Non-tumor breast tissue from obese black women exhibit higher prevalence of crown like structures and inflammation compared to Caucasians Open Access

Abstract

Background: BC rates are higher among NHW women, however, there is an increased BC incidence risk and worse prognosis among NHB [1]. These disparities maybe partly due to the higher rates of obesity in NHB population. In this pilot study, we conducted an epidemiologic investigation of obesity, CLS prevalence, and associated outcomes in a retrospective cohort of NHB and NHW women diagnosed with BC, and we hypothesized that the presence and density of CLS-B are more prevalent among NHB than NHW women.

Methods: The study population consisted of 283 NHB and NHW women. Preoperative height and weight were used to calculate BMI measured using cut-points based on World Health Organization (WHO) definitions[2]. CLS-B presence was defined as any CLS-B observed on the tissue section examined. The severity of breast WAT inflammation was quantified as number of CLS-B per square centimeter of breast WAT with the median as the cutoff to differentiate between severe and mild inflammation. To assess whether race and BMI were associated with CLS-B presence and breast WAT inflammation, we evaluated relationships using multivariable logistic regression to determine prevalence odds ratios (PORs) and 95% confidence intervals (CIs) for the presence of CLS-B.

Results: A total of 155 (53%) of the women where NHB and the remaining were NHW. The higher proportion of obese women were NHB, while a higher proportion of normal weight women were NHW. The age-adjusted prevalence odds of having presence of any CLS-B was 1.15 times [95% CI (0.69, 1.92] for NHB compared to NHW women. The adjusted prevalence odds of presence of any CLS-B was highest among obese women when compared to normal weight women [ POR = 5.42; 95% CI (2.72, 10.82)]. NHB women were approximately 83% more likely to have severe breast WAT inflammation compared to NHW women [POR=1.83; 95% CI (0.937, 3.59]. The adjusted prevalence odds of severe breast WAT inflammation among women with BMI ≥30kg/m² was 3.60 [95% CI (1.76, 7.37)] compared to women with BMI ≤ 29.9kg/m².

Conclusion: Our work demonstrates that CLS-B presence and breast WAT inflammation is associated with higher BMI among NHB women with breast cancer compared to NHW women. 

Table of Contents

Table of Contents

INTRODUCTION.. 1

METHODS. 4

Study population and biospecimen acquisition. 4

Demographics and clinical characteristics. 5

CLS-B Analysis. 6

CLS- B density or Breast WAT inflammation. 7

RESULTS. 8

DISCUSSION.. 11

CONCLUSIONS. 14

REFERENCES. 16

TABLES. 20

FIGURES. 26

About this Master's Thesis

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School	Rollins School of Public Health
Department	Epidemiology
Subfield / Discipline	Epidemiology - MPH & MSPH
Degree	M.P.H.
Submission	Master's Thesis
Language	English
Research Field	Health Sciences, Epidemiology
Keyword	Inflammation Race Obesity Macrophages Crown-like-structures Breast Cancer
Committee Chair / Thesis Advisor	Dr. Lauren E. McCullough, Emory University

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