Chronic Inflammation and Breast Cancer Recurrence

On page of this issue, Pierce and colleagues 1 present some of the most persuasive evidence yet that chronic inflammation might increase the risk of breast cancer recurrence. In a multi-site study of 734 women treated successfully for early stage breast cancer, high levels of circulating acute phase proteins (APPs) ~3 years after treatment were associated with a 2-fold elevation in the risk of subsequent disease recurrence and mortality. Risk ratios were similar across primary tumor types (stage, ER/PR status), and independent of potential confounders such as age, estrogen level, and adiposity. These results are consistent with previous studies linking circulating inflammatory markers to progression of metastatic breast cancer 2–8. However, the findings of Pierce et al. are novel in suggesting that serum inflammatory markers might provide early information about disease recurrence risk in patients with no history of metastatic disease and no current evidence of cancer. If the present findings are replicated in larger cohorts with more recurrent cases, post-treatment APP monitoring could provide new a strategy for assessing the risk of breast cancer recurrence in apparently cured patients.