scholarly journals Metabolic Syndrome and the Risk of Breast Cancer and Subtypes by Race, Menopause and BMI

Cancers ◽  
2018 ◽  
Vol 10 (9) ◽  
pp. 299 ◽  
Author(s):  
Daniel Dibaba ◽  
Dejana Braithwaite ◽  
Tomi Akinyemiju
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Invasive Breast Cancer ◽  
Ductal Carcinoma ◽  
Breast Cancer Subtype ◽  
Normal Weight ◽  
Health Study ◽  
Cancer Subtypes ◽  
Increased Risk ◽  
Cox Proportional Hazard Regression

The objective of this study was to investigate the association of metabolic syndrome (MetS) with the risk of invasive breast cancer and molecular subtypes across race, menopause, and body mass index (BMI) groups. We examined the association of metabolic syndrome and its components with risk of invasive breast cancer among 94,555 female participants of the National Institute of Health-American Association of Retired Persons (NIH-AARP) Diet and Health Study, accounting for ductal carcinoma in situ as a competing risk. Cox proportional hazard regression with the Fine and Gray method was used to generate hazard ratios (HR) and 95% confidence intervals (CI) adjusting for baseline sociodemographic, behavioral, and clinical covariates. During a mean follow-up of 14 years, 5380 (5.7%) women developed breast cancer. Overall, MetS at baseline was associated with a 13% increased risk of breast cancer compared to women without MetS (HR: 1.13, 95% CI: 1.00, 1.27); similar estimates were obtained among postmenopausal women (HR: 1.14, 95% CI: 1.01, 1.29). MetS was associated with a slight but non-significantly increased risk of breast cancer among those with both normal weight and overweight/obesity, and those with estrogen receptor positive breast cancer subtype. In the NIH-AARP cohort, MetS was associated with an increased risk of breast cancer. Further studies are needed to definitively evaluate the association of MetS with triple negative breast cancer subtypes across all levels of BMI.

scholarly journals Genomic profiling defines variable clonal relatedness between invasive breast cancer and primary ductal carcinoma in situ

2021 ◽  
Author(s):  
Esther H. Lips ◽  
Tapsi Kumar ◽  
Anargyros Megalios ◽  
Lindy L. Visser ◽  
Michael Sheinman ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Single Cell ◽  
Ductal Carcinoma In Situ ◽  
Invasive Breast Cancer ◽  
Carcinoma In Situ ◽  
Ductal Carcinoma ◽  
Invasive Disease ◽  
Clonal Relatedness ◽  
Increased Risk

Pure ductal carcinoma in situ (DCIS) is being diagnosed more frequently through breast screening programmes and is associated with an increased risk of developing invasive breast cancer. We assessed the clonal relatedness of 143 cases of pure DCIS and their subsequent events using a combination of whole exome, targeted and copy number sequencing, supplemented by single cell analysis. Unexpectedly, 18% of all invasive events after DCIS were clonally unrelated to the primary DCIS. Single cell sequencing of selected pairs confirmed our findings. In contrast, synchronous DCIS and invasive disease (n=44) were almost always (93%) clonally related. This challenges the dogma that most invasive events after DCIS represent invasive transformation of the initial DCIS and suggests that DCIS could be an independent risk factor for developing invasive disease as well as a precursor lesion.

The association between volumetric breast density and breast cancer subtypes among women newly diagnosed with breast cancer.

