title: Pre-diagnostic high-sensitive C-reactive protein and breast cancer risk, recurrence, and survival.
abstract: Inflammation may initiate and promote breast cancer development, and be associated with elevated circulating levels of inflammation markers. A total of eight 130 initially healthy women, participated in the population-based Tromsø study (1994-2008). Pre-diagnostic high-sensitivity C-reactive protein (hs-CRP) was assessed. During 14.6 years of follow-up, a total of 192 women developed invasive breast cancer. These cases were followed for additional 7.2 years. Detailed medical records were obtained. We observed an overall positive dose-response relationship between pre-diagnostic hs-CRP and breast cancer risk (hazard ratio (HR) = 1.06, 95 % CI 1.01-1.11). Postmenopausal women with above median levels of hs-CRP (>1.2 mg/l) had a 1.42 (95 % CI 1.01-2.00) higher breast cancer risk compared to postmenopausal women with hs-CRP below median. Postmenopausal women, who were hormone replacement therapy non-users, and were in the middle tertile (0.8-1.9 mg/l), or highest tertile of hs-CRP (>1.9 mg/l), had a 2.31 (95 % CI 1.31-4.03) and 2.08 (95 % CI 1.16-3.76) higher breast cancer risk, respectively, compared with women in the lowest tertile. For each unit increase in pre-diagnostic hs-CRP levels (mg/l), we observed an 18 % increase in disease-free interval (95 % CI 0.70-0.97), and a 22 % reduction in overall mortality (95 % CI 0.62-0.98). Our study supports a positive association between pre-diagnostic hs-CRP and breast cancer risk. In contrast, increased pre-diagnostic hs-CRP was associated with improved overall mortality, but our findings are based on a small sample size, and should be interpreted with caution.
authors.affiliation: Department of Oncology, The Cancer Centre, Ullevål, Oslo University Hospital HF, 0424, Oslo, Norway. h.frydenberg@gmail.com.
authors.forename: H
authors.initials: H
authors.lastname: Frydenberg
authors.affiliation: Department of Oncology, The Cancer Centre, Ullevål, Oslo University Hospital HF, 0424, Oslo, Norway.|Institute of Clinical Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: I
authors.initials: I
authors.lastname: Thune
authors.affiliation: Department of Oncology, The Cancer Centre, Ullevål, Oslo University Hospital HF, 0424, Oslo, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Lofterød
authors.affiliation: Molecular Pathology Research Group, Department of Medical Biology, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: E S
authors.initials: ES
authors.lastname: Mortensen
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: A E
authors.initials: AE
authors.lastname: Eggen
authors.affiliation: Department of Oncology, University Hospital of Northern Norway, Tromsø, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Risberg
authors.affiliation: Department of Oncology, The Cancer Centre, Ullevål, Oslo University Hospital HF, 0424, Oslo, Norway.
authors.forename: E A
authors.initials: EA
authors.lastname: Wist
authors.affiliation: Department of Oncology, The Cancer Centre, Ullevål, Oslo University Hospital HF, 0424, Oslo, Norway.
authors.forename: V G
authors.initials: VG
authors.lastname: Flote
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.|Department of Microbiology and Infection Control, University Hospital of North Norway, Tromsø, Norway.
authors.forename: A-S
authors.initials: AS
authors.lastname: Furberg
authors.affiliation: Department of Community Medicine, Faculty of Health Sciences, UiT, The Arctic University of Norway, Tromsø, Norway.
authors.forename: T
authors.initials: T
authors.lastname: Wilsgaard
authors.affiliation: Department of Clinical Medicine, Centre for Cancer Biomarkers CCBIO, University of Bergen, Bergen, Norway.
authors.forename: L A
authors.initials: LA
authors.lastname: Akslen
authors.affiliation: Fred Hutchinson Cancer Research Center, Seattle, WA, USA.
authors.forename: A
authors.initials: A
authors.lastname: McTiernan
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D001943:Breast Neoplasms / Q000378:metabolism / Q000401:mortality* / Q000473:pathology*; D002097:C-Reactive Protein / Q000378:metabolism*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007249:Inflammation / Q000378:metabolism; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000378:metabolism / Q000401:mortality / Q000473:pathology*; D017698:Postmenopause / Q000378:metabolism; D012307:Risk Factors
chemical_list: D015415:Biomarkers; D002097:C-Reactive Protein
keywords: Breast cancer; CRP; Inflammation markers