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Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors

  • Epidemiology
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Abstract

Introduction Inflammatory status may be an important prognostic factor for breast cancer. Correlates of markers of inflammation in breast cancer survivors have not been thoroughly evaluated. Methods Using data from, the Health, Eating, Activity, and Lifestyle (HEAL) Study (a population-based, multiethnic prospective cohort study of female breast cancer patients) we evaluated the associations between circulating markers of inflammation (C-reactive protein [CRP] and serum amyloid A [SAA], measured ∼31 months after diagnosis) and several demographic, lifestyle, and clinical characteristics in 741 disease-free breast cancer survivors. Analysis of variance and regression methods were used for statistical analyses of log-transformed values of CRP and SAA. Results After adjusting for age, BMI, ethnicity, and study site, higher concentrations of CRP were associated with increasing concentration of SAA (P-trend < 0.0001), increasing age (P-trend < 0.0001), increasing BMI (P-trend < 0.0001), increasing waist circumference (P-trend < 0.0001), positive history of heart failure (P = 0.0007), decreasing physical activity (P-trend = 0.005), Hispanic ethnicity (P = 0.05 vs. non-Hispanic white), and current smoking (P = 0.03 vs. never smoking). Vitamin E supplementation (P = 0.0005), tamoxifen use (P = 0.008), and radiation treatment (compared to no chemotherapy or radiation; P = 0.04) were associated with reduced CRP. Associations of CRP with clinical characteristics were not significant in the adjusted models. In a multivariate analysis, CRP showed significant associations with waist circumference, BMI, age, history of heart failure, tamoxifen use, and vitamin E supplementation (R2 = 0.35). Similar, yet fewer, associations were observed for SAA (R2 = 0.19). Conclusions This study highlights important correlates of inflammatory status in breast cancer patients. Our results are consistent with those from similar studies of healthy women.

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Acknowledgements

The Authors would like to thank Dr. Peter Campbell and Dr. Kristen Campbell for their helpful comments related to this manuscript, and the HEAL participants for their ongoing dedication to this study. This study was supported through National Cancer Institute contracts N01-CN-75036–20, NO1-CN-05228, NO1-PC-67010, U54-CA116847 and training grant R25-CA94880. A portion of this work was conducted through the Clinical Research Center at the University of Washington and supported by the National Institutes of Health grant M01-RR-00037, and University of New Mexico grant, NCRR M01-RR-0997. Data collection for the Women’s CARE Study at the University of Southern California was supported by contract N01-HD-3-3175 from the National Institute of Child Health and Human Development and patient identification was supported in part by contract 050Q-8709-S1528 from the California Department of Health Services.

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Authors and Affiliations

  1. Cancer Prevention Program, Fred Hutchinson Cancer Research Center, 1100 Fairview Ave N, M4-B402, Seattle, WA, 98109-1024, USA

    Brandon L. Pierce, Marian L. Neuhouser, Bess Sorensen, Anne McTiernan & Cornelia M. Ulrich

  2. Epidemiology Research Program, Fred Hutchinson Cancer Research Center, Seattle, WA, USA

    Brandon L. Pierce

  3. Institute for Public Health Genetics, University of Washington, Seattle, WA, USA

    Brandon L. Pierce

  4. Department of Laboratory Medicine, University of Washington, Seattle, WA, USA

    Mark H. Wener

  5. Department of Cancer Etiology, City of Hope National Medical Center, Duarte, CA, USA

    Leslie Bernstein

  6. Department of Epidemiology and Population Health, University of Louisville, Louisville, KY, USA

    Richard N. Baumgartner & Kathy B. Baumgartner

  7. Applied Research Program, Division of Cancer Control and Population Sciences, National Cancer Institute, Bethesda, MD, USA

    Rachel Ballard-Barbash

  8. Department of Preventive Medicine, University of Southern California, Los Angeles, CA, USA

    Frank D. Gilliland

  9. Department of Epidemiology, University of Washington, Seattle, WA, USA

    Anne McTiernan & Cornelia M. Ulrich

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  1. Brandon L. Pierce
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Correspondence to Cornelia M. Ulrich.

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Pierce, B.L., Neuhouser, M.L., Wener, M.H. et al. Correlates of circulating C-reactive protein and serum amyloid A concentrations in breast cancer survivors. Breast Cancer Res Treat 114, 155–167 (2009). https://doi.org/10.1007/s10549-008-9985-5

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