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Breast Cancer Research and Treatment

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01-12-2020 | Obesity | Epidemiology

Prognostic associations of plasma hepcidin in women with early breast cancer

Authors: Katarzyna J. Jerzak, Ana E. Lohmann, Marguerite Ennis, Elizabeta Nemeth, Tomas Ganz, Pamela J. Goodwin

Published in: Breast Cancer Research and Treatment | Issue 3/2020

Abstract

Purpose

Iron is essential to energy metabolism, cell proliferation and DNA synthesis, and sufficient iron availability may be required for tumor growth. The hormone hepcidin is a systemic regulator of iron concentration in plasma. Intra-tumor RNA expression of hepcidin has been linked to shorter metastasis-free survival in women with early breast cancer, but the prognostic implications of this inflammatory marker and iron-regulating plasma peptide in the blood are unknown.

Methods

Using an ELISA assay, hepcidin was measured in the banked blood of 518 women who were recruited from 1989 to 1996 for a prospective cohort study of diet and lifestyle factors in breast cancer. Blood samples were obtained 4–12 weeks post-operatively, prior to treatment with chemotherapy or tamoxifen.

Results

Hepcidin was not associated with time to distant breast cancer recurrence (primary outcome) nor time to death from any cause. However, a pre-planned interaction test of body mass index (BMI) was statistically significant (p < 0.01). Among obese women (BMI > 30 kg/m²), higher hepcidin was associated with a shorter time to distant breast cancer recurrence in both uni- and multivariable analyses (adjusted HR 1.84; 95% CI 1.04–3.25). For overall survival, a similar pattern was seen in the univariable model but the effect was diminished in a multivariable analysis. Plasma hepcidin was not associated with high-sensitivity C-reactive protein, but it was significantly associated (r ≥ 0.32) with iron indices, including total iron (p < 0.01), transferrin (p < 0.01) and soluble transferrin receptor (p < 0.01).

Conclusions

Hepcidin may be associated with poor breast cancer outcome in obese women, however, replication is required. The biologic basis for this prognostic association requires further research.

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Title: Prognostic associations of plasma hepcidin in women with early breast cancer
Authors: Katarzyna J. Jerzak
Ana E. Lohmann
Marguerite Ennis
Elizabeta Nemeth
Tomas Ganz
Pamela J. Goodwin
Publication date: 01-12-2020
Publisher: Springer US
Keywords: Obesity
Obesity
Breast Cancer
Breast Cancer
Published in: Breast Cancer Research and Treatment / Issue 3/2020
Print ISSN: 0167-6806
Electronic ISSN: 1573-7217
DOI: https://doi.org/10.1007/s10549-020-05903-z

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