Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk, recurrence, and survival

• Published in: Breast cancer research and treatment 2016-01, Vol.155 (2), p.345-354
• Main Authors: Frydenberg, H., Thune, I., Lofterød, T., Mortensen, E. S., Eggen, A. E., Risberg, T., Wist, E. A., Flote, V. G., Furberg, A-S, Wilsgaard, T., Akslen, L. A., McTiernan, A.
• Format: Article
• Language: English
• Subjects: Adult; Aged; Aged, 80 and over; Biomarkers - metabolism; Breast cancer; Breast Neoplasms - metabolism; Breast Neoplasms - mortality; Breast Neoplasms - pathology; C-reactive protein; C-Reactive Protein - metabolism; Cancer research; Cancer therapies; Development and progression; Epidemiology; Female; Follow-Up Studies; Health aspects; Humans; Inflammation; Inflammation - metabolism; Medical records; Medicine; Medicine & Public Health; Middle Aged; Mortality; Neoplasm Recurrence, Local - metabolism; Neoplasm Recurrence, Local - mortality; Neoplasm Recurrence, Local - pathology; Oncology; Postmenopausal women; Postmenopause - metabolism; Proteins; Recurrence (Disease); Risk Factors; Tumorigenesis; Women's health
• ISSN: 0167-6806; 1573-7217
• DOI: 10.1007/s10549-015-3671-1

Inflammation may initiate and promote breast cancer development, and be associated with elevated circulating levels of inflammation markers. A total of eight 130 initially healthy women, participated in the population-based Tromsø study (1994–2008). Pre-diagnostic high-sensitivity C-reactive protein (hs-CRP) was assessed. During 14.6 years of follow-up, a total of 192 women developed invasive breast cancer. These cases were followed for additional 7.2 years. Detailed medical records were obtained. We observed an overall positive dose–response relationship between pre-diagnostic hs-CRP and breast cancer risk (hazard ratio (HR) = 1.06, 95 % CI 1.01–1.11). Postmenopausal women with above median levels of hs-CRP (>1.2 mg/l) had a 1.42 (95 % CI 1.01–2.00) higher breast cancer risk compared to postmenopausal women with hs-CRP below median. Postmenopausal women, who were hormone replacement therapy non-users, and were in the middle tertile (0.8–1.9 mg/l), or highest tertile of hs-CRP (>1.9 mg/l), had a 2.31 (95 % CI 1.31–4.03) and 2.08 (95 % CI 1.16–3.76) higher breast cancer risk, respectively, compared with women in the lowest tertile. For each unit increase in pre-diagnostic hs-CRP levels (mg/l), we observed an 18 % increase in disease-free interval (95 % CI 0.70–0.97), and a 22 % reduction in overall mortality (95 % CI 0.62–0.98). Our study supports a positive association between pre-diagnostic hs-CRP and breast cancer risk. In contrast, increased pre-diagnostic hs-CRP was associated with improved overall mortality, but our findings are based on a small sample size, and should be interpreted with caution.