Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Researchers identify biological markers that may indicate poor breast cancer prognosis

27.05.2009
A team of researchers has found an association between breast cancer survival and two proteins that, when present in the blood in high levels, are indicators of inflammation.

Using data from the Health, Eating, Activity and Lifestyle (HEAL) study sponsored by the National Cancer Institute, part of the National Institutes of Health, the researchers found that breast cancer patients with elevated levels of C-reactive protein (CRP) and serum amyloid A (SAA) were approximately two to three times more likely to die sooner or have their cancer return than those patients who had lower levels of these proteins, regardless of the patient's age, tumor stage, race, body mass index, or history of previous cardiovascular issues. The results of this study were published online, May 26, 2009, in the Journal of Clinical Oncology.

Inflammation is an immune response. It is part of the body's natural defense against harmful elements, such as pathogens, damaged cells, or other irritants, and helps facilitate the healing process. Inflammation can be classified as either acute or chronic. Acute inflammation is the short-term, beneficial response to harmful stimuli. Chronic inflammation is a disease in which the inflammatory state persists and may result in tissue damage.

CRP and SAA accumulate in the blood in response to inflammation. CRP is produced by the liver, as well as by fat cells, and has several immune-related functions. SAA, which is also secreted by the liver, is involved in both the transport of cholesterol from the liver to the bile, and the recruitment of immune cells to sites of inflammation. Both proteins are found in higher concentrations in the blood of people with low-grade chronic inflammation. Chronic inflammation is believed to contribute to the development and spread of breast cancer, and breast cancer survivors with chronic inflammation may be at a higher risk of recurrence. Elevated CRP is also linked to increased risk of heart disease.

"This HEAL study of inflammation and breast cancer survival contributes uniquely to this emerging research in that it is the largest study to date to examine this association," said Rachel Ballard-Barbash, M.D., M.P.H., a co-author of the study and principal investigator of the HEAL study at NCI, in the Division of Cancer Control and Population Sciences. "Because of the detailed data on diet, physical activity and weight in the HEAL study, we were able to examine the extent to which these health behaviors altered this association."

This study joins an increasing body of research indentifying CRP and SAA as indicators of reduced survival from cancer. Previous studies have shown an association between elevated levels of CRP and poor survival outcomes in metastatic prostate cancer, as well as gastroesophageal, colorectal, inoperable non-small-cell lung, and pancreatic cancers. In other studies, a similar association was shown for SAA and gastric cancer and renal cell carcinoma. Although research has indicated that inflammation may play a role in the progression of cancer, the exact mechanism by which this happens has been unclear.

This is one of many papers to come out of NCI's HEAL study, an initiative designed to investigate the effects that physical activity, eating habits, weight patterns, diet, hormones, and other factors have on breast cancer prognosis. For this study, 1,183 women with early-stage breast cancer were recruited from three cancer centers, including the Fred Hutchinson Cancer Research Center in Seattle, the University of New Mexico, Albuquerque, and the University of Southern California, Los Angeles. Participants completed a lifestyle questionnaire when they joined the study and the researchers collected blood samples (which were analyzed for CRP and SAA levels) and height and weight measurements at a subsequent visit two years later (approximately 2.5 years after their initial diagnosis). The women will be followed for a total of 10 years.

This is the first large, population-based study to look at the relationship between breast cancer survivorship and biomarkers of inflammation that were measured after treatment. Because the biomarkers were measured approximately 31 months after diagnosis, enough time had passed so that the researchers could accurately assess the effect of chronic inflammation, as opposed to acute inflammation that may have been a result of the breast cancer treatments each patient received.

The researchers examined the relationships between the inflammation biomarkers and both overall survival and disease-free survival. Overall survival was defined as the amount of time from the follow-up appointment until the patient died (from any cause) or the study period ended. Disease-free survival was defined as the amount of time from the follow-up appointment until the patient's breast cancer returned, another, new cancer was diagnosed, the patient died, or the study period ended. The researchers found that elevated levels of both SAA and CRP were associated (statistically significant) with reduced overall survival. Women with high levels of SAA were three times as likely to die sooner, and women with high levels of CRP were two times as likely to die sooner. They found similar, but weaker, associations with disease-free survival, in that women with high levels of SAA were two times as likely to die of have their cancer return, and women with high levels of CRP were more than 1.5 times as likely to die or have their cancer return. This suggests that SAA and CRP may be more closely related to overall survival than disease-free survival. More research is needed to get a better understanding of these associations and other potential mediating factors, in order to create more precise risk estimates.

