Obesity is associated with atypia in breast ductal lavage of women with proliferative breast disease

Abstract

Background-Benign proliferative breast disease without atypia slightly increases breast cancer risk but there are currently few clinical options for breast cancer prevention in this group of women.Methods-We conducted a pilot study of women with a past diagnosis of proliferative breast disease with a goal to determine if the characteristics of cells obtained by breast ductal lavage were related to nutritional factors.Results-There were 57 women who enrolled. A total of 39 women yielded nipple aspirate fluid (NAF) samples and 36 underwent breast ductal lavage. Five of the lavage samples were acellular and 28 had at least 200 cells. Surprisingly, atypia was present in 11 women. Presence of atypia was associated with slight changes in morphometric features of the epithelial cells such as measures of circularity) as obtained by image analysis, but the only variable significantly different in women with atypia (versus no atypia) was a higher mean body mass index. Body mass index also was significantly correlated with C-reactive protein (CRP) levels in the nipple aspirate fluid, indicating that obesity might have a pro-inflammatory effect on the breast that can contribute to increased rates of atypia.Conclusions-Although the clinical significance of atypia in breast ductal lavage is uncertain, these results support further work on prevention of obesity as a strategy for reducing breast cancer risk. Keywordsproliferative breast disease; nuclear morphometry; breast ductal lavage; obesity

Adipocytokines and Insulin Resistance: Their Role as Benign Breast Disease and Breast Cancer Risk Factors in a High-Prevalence Overweight-Obesity Group of Women over 40 Years Old

“…BBD is considered a risk factor for BC. If BBD is associated with elevated BMI and C-reactive protein levels, the risk increases through inflammatory pathways [25].…”

From Molecular Biology to Epithelial Carcinogenesis

“…Epidemiological studies indicate the importance of lifestyle factors in carcinoma development. With the exception of age, the modifiable lifestyle risk factors associated with epithelial carcinogenesis are obesity, metabolic syndrome, hormone therapy, physical inactivity, western diet, smoking, alcohol consumption, and certain infectious diseases 7,[13][14][15] . Therefore, sporadic carcinomas are considered lifestyle diseases where most cases are associated with unhealthy habits or infections.…”

“…Breast Cancer Breast cancer is the leading cause of mortality from cancer in women. Epidemiological studies indicate that the most relevant risk factors for the development of this carcinoma are age, obesity, metabolic syndrome, hormonal therapy, physical inactivity, the Western diet, smoking, and alcohol consumption 7,[13][14][15] . They also point to the carcinogenic effect of chronic exposure to high levels of insulin, IGF-1, pro-inflammatory cytokines such as IL-8, IL-6, leptin, and estrogens 17,18 .…”