Odds of breast cancer by molecular subtype: analysis of MEND study

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Oncotarget

published “Association of high-sensitivity C-reactive protein and odds of breast cancer by molecular subtype: analysis of the MEND study” which reported that the authors examined the association of high-sensitivity CRP with odds of BC by molecular subtype among Nigerian women.

Among 296 newly diagnosed BC cases and 259 healthy controls, multivariable logistic regression models were used to estimate adjusted odds ratios and 95% confidence intervals for the association between hsCRP and odds of BC overall and by molecular subtype.

High hsCRP was observed in 57% of cases and 31% of controls and was associated with 4 times the odds of BC after adjusting for socio-demographic, reproductive, and clinical variables.

High hsCRP was associated with increased odds of TNBC, luminal A BC, and HER2-enriched BC.

Future studies are necessary in this population to further evaluate a potential role for CRP as a predictive biomarker for BC.

Dr. Tomi Akinyemiju from The Duke University said, “In 2018, there were over 2 million cases and 0.6 million deaths from breast cancer (BC), making it the most common cancer globally among women.”

BC in Nigeria is characterized by disproportionately aggressive molecular subtypes, with exceptionally high rates of triple-negative BC, similar to BC in other countries in West Africa and among African American women in the United States.

Another systematic review found no strong evidence for an association between circulating CRP and BC risk among prospective studies, while a third systematic review observed a modest but significant positive association.

Analyses of the Women’s Health Study found that baseline CRP level was not associated with risk of invasive BC during 10 years of follow-up, however, in the Women’s Health Initiative, pre-diagnostic CRP was associated with an increased BC risk among lean women, whereas no association was observed among overweight-obese women.

On the contrary, another study in Europe found a positive association between CRP levels and postmenopausal BC risk restricted to women with excess adiposity.

Notably, few epidemiological studies have analyzed the relationship between CRP levels and BC by molecular subtype, and results have been conflicting. One study in Italy reported a significant association between high CRP and TNBC and luminal B premenopausal BC, while another study in China found an association only for hormone receptor positive and HER2 negative BC.

The Akinyemiju Research Team concluded in their Oncotarget Research Output, “our analysis revealed a positive association between hsCRP and odds of BC, overall and for all molecular subtypes. Because CRP is an easily measured biomarker in the blood, it may represent a useful predictor of BC in the Nigerian context. We urge larger studies, preferably prospective cohort studies, among women of African descent to further characterize this association.”

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