A team of researchers has found an association between breast cancer survival and two proteins that, when present in the blood in high levels, are indicators of inflammation. Using data from the Health, Eating, Activity and Lifestyle (HEAL) study sponsored by the National Cancer Institute, part of the National Institutes of Health, the researchers found that breast cancer patients with elevated levels of C-reactive protein (CRP) and serum amyloid A (SAA) were approximately two to three times more likely to die sooner or have their cancer return than those patients who had lower levels of these proteins, regardless of the patient's age, tumor stage, race, body mass index, or history of previous cardiovascular issues. The results of this study were published online, May 26, 2009, in the Journal of Clinical Oncology.

Inflammation is an immune response. It is part of the body's natural defense against harmful elements, such as pathogens, damaged cells, or other irritants, and helps facilitate the healing process. Inflammation can be classified as either acute or chronic. Acute inflammation is the short-term, beneficial response to harmful stimuli. Chronic inflammation is a disease in which the inflammatory state persists and may result in tissue damage.

CRP and SAA accumulate in the blood in response to inflammation. CRP is produced by the liver, as well as by fat cells, and has several immune-related functions. SAA, which is also secreted by the liver, is involved in both the transport of cholesterol from the liver to the bile, and the recruitment of immune cells to sites of inflammation. Both proteins are found in higher concentrations in the blood of people with low-grade chronic inflammation. Chronic inflammation is believed to contribute to the development and spread of breast cancer, and breast cancer survivors with chronic inflammation may be at a higher risk of recurrence. Elevated CRP is also linked to increased risk of heart disease.
"This HEAL study of inflammation and breast cancer survival contributes uniquely to this emerging research in that it is the largest study to date to examine this association," said Rachel Ballard-Barbash, M.D., M.P.H., a co-author of the study and principal investigator of the HEAL study at NCI, in the Division of Cancer Control and Population Sciences. "Because of the detailed data on diet, physical activity and weight in the HEAL study, we were able to examine the extent to which these health behaviors altered this association."

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