Presence of crown-like structures in breast adipose tissue proximal and distant to tumor site among African American and White women with invasive breast cancer Público
Mitchell, Ellen (Spring 2022)
Abstract
Background: The etiologic drivers and clinical outcomes of crown-like structures in breast adipose tissue (CLS-B), a local marker of inflammation, within breast cancer patients remain largely under researched, especially among diverse populations. Inconsistencies in the methodologies used to detect and evaluate CLS-B likely contribute to the heterogenous findings.
Methods: CLS-B in tissue samples containing tumor (CLS-BT) were assessed in 23 African American and 43 White women with invasive breast cancer. Tissue with tumor evidence was immunohistochemically stained for CD68 to visually assess CLS-BT presence (yes vs. no). Patient demographics and clinical outcomes were abstracted from medical records and modeled in logistic regression as either risk factors (demographic and lifestyle information) or outcomes (tumor characteristics) of CLS-BT to calculate odds ratios (ORs) and 95% confidence intervals (CIs). Associations between CLS-BT presence and progression-free survival (PFS) were calculated as hazard ratios (HRs) with 95% CIs using Cox proportional hazards models. Results were compared to previous analyses of CLS-B detected in tissue samples uninvolved by tumor (CLS-BnT).
Results: A weak association between race (African American vs. White) and CLS-BT presence was observed in multivariable regression (OR = 0.54, 95% CI = 0.16, 1.82). Obesity (body mass index [BMI] ≥ 30) (OR = 1.49, 95% CI = 0.35, 6.41), age ≥ 60 at diagnosis (OR = 1.69, 95% CI = 0.47, 6.06) and having ever been a smoker (OR = 3.20, 95% CI = 1.01, 10.1) were positively associated with CLS-BT presence. A weak, inverse association between CLS-BT presence and PFS was observed (HR = 0.67, 95% CI = 0.12, 3.62). The percent agreement of CLS-BT and CLS-BnT within the sample of 66 was approximately 64%, and the percent agreement among those without CLS-BnT or CLS-BT was 74%.
Conclusions: CLS-BT was not meaningfully different across demographic factors including race, but some evidence suggests that it is more common among women of older age, with increased adiposity, and among smokers. There is some evidence of a correlation between CLS-BnT and CLS-BT presence within the same study population. Standardized guidelines for CLS-B assessment are needed.
Table of Contents
TABLE OF CONTENTS …………………………………………………………………... 1
CHAPTER
I MANUSCRIPT ……………………………………………………………………… 2
ABSTRACT …………………………………………………………………. 3
INTRODUCTION …………………………………...….....……………… 5
METHODS ………………………………………………………………….. 7
RESULTS ………………………………...…………………………………. 12
DISCUSSION …………………………………………………………..….. 15
REFERENCES ………………………………………………………………. 19
TABLES & FIGURES ………………………………………………….….. 21
II EXTENDED RESULTS …………………………………………………………….. 31
LITERATURE REVIEW ………………………………………………….. 32
DIRECTED ACYCLIC GRAPH ………………………………………….. 40
SUPPLEMENTARY TABLES …………………………………………….. 42
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