Prognostic markers of disease-free survival in breast cancer patients with or without a history of hypertension

Abstract

Breast cancer (BC) is the most common malignancy among women in Russia and worldwide. Tumor biology criteria alone are insufficient for predicting BC outcomes and treatment efficacy. Additional prognostic criteria are required based on patient’s individual traits, overall health, and comorbidities. Immunological mechanisms drive the development of many diseases, including arterial hypertension (AH). Post-treatment monitoring of BC patients with a follow-up period of over 20 years was conducted at the Tomsk Cancer Research Institute. The aim of our study was to reveal the factors associated with disease-free and metastasis-free survival in BC patients with or without HT. The study included 62 female patients with BC (T1-4N0-3M0). The median age of the patients was 45 (37-55) years. All patients were examined and treated at Cancer Research Institute, Tomsk National Research Medical Center. Immunological parameters and comorbidities were registered before treatment. Statistical analysis was performed using the standard STATISTICA for Windows 10.0 software package. Differences were considered statistically significant at a p-value of 0.05. All BC patients were classified in two groups: those who survived ≥ 20 years after treatment, and those who did not survive 20 years, with further stratifying into subgroups with versus without history of AH. No statistical association was found between the presence of hypertension and survival in BC patients. Markers associated with tumor biology only partially confirmed their prognostic value. Pre-treatment immune features associated with overall and relapse-free survival over 20 years were detected within the entire cohort of BC patients. These findings included lower levels of PBMC apoptosis, higher values of stimulated secretion of the anti-inflammatory IL-10 cytokine, and the ratio of stimulated to spontaneous secretion of IFNγ, as well as low stimulation index of IL-1β. We have identified immunological markers of BC outcomes associated with the presence or absence of HT before treatment. A statistically significant difference in comorbidity incidence was found for pre-existing AH disease between patients with favorable and unfavorable BC outcomes.