2019 ◽  
Vol 37 (15_suppl) ◽  
pp. e13115-e13115 ◽  
Author(s):  
Wintana A. Balema ◽  
Tanya W. Moseley ◽  
Olena Weaver ◽  
Kenneth R. Hess ◽  
Abenaa M. Brewster
Keyword(s):  
Breast Cancer ◽  
Risk Factor ◽  
Breast Density ◽  
Breast Cancer Subtype ◽  
Breast Cancer Subtypes ◽  
Her2 Positive ◽  
Cancer Subtypes ◽  
Volumetric Density ◽  
Increased Risk ◽  
Cancer Subtype

e13115 Background: Increased breast density is a strong risk factor for breast cancer, women with high breast density have a four to six-fold increased risk of breast cancer compared to those with low density. This study explores breast density as a risk factor for specific breast cancer subtypes in order to improve risk assessment and screening recommendations for the general population. Methods: 790 women ≥ 18 years with breast cancer were evaluated who had volumetric percent density and volumetric density grade (VDG) assessed from diagnostic mammograms obtained within 9 months of diagnosis. Breast cancer subtypes were approximated based on the estrogen receptor (ER), progesterone (PR) and Her2neu status; ER and/or PR positive/Her2 negative or positive (HR+), ER and PR negative and Her2 positive (Her2-positive) and ER, PR and Her2 negative (TN). A linear model on a log scale was conducted to evaluate the associations between percentage volumetric breast density and VDG and breast cancer subtypes and race. Results: 36% of women were < 50 years and 64% ≥50 years, 76% were white, 12% Black and 12% other race. There was no significant association between breast cancer subtype with age ( P = 0.068), BMI ( P = 0.81) or race ( P = 0.11). Women with VDG 1 or 2 were more likely to have HR+ (81.3%) than Her2-positive (5.1%) or TN subtypes (13.6%) (P = 0.024). There was no significant association between the percent volumetric breast density and breast tumor subtype or race. Conclusions: We found a significant association between lower breast density measured using VDG and the HR+ breast cancer subtype. This suggests a potential opportunity for assessing volumetric density grade for the development of individualized risk prediction models and for the identification of women who may benefit from preventive therapy to reduce HR+ breast cancer risk.

scholarly journals Changes in Metabolic Syndrome Status and Breast Cancer Risk: A Nationwide Cohort Study

Cancers ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 1177
Author(s):  
In Young Choi ◽  
Sohyun Chun ◽  
Dong Wook Shin ◽  
Kyungdo Han ◽  
Keun Hye Jeon ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Metabolic Syndrome ◽  
Proportional Hazards ◽  
Screening Program ◽  
Cox Proportional Hazards ◽  
Cox Proportional Hazards Models ◽  
Hazard Ratios ◽  
Increased Risk ◽  
Health Screening Program ◽  
Design And Methods

Objective: To our knowledge, no studies have yet looked at how the risk of developing breast cancer (BC) varies with changes in metabolic syndrome (MetS) status. This study aimed to investigate the association between changes in MetS and subsequent BC occurrence. Research Design and Methods: We enrolled 930,055 postmenopausal women aged 40–74 years who participated in a biennial National Health Screening Program in 2009–2010 and 2011–2012. Participants were categorized into four groups according to change in MetS status during the two-year interval screening: sustained non-MetS, transition to MetS, transition to non-MetS, and sustained MetS. We calculated multivariable-adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for BC incidence using the Cox proportional hazards models. Results: At baseline, MetS was associated with a significantly increased risk of BC (aHR 1.11, 95% CI 1.06–1.17) and so were all of its components. The risk of BC increased as the number of the components increased (aHR 1.46, 95% CI 1.26–1.61 for women with all five components). Compared to the sustained non-MetS group, the aHR (95% CI) for BC was 1.11 (1.04–1.19) in the transition to MetS group, 1.05 (0.96–1.14) in the transition to non-MetS group, and 1.18 (1.12–1.25) in the sustained MetS group. Conclusions: Significantly increased BC risk was observed in the sustained MetS and transition to MetS groups. These findings are clinically meaningful in that efforts to recover from MetS may lead to reduced risk of BC.

scholarly journals Longitudinal obesity exposure over two decades is associated with subclinical myocardial injury: the Nord-Trondelag Health Study

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
M.N Lyngbakken ◽  
H Rosjo ◽  
K Hveem ◽  
T Omland
Keyword(s):  
Cardiac Troponin ◽  
Myocardial Injury ◽  
Troponin I ◽  
Linear Increase ◽  
Normal Weight ◽  
Public Institution ◽  
Health Study ◽  
Funding Source ◽  
Study Visit ◽  
Increased Risk

