their effects on TNBC, ranging from receptor conversion, to alternative receptors capable of binding estrogens, as well as paracrine pathways, such as RANK/RANKL, which can cause progestogens to indirectly stimulate growth and metastasis of TNBC. Finally, HRT may also influence other hormones, such as androgens, and their effects on TNBCs expressing androgen receptors (AR). Concluding, the assumption that TNBC is completely hormone-insensitive is incorrect. However, the direction of the effects of the alternative pathways is not always clear, and will need to be investigated further.

Racial Disparities in Pregnancy-associated Intimate Partner Homicide

2021 ◽  
pp. 088626052199083
Author(s):  
Aaron J. Kivisto ◽  
Samantha Mills ◽  
Lisa S. Elwood
Keyword(s):  
Black Women ◽  
Ethnic Minority ◽  
Racial Disparities ◽  
White Women ◽  
The United States ◽  
Intimate Partner ◽  
Intimate Partner Homicide ◽  
Homicide Victimization ◽  
Increased Risk ◽  
Racial Ethnic

Pregnancy-associated femicide accounts for a mortality burden at least as high as any of the leading specific obstetric causes of maternal mortality, and intimate partners are the most common perpetrators of these homicides. This study examined pregnancy-associated and non-pregnancy-associated intimate partner homicide (IPH) victimization among racial/ethnic minority women relative to their non-minority counterparts using several sources of state-level data from 2003 through 2017. Data regarding partner homicide victimization came from the National Violent Death Reporting System, natality data were obtained from the Centers for Disease Control and Prevention’s National Center for Health Statistics, and relevant sociodemographic information was obtained from the U.S. Census Bureau. Findings indicated that pregnancy and racial/ethnic minority status were each associated with increased risk for partner homicide victimization. Although rates of non-pregnancy-associated IPH victimization were similar between Black and White women, significant differences emerged when limited to pregnancy-associated IPH such that Black women evidenced pregnancy-associated IPH rates more than threefold higher than that observed among White and Hispanic women. Relatedly, the largest intraracial discrepancies between pregnant and non-pregnant women emerged among Black women, who experienced pregnancy-associated IPH victimization at a rate 8.1 times greater than their non-pregnant peers. These findings indicate that the racial disparities in IPH victimization in the United States observed in prior research might be driven primarily by the pronounced differences among the pregnant subset of these populations.

scholarly journals Association of Tumor Necrosis Factor-α -308G>A, -238G>A and -376G>A polymorphisms with recurrent pregnancy loss risk in the Greek population

2021 ◽  
Vol 7 (1) ◽  
Author(s):  
Sofoklis Stavros ◽  
Despoina Mavrogianni ◽  
Myrto Papamentzelopoulou ◽  
Evaggelos Basamakis ◽  
Hend Khudeir ◽  
...  
Keyword(s):  
Pregnancy Loss ◽  
Recurrent Pregnancy Loss ◽  
Pcr Amplification ◽  
Greek Population ◽  
Control Group ◽  
Increased Risk ◽  
Tnf Α ◽  
Caucasian Women ◽  
Factor Α ◽  
And Control

Abstract Background Promoter region SNPs in TNF-α have been studied in association with Recurrent Pregnancy Loss (RPL) occurrence in various populations. Among them, −238G > A, −308G > A and − 376G > A have been frequently investigated for their potential role in recurrent abortions. The aim of the present study is to evaluate the correlation among TNF-α 238, TNF-α 308 and TNF-α 376 polymorphisms and recurrent pregnancy loss risk in Greek women. Methods This study included 94 Caucasian women with at least two miscarriages of unexplained aetiology, before the 20th week of gestation. The control group consisted of 89 Caucasian women of proven fertility, with no history of pregnancy loss. DNA samples were subjected to PCR amplification using specific primers. Sanger sequencing was applied to investigate the presence of TNF-α 238, TNF-α 308, TNF-α 376 polymorphisms in all samples. Results The TNF-α 238 and TNF-α 308 variants were both detected in RPL and control groups (7.45% vs 4.49 and 45.16% vs 36.73%, respectively), but with no statistically significant association (p-value 0.396 and 0.374, respectively). The TNF-α 376 variant was not detected at all in both control and RPL groups. When TNF-α 238 and TNF-α 308 genotypes were combined no association with RPL was detected (p-value = 0.694). In subgroup analysis by parity, RPL patients carrying the A allele reported less previous births. Conclusions This is the first study demonstrating TNF-α 238 and TNF-α 308 gene expression and the absence of TNF-α 376 variant in Greek women with RPL. However, no association emerged between each polymorphism studied and the occurrence of recurrent pregnancy loss. Accordingly, TNF-α -308G > A, −238G > A and -376G > A variants are not considered genetic markers for identifying women at increased risk of recurrent pregnancy loss in the Greek population.

Sign in / Sign up

Export Citation Format

Share Document