TY - JOUR
T1 - Prognostic Value of Pre-treatment Plasma C-Reactive Protein in Patients with Early-Stage Breast Cancer
AU - Andersen, Høgni H
AU - Bojesen, Stig E
AU - Johansen, Julia S
AU - Ejlertsen, Bent
AU - Berg, Tobias
AU - Tuxen, Malgorzata
AU - Madsen, Kasper
AU - Danø, Hella
AU - Flyger, Henrik
AU - Jensen, Maj-Britt
AU - Nielsen, Dorte L
PY - 2024/5/1
Y1 - 2024/5/1
N2 - BACKGROUND: Breast cancer incidence is now the highest among all cancers and accountable for 6.6% of all cancer-related deaths worldwide. Studies of the prognostic utility of plasma C-reactive protein (CRP) measurement in early-stage breast cancer have given discrepant results.METHODS: We identified 6,942 patients in the Danish Breast Cancer Cooperative Group database with early-stage breast cancer diagnosed between 2002 and 2016 who had a measure of pretreatment plasma CRP. Outcomes were recurrence-free interval and survival for a period up to 10 years. We analyzed associations with plasma CRP using Fine-Gray proportional subdistribution hazards model with recurrence-free interval. Data on plasma CRP were analyzed per doubling of concentration and in relation to CRP levels of <3 mg/L, 3 to 10 mg/L, and >10 mg/L and stratified according to standard clinical parameters in sensitivity analyses.RESULTS: A doubling of the plasma CRP concentration was associated with increased risk of recurrence (multivariate adjusted HR, 1.05; 95% CI, 1.01-1.08) and shorter survival (HR, 1.13; 95% CI, 1.09-1.16) in multivariate analyses. Survival was shorter in patients with plasma CRP levels of 3 to 10 and >10 mg/L versus <3 mg/L, with multivariate adjusted HRs of 1.30; 95% CI, 1.17-1.45 and 1.65; 95% CI, 1.39-1.95, respectively.CONCLUSIONS: Elevated plasma CRP measured before treatment in patients with early-stage breast cancer is an independent biomarker of increased risk of recurrence and early death.IMPACT: CRP measures before treatment might be used to individualize follow-up of patients with early-stage breast cancer.
AB - BACKGROUND: Breast cancer incidence is now the highest among all cancers and accountable for 6.6% of all cancer-related deaths worldwide. Studies of the prognostic utility of plasma C-reactive protein (CRP) measurement in early-stage breast cancer have given discrepant results.METHODS: We identified 6,942 patients in the Danish Breast Cancer Cooperative Group database with early-stage breast cancer diagnosed between 2002 and 2016 who had a measure of pretreatment plasma CRP. Outcomes were recurrence-free interval and survival for a period up to 10 years. We analyzed associations with plasma CRP using Fine-Gray proportional subdistribution hazards model with recurrence-free interval. Data on plasma CRP were analyzed per doubling of concentration and in relation to CRP levels of <3 mg/L, 3 to 10 mg/L, and >10 mg/L and stratified according to standard clinical parameters in sensitivity analyses.RESULTS: A doubling of the plasma CRP concentration was associated with increased risk of recurrence (multivariate adjusted HR, 1.05; 95% CI, 1.01-1.08) and shorter survival (HR, 1.13; 95% CI, 1.09-1.16) in multivariate analyses. Survival was shorter in patients with plasma CRP levels of 3 to 10 and >10 mg/L versus <3 mg/L, with multivariate adjusted HRs of 1.30; 95% CI, 1.17-1.45 and 1.65; 95% CI, 1.39-1.95, respectively.CONCLUSIONS: Elevated plasma CRP measured before treatment in patients with early-stage breast cancer is an independent biomarker of increased risk of recurrence and early death.IMPACT: CRP measures before treatment might be used to individualize follow-up of patients with early-stage breast cancer.
KW - Adult
KW - Aged
KW - Biomarkers, Tumor/blood
KW - Breast Neoplasms/blood
KW - C-Reactive Protein/metabolism
KW - Denmark/epidemiology
KW - Female
KW - Humans
KW - Middle Aged
KW - Neoplasm Recurrence, Local/blood
KW - Neoplasm Staging
KW - Prognosis
UR - http://www.scopus.com/inward/record.url?scp=85192028644&partnerID=8YFLogxK
U2 - 10.1158/1055-9965.EPI-23-1299
DO - 10.1158/1055-9965.EPI-23-1299
M3 - Journal article
C2 - 38358318
SN - 1055-9965
VL - 33
SP - 662
EP - 670
JO - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
JF - Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology
IS - 5
ER -