Abstract C011: The impact of reproductive factors on breast tumor and normal-adjacent tissue immune profile from menarche to menopause
Authors: Peng Cheng , Liu Yuxi , Heng Yujing , Bodelon Clara , Stover Daniel , Chen Wendy Y. , Holmes Michelle D. , Eliassen A. Heather , Kraft Peter , Tamimi Rulla M. 
Published: November 2024

Background: Reproductive factors and sex hormones are tightly linked to systemic immunity. However, no studies have examined whether reproductive factors and exogenous hormone use modulate the immune microenvironment of breast tissue. Methods: We prospectively evaluated the associations of reproductive factors (age at menarche, parity, age at first birth, age at menopause, and menopausal status) and exogenous hormone use (oral contraceptives, and menopausal hormone therapy (MHT)) with breast tumor and normal-adjacent tissue immune cell markers among 935 breast cancer cases in the Nurses’ Health Studies. We deconvoluted immune cell abundance using CIBERSORTx and derived gene expression signatures of markers for immune checkpoint (PD1, PDL1, and CTLA4), co-regulatory signal and antigen presentation (MHC class I/ II and T cell receptor) and mammary cytokine signaling (IFN gamma, IL2, IL4, IL12, IL13, TGF beta). Linear regression was used with adjustment for potential confounders. Results: Majority of participants had estrogen receptor (ER)-positive breast cancer (81%) and were post-menopausal at diagnosis (72%). Compared to tumors from pre-menopausal women, tumors from post-menopausal women had higher signature scores for tumor pro-inflammatory cytokine signaling (IFN gamma, IL2, IL4, IL12, IL13, TGF beta) and antigen presentation (FDR≤0.05). Several of the inflammatory cytokine signatures showed modest inverse relations with signatures of immune checkpoint markers (ρ=-0.3 to -0.4). Women who reported current use of estrogen only MHT had higher expression of CTLA4 in ER-positive breast tumors. For normal-adjacent tissues of ER-positive tumors, parity was associated with higher CD8+ T cell abundance, higher PDL1 expression and lower cytokine signaling in normal-adjacent tissues at p≤0.05; while breastfeeding was associated with lower abundance of CD8+ T cell and higher expression of cytokine signaling in normal-adjacent tissues of ER-negative tumors (p≤0.05). None of the associations in normal-adjacent tissues met FDR significance. The associations between other reproductive factors and immune cell profiles were in general weak. Conclusions: Our study suggests pre-diagnostic reproductive factors may influence breast tumor immune profiles. Future studies are needed to validate these results.

Citation Format: Cheng Peng, Yuxi Liu, Yujing Heng, Clara Bodelon, Daniel Stover, Wendy Y. Chen, Michelle D. Holmes, A. Heather Eliassen, Peter Kraft, Rulla M. Tamimi. The impact of reproductive factors on breast tumor and normal-adjacent tissue immune profile from menarche to menopause [abstract]. In: Proceedings of the AACR Special Conference in Cancer Research: Tumor-body Interactions: The Roles of Micro- and Macroenvironment in Cancer; 2024 Nov 17-20; Boston, MA. Philadelphia (PA): AACR; Cancer Res 2024;84(22_Suppl):Abstract nr C011.