ASPO Abstracts
Clinicopathologic consequences of allostatic load among Black women with breast cancer
Category: Molecular Epidemiology & Environment
Conference Year: 2019
Abstract Body:
Purpose of the study: In the U.S., Black women tend to have higher cumulativephysiological stress compared with women of other races/ethnicities, which may contribute to aggressive breastcancer (BrCa) clinicopathology. However, few empirical studies have tested this hypothesis amongBlack women. The aim of this study is to examine the association of allostatic load (AL; as ameasure of cumulative physiological stress) and BrCa clinicopathology among Black women with BrCa. Methods: In a sample of 409 Black women with non-metastatic BrCa enrolled in the Women’sCircle of Health Study, we estimated pre-diagnostic AL using two adapted measures: AL measure 1(lipid profile-based measure — assessed by systolic and diastolic blood pressure [SBP, DBP], high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides and glucose levels,waist circumference, and use of medications to treat diabetes, hypertension, orhypercholesterolemia) and AL measure 2 (inflammatory index-based measure — assessed by SBP, DBP, glucose and albumin levels, glomerular filtration rate, body mass index, waist circumference, and use ofmedications described above). We used kappa analysis to assess agreement between the two AL measures and multivariable-adjusted models to assess the associations of interest. Results: AL measures 1 and 2 demonstrated moderate-to-fair agreement (kappa=50.4%). Higher AL was found to be a significant predictor of higher tumor grade (poorly differentiated vs.well/moderately differentiated) using AL measure 1 (aOR=2.17; 95% CI: 1.20, 3.92) and AL measure 2 (aOR=1.62; 95% CI: 1.04, 2.54). Higher AL measure 2 was also a significant predictor of larger tumorsize (≥2cm vs. <2cm; aOR=1.57; 95% CI: 1.00, 2.45). There were also suggestive relationships betweenhigher AL and estrogen receptor- status and advanced tumor stage, albeit with p-value >0.05. Conclusions: These findings suggest that unfavorable BrCa clinicopathologiccharacteristics, namely higher tumor grade and larger tumor size, are potential consequences of high AL amongBlack women. These preliminary findings contribute to important gaps in knowledge related to themechanisms involved in the development of aggressive BrCa phenotypes.
Keywords: breast cancer clinicopathology; allostatic load;Black women