Breast Cancer Research and Treatment

, Volume 141, Issue 3, pp 485–493 | Cite as

Post-surgical highly sensitive C-reactive protein and prognosis in early-stage breast cancer

  • Ariadna Tibau
  • Marguerite Ennis
  • Pamela J. Goodwin


Obesity, associated with inflammation, has been linked to poor prognosis in breast cancer. Research investigating the potential role of C-reactive protein (CRP), an obesity-associated systemic marker of inflammation, as a mediator of adverse prognostic effects of obesity has yielded inconsistent results. We examined the association of highly sensitive CRP (hsCRP) with obesity-related factors and breast cancer outcome. A cohort of 535 non-diabetic women diagnosed with T1-3, N0-1, M0 breast cancer, was assembled between 1989 and 1996 and followed prospectively. Circulating levels of hsCRP were analyzed on blood obtained postoperatively, prior to systemic therapy, in 501 women. Correlations and prognostic associations were analyzed using one-way analysis of variance, Spearman’s rank correlation coefficients (r) and Cox models. hsCRP was significantly correlated with body mass index (r = 0.60), insulin (r = 0.44), leptin (r = 0.54), and lipids, but not T or N stage, grade or estrogen receptor/progesterone receptor. At a median follow-up of 12 years, hsCRP was not associated with distant disease-free survival or overall survival in univariable [Q4 vs. Q1 hazard ratio (HR) 1.03, 95 % confidence interval (CI) 0.69–1.52, P = 0.9 and HR 1.27, 95 % CI 0.86–1.86, P = 0.24, respectively] or multivariable [Q4 vs Q1 HR 1.02, 95 % CI 0.66–1.59, P = 0.93 and HR 1.17, 95 % CI 0.76–1.81, P = 0.48 respectively] analyses. hsCRP was associated with age, comorbidities, and the insulin resistance syndrome but not with breast cancer outcome.


Breast cancer hsCRP Inflammation Obesity Prognosis 



This work was funded by The Breast Cancer Research Foundation and The Canadian Cancer Society Research Institute (formerly The Canadian Breast Cancer Research Initiative). Dr. Ariadna Tibau is a recipient of a Spanish Society of Medical Oncology (SEOM) Translational Research Grant.

Conflicts of interest

The authors declare that there are no conflicts of interest.


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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  • Ariadna Tibau
    • 1
    • 2
  • Marguerite Ennis
    • 3
  • Pamela J. Goodwin
    • 1
    • 2
  1. 1.Division of Medical Oncology and Hematology, Department of MedicineMount Sinai HospitalTorontoCanada
  2. 2.Division of Clinical Epidemiology, Lunenfeld Tanenbaum Research Institute University of Toronto, Mount Sinai HospitalTorontoCanada
  3. 3.MarkhamCanada

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