Abstract Background Obesity is associated with subclinical myocardial injury as quantified by concentrations of cardiac troponin, but whether excess weight history is associated with increased cardiac troponin I (cTnI) remains unclear. We aimed to explore the association of obesity with cTnI using different indices of cumulative obesity exposure. Methods We analyzed cTnI with a high-sensitivity assay in 14,157 participants with follow-up over two decades in the prospective observational Nord-Trøndelag Health (HUNT) Study at study visit 4 (2017–2019). All subjects were free from known cardiovascular disease at baseline, and we excluded subjects with BMI &lt;18.5 kg/m2. BMI was assessed at study visit 2 (1995–1997), 3 (2006–2008) and 4, and we categorized participants as normal weight (BMI &lt;25), overweight (BMI ≥25 to &lt;30) and obesity (BMI ≥30). At each study visit, BMI was designated a score of 0 (normal weight), 1 (overweight) or 2 (obesity), totaling a score from 0 to 6. Cumulative obesity exposure was calculated as average BMI above 25 kg/m2 between visits multiplied by the time between visits (excess BMI years, kg/m2 × years). Results Median age at visit 4 was 64.1 (range 40.9 to 101.5) years and 60% were women. Concentrations of cTnI were detectable in 77.2% of study participants, and were median 2.2 (1.3 to 3.9) ng/L. There was a linear increase in cTnI with increasing BMI score (p for trend &lt;0.001) and increasing BMI score was associated with increased risk of high cTnI (p for trend &lt;0.001; Table 1). For every 100 excess BMI years, there was a 15.6 (95% CI, 13.0 to 18.2) % increase in cTnI at study visit 4 (Figure 1). Conclusion Cumulative obesity exposure is associated with a linear increase in cTnI, a highly sensitive index of subclinical myocardial injury, reflecting the detrimental effect of long standing obesity on cardiovascular health. Figure 1. BMI years and cTnI Funding Acknowledgement Type of funding source: Public Institution(s). Main funding source(s): South-Eastern Norway Regional Health Authority

scholarly journals NCCN Task Force Report: Estrogen Receptor and Progesterone Receptor Testing in Breast Cancer by Immunohistochemistry

2009 ◽  
Vol 7 (Suppl_6) ◽  
pp. S-1-S-21 ◽  
Author(s):  
D. Craig Allred ◽  
Robert W. Carlson ◽  
Donald A. Berry ◽  
Harold J. Burstein ◽  
Stephen B. Edge ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Estrogen Receptor ◽  
Progesterone Receptor ◽  
Invasive Breast Cancer ◽  
Hormone Receptors ◽  
Ductal Carcinoma ◽  
Task Force ◽  
Strong Predictor ◽  
Surgical Oncology ◽  
Task Force Report

The NCCN Task Force on Estrogen Receptor and Progesterone Receptor Testing in Breast Cancer by Immunohistochemistry was convened to critically evaluate the extent to which the presence of the estrogen receptor (ER) and progesterone receptor (PgR) biomarkers in breast cancer serve as prognostic and predictive factors in the adjuvant and metastatic settings, and the ability of immunohistochemical (IHC) detection of ER and PgR to provide an accurate assessment of the expression of these biomarkers in breast cancer tumor tissue. The task force is a multidisciplinary panel of 13 experts in breast cancer who are affiliated with NCCN member institutions and represent the disciplines of pathology, medical oncology, radiation oncology, surgical oncology, and biostatistics. The main overall conclusions of the task force are ER is a strong predictor of response to endocrine therapy; ER status of all samples of invasive breast cancer or ductal carcinoma in situ (DCIS) should be evaluated by IHC; IHC measurements of PgR, although not as important clinically as ER, can provide useful information and should also be performed on all samples of invasive breast cancer or DCIS; IHC is the main testing strategy for evaluating ER and PgR in breast cancer and priority should be given to improve the quality of IHC testing methodologies; all laboratories performing IHC assays of ER and PgR should undertake formal validation studies to show both technical and clinical validation of the assay in use; and all laboratories performing IHC assays of hormone receptors in breast cancer should follow additional quality control and assurance measures as outlined in the upcoming guidelines from the American Society of Clinical Oncology and College of American Pathologists.

