Adiposity, inflammation, and breast cancer pathogenesis in Asian Women
Journal
Cancer Prevention Research
Journal Volume
11
Journal Issue
4
Pages
227-236
Date Issued
2018
Author(s)
Iyengar N.M.
Zhou X.K.
Giri D.D.
Falcone D.J.
Winston L.A.
Wang H.
Williams S.
Hsueh T.-H.
Hudis C.A.
Dannenberg A.J.
Abstract
Obesity is associated with white adipose tissue (WAT) inflammation in the breast, elevated levels of the estrogen biosynthetic enzyme, aromatase, and systemic changes that predispose to breast cancer development. We examined whether WAT inflammation and its associated systemic effects correlate with body fat levels in an Asian population where body mass index (BMI) is not an accurate assessment of obesity and cancer risk. We also investigated whether biologic differences could account for the greater proportion of premenopausal estrogen receptor (ER)-positive breast cancer in Asian versus Western countries. Breast WAT and fasting blood were prospectively collected from Taiwanese women undergoing mastectomy for breast cancer treatment. Body composition was measured in a subgroup using bioelectrical impedance analysis. WAT inflammation was defined by the presence of crown-like structures of the breast, which are composed of dead or dying adipocytes surrounded by macrophages. Findings were compared with U.S. Caucasian women. In the Taiwanese cohort (n = 72), breast WAT inflammation was present in 31 (43%) women and was associated with elevated BMI (P < 0.01) and increased levels of body fat (P < 0.01), C-reactive protein (P = 0.02), triglycerides (P < 0.01), insulin resistance scores (P = 0.04), and lower HDL cholesterol (P < 0.01). ER+ tumors were associated with greater body fat versus other subtypes (P = 0.03). Compared with U.S. Caucasians (n = 267), Taiwanese women had larger breast adipocytes despite lower BMI after adjusting for BMI and menopausal status (P = 0.01). A subclinical inflammatory state associated with increased adiposity and metabolic dysfunction could contribute to breast cancer pathogenesis in Asian women. ? 2018 American Association for Cancer Research.
SDGs
Other Subjects
adult; Article; Asian; body fat; breast carcinogenesis; cohort analysis; cross-sectional study; ethnic difference; European American; female; human; human tissue; inflammation; major clinical study; obesity; priority journal; race difference; Taiwanese; white adipose tissue; Asian continental ancestry group; Caucasian; complication; female; follow up; immunology; inflammation; middle aged; obesity; pathology; prognosis; statistics and numerical data; triple negative breast cancer; Adipose Tissue, White; Adiposity; Adult; Asian Continental Ancestry Group; Cohort Studies; Cross-Sectional Studies; European Continental Ancestry Group; Female; Follow-Up Studies; Humans; Inflammation; Middle Aged; Prognosis; Triple Negative Breast Neoplasms
Publisher
American Association for Cancer Research Inc.
Type
journal article