Detection of crown-like structures in breast adipose tissue and clinical outcomes among African-American and White women with breast cancer

• Authors: Maret L. Maliniak, Emory University; Aswathy Miriam Cheriyan, Emory University; Mark E. Sherman, Mayo Clinic; Yuan Liu, Emory University; Keerthi Gogineni, Emory University; Jiaqi Liu, Emory University; Jiabei He, Emory University; Uma Krishnamurti, Emory University; Jasmine Miller-Kleinhenz, Emory University; Ryan Ashiqueali, Emory University; Jinjing He, Emory University; Rami Yacoub, Emory University; Lauren McCullough, Emory University
• Journal Title: BREAST CANCER RESEARCH
• Volume: Volume 22
• Publisher: BMC | 2020-06-17
• Type of Work: Article | Final Publisher PDF
• Publisher DOI: http://doi.org/10.1186/s13058-020-01308-4
• Subjects: Health Sciences, Oncology; Health Sciences, Public Health; Sociology, Ethnic and Racial Studies; Health Sciences, Health Care Management
• Keywords: Crown-like structures; Breast adipose tissue; Obesity; Progression-free survival; Breast cancer outcome disparity

Abstract

Background Crown-like structures in breast adipose tissue (CLS-B), composed of necrotic adipocytes encircled by macrophages, are associated with obesity and hypothesized to worsen breast cancer prognosis; however, data are sparse, particularly in multi-racial populations. Methods We assessed specimens for CLS-B from 174 African-American and 168 White women with stage I–III breast cancer treated by mastectomy. Benign breast tissue from an uninvolved quadrant was immunohistochemically stained for CD68 to determine CLS-B presence and density (per cm2 of adipose tissue). Demographic and lifestyle factors, collected via medical record review, were analyzed for associations with CLS-B using logistic regression. Multivariable Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between CLS-B and overall (OS) or progression-free (PFS) survival. Results Detection of any CLS-B was similar between African-American (32%) and White (29%) patients with no evidence of an association between race and CLS-B in multivariable models (OR = 0.82, 95% CI = 0.49–1.36). Detection of CLS-B was associated with obesity (OR = 4.73, 95% CI = 2.48–9.01) and age ≥ 60 years at diagnosis (OR = 1.78, 95% CI = 0.99–3.21). There was some evidence of associations with parity and current smoking status. Detection of CLS-B was not associated with OS (HR = 1.02, 95% CI = 0.55–1.87) or PFS (HR = 0.99, 95% CI = 0.59–1.67). Conclusions Our results show a strong, positive association between BMI and CLS-B in non-tumor tissue similar to previous findings. Detection of CLS-B did not vary by race and was not associated with worse OS or PFS.