scholarly journals Expression of CD4, CD8 Biomarkers in Invasive Carcinoma of Breast with Clinicopathological Correlation

2021 ◽  
pp. 65-73
Author(s):  
C. Divyapriya ◽  
Aarthi Kannan ◽  
Vijayashree Raghavan
Keyword(s):  
Breast Cancer ◽  
T Lymphocytes ◽  
Invasive Breast Cancer ◽  
Triple Negative ◽  
Invasive Carcinoma ◽  
Tumour Size ◽  
Breast Cancer Subtype ◽  
Lymph Node Status ◽  
Breast Cancers ◽  
Cd8 T Lymphocytes

Introduction: Tumor infiltrating lymphocytes (TILs) are widely considered a key sign of the immune interaction between host and tumor, and potentially prognostic biomarkers of good or bad outcome in various cancers, including invasive breast cancer (IBC). Aim and Objectives: To correlate the expression of CD4, CD8 T-lymphocytes in invasive carcinoma breast with established markers of prognosis like tumour size, grade, lymph node status and molecular subtypes mainly ER, PR, Her 2Neu, Ki67 status, mainly the triple negative breast cancers(TNBC). Methodology: 58 Invasive breast carcinoma proven tissue blocks were subjected to immunohistochemistry and morphometric analysis for positive CD4, CD8 T-lymphocytes were done. Results:  Triple negative breast cancer subtype shows high TILs than other pathologic subtypes. Tumor interface CD8+ cells very well correlated with the pathological higher nodal stage. Majority CD4, CD8 positive cells were populated more towards the stromal and interface of the tumor microenvironment rather thatintratumoral. Conclusion: CD4+ and CD8+ counts may be a valuable independent prognostic tool in predicting the outcome in invasive breast cancer.

Abstract 3073: Metabolic Syndrome, Inflammation and Risk of Symptomatic Peripheral Artery Disease in Women: A Prospective Study

Circulation ◽  
2008 ◽  
Vol 118 (suppl_18) ◽  
Author(s):  
David Conen ◽  
Kathryn M Rexrode ◽  
Paul M Ridker ◽  
Aruna D Pradhan
Keyword(s):  
Metabolic Syndrome ◽  
Peripheral Artery Disease ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Intercellular Adhesion Molecule ◽  
Peripheral Artery ◽  
Risk Increase ◽  
Increased Risk ◽  
Multivariable Models ◽  
Artery Disease

Background Metabolic syndrome (MetS) includes a number of cardiovascular risk factors known to predict vascular disease. Little is known, however, about the interrelationships between MetS, inflammation and the risk of incident peripheral artery disease (PAD). Methods We conducted a prospective cohort study among 27111 women participating in the Women’s Health Study. Subjects were free of cardiovascular disease at baseline and followed for the incidence of symptomatic PAD (n=114) over a follow-up period of 13.3 years. We used Cox proportional-hazards models to compare the risk of PAD among women with and without the MetS. We also evaluated relationships between MetS and markers of subclinical inflammation including high sensitivity C-reactive protein (hsCRP) and soluble intercellular adhesion molecule-1 (sICAM-1) and adjusted for these biomarker levels in multivariable models. Results At study entry, 25.5% of participants had the MetS. Women with the MetS had a 62% increased risk of incident PAD (HR 1.62; 95% CI 1.10 –2.38). After multivariable adjustment, MetS remained significantly associated with incident PAD (Table ). Similar results were obtained when we assessed the risk of PAD according to the number of MetS defining traits (21% risk increase per additional trait) (Table ). Median plasma levels of hsCRP and sICAM-1 were 4.0 mg/L versus 1.53 mg/L (p<0.0001) and 374 ng/mL versus 333 ng/mL (p<0.0001) in women with and without MetS, respectively. From 0 to 5 MetS defining traits, median hsCRP levels gradually increased from 1.0 to 5.9 mg/L (p<0.0001) and median sICAM-1 levels increased from 321 to 413 ng/mL (p<0.0001). When hsCRP and sICAM-1 were added to multivariable models for incident PAD, risk estimates for the MetS were substantially attenuated and became non-significant (Table ). Conclusion Women with the MetS have an increased risk of incident PAD. This increased risk may be largely mediated by the effects of inflammation and/or endothelial activation. Metabolic Syndrome and Risk of PAD