"Inflammation has been associated with several modifiable risk factors, such as obesity, low physical activity, and cardiovascular disease, all of which can affect a cancer survivor's prognosis," said Robert Croyle, Ph.D., director of NCI's Division of Cancer Control and Population Sciences. "Investigating the effect that reductions in these markers, through medications or lifestyle changes, can have on breast cancer recurrence and survival will be an important next step."

NCI leads the National Cancer Program and the NIH effort to dramatically reduce the burden of cancer and improve the lives of cancer patients and their families, through research into prevention and cancer biology, the development of new interventions, and the training and mentoring of new researchers. For more information about cancer, please visit the NCI Web site at http://www.cancer.gov or call NCI's Cancer Information Service at 1-800-4-CANCER (1-800-422-6237).

To learn more about the Health, Eating, Activity, and Lifestyle (HEAL) study, please visit: http://appliedresearch.cancer.gov/surveys/heal/

Reference: Pierce BL, Ballard-Barbash R, Bernstein L, Baumgartner RN, Neuhouser ML, Wener MH, Baumgartner KB, Gilliand FD, Sorensen BE, McTieran A, Ulrich CM. Elevated Biomarkers of Inflammation Are Associated With Reduced Survival Among Breast Cancer Patients. Online May 26, 2009, J Clin Oncol 27.

NCI Office of Media Relations | EurekAlert!
Further information:
http://www.nih.gov

More articles from Life Sciences:

nachricht Topologische Quantenchemie
21.07.2017 | Max-Planck-Institut für Chemische Physik fester Stoffe

nachricht Topological Quantum Chemistry
21.07.2017 | Max-Planck-Institut für Chemische Physik fester Stoffe

All articles from Life Sciences >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: 3-D scanning with water

3-D shape acquisition using water displacement as the shape sensor for the reconstruction of complex objects

A global team of computer scientists and engineers have developed an innovative technique that more completely reconstructs challenging 3D objects. An ancient...

Im Focus: Manipulating Electron Spins Without Loss of Information

Physicists have developed a new technique that uses electrical voltages to control the electron spin on a chip. The newly-developed method provides protection from spin decay, meaning that the contained information can be maintained and transmitted over comparatively large distances, as has been demonstrated by a team from the University of Basel’s Department of Physics and the Swiss Nanoscience Institute. The results have been published in Physical Review X.

For several years, researchers have been trying to use the spin of an electron to store and transmit information. The spin of each electron is always coupled...

Im Focus: The proton precisely weighted

What is the mass of a proton? Scientists from Germany and Japan successfully did an important step towards the most exact knowledge of this fundamental constant. By means of precision measurements on a single proton, they could improve the precision by a factor of three and also correct the existing value.

To determine the mass of a single proton still more accurate – a group of physicists led by Klaus Blaum and Sven Sturm of the Max Planck Institute for Nuclear...

Im Focus: On the way to a biological alternative

A bacterial enzyme enables reactions that open up alternatives to key industrial chemical processes

The research team of Prof. Dr. Oliver Einsle at the University of Freiburg's Institute of Biochemistry has long been exploring the functioning of nitrogenase....

Im Focus: The 1 trillion tonne iceberg

Larsen C Ice Shelf rift finally breaks through

A one trillion tonne iceberg - one of the biggest ever recorded -- has calved away from the Larsen C Ice Shelf in Antarctica, after a rift in the ice,...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

Closing the Sustainability Circle: Protection of Food with Biobased Materials

21.07.2017 | Event News

»We are bringing Additive Manufacturing to SMEs«

19.07.2017 | Event News

The technology with a feel for feelings

12.07.2017 | Event News

 
Latest News

Ultrathin device harvests electricity from human motion

24.07.2017 | Power and Electrical Engineering

Scientists announce the quest for high-index materials

24.07.2017 | Materials Sciences

ADIR Project: Lasers Recover Valuable Materials

24.07.2017 | Materials Sciences

VideoLinks
B2B-VideoLinks
More VideoLinks >>>