Abstract P196: Bidirectional Association Between Hypertension and Gout: The Singapore Chinese Health Study

Circulation ◽  
2015 ◽  
Vol 131 (suppl_1) ◽  
Author(s):  
An Pan ◽  
Gim Gee Teng ◽  
Jian-Min Yuan ◽  
Woon-Puay Koh
Keyword(s):  
Smoking Status ◽  
Final Analysis ◽  
Normal Weight ◽  
Cox Proportional Hazards ◽  
Health Study ◽  
Increased Risk ◽  
Bidirectional Association ◽  
Singapore Chinese ◽  
Incident Cases

Introduction: Although it has been hypothesized that the hypertension-gout relation is bidirectional, few studies have addressed this hypothesis in a prospective setting, particularly in the Asian populations. Methods: We analyzed data from the Singapore Chinese Health Study (SCHS), a cohort of 63,257 Chinese aged 45-74 years at recruitment from 1993-98. The information about self reports of physician-diagnosed hypertension and gout was enquired at follow-ups I (1999-2004) and II (2006-2010). We included participants with complete data for both follow-ups and who were free of heart disease, stroke and cancer at follow-up I. For the analysis of hypertension and risk of incident gout, participants with prevalent gout were further excluded and the final analysis included 31,694 participants. For the analysis of gout and risk of incident hypertension, participants with prevalent hypertension were further excluded and the final analysis included 20,490 participants. Cox proportional hazards models were used to estimate multivariable-adjusted relative risks (RRs) and 95% confidence intervals (CIs) with adjustment for age, sex, years of interview, dialect group, education, smoking status, alcohol intake, physical activity, body mass index (BMI) and history of diabetes. Results: The mean age of the participants at baseline was 60.1 (SD 7.3) years, and the average follow-up year was 6.8 (SD 1.4) years. In the analysis of hypertension and risk of gout, 836 incident cases were identified. Compared to normotensive participants, hypertensive patients had a 93% increased risk of developing gout (RR 1.93; 95% CI 1.66-2.24). The association was slightly stronger in women (RR 2.09; 95% CI 1.69-2.58) compared to men (RR 1.72; 95% CI 1.39-2.14; P for interaction=0.056). The association was also stronger in normal weight adults (BMI <24 kg/m2; RR 2.25; 95% CI 1.82-2.77) compared to overweight/obese individuals (BMI ≥24 kg/m2; RR 1.66; 95% CI 1.34-2.04; P for interaction=0.03). In the parallel analysis of gout and risk of hypertension, 5491 participants reported to have newly diagnosed hypertension during the follow-up. Compared to participants without gout, those with gout had a 17% increased risk of developing hypertension (RR 1.17; 95% CI 1.01-1.35). The association was evident in men (RR 1.29; 95% CI 1.07-1.55) but not in women (RR 0.94; 95% CI 0.73-1.20; P for interaction=0.03). The association was present in normal weight adults (RR 1.34; 95% CI 1.09-1.64) but not among overweight/obese individuals (RR 0.99; 95% CI 0.80-1.23; P for interaction=0.03). Conclusions: Our results provide compelling evidence that the hypertension-gout association is bidirectional in Chinese population. The potential interactions of the bidirectional association with sex and obesity deserve further investigations.

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