Abstract P4-07-24: High Mammographic Breast density was correlated with overall survival of operable breast cancer which expressed CD44+CD24-/ALDH-1+
Authors: Lee JungSun , Kim Woo-Gyeong 
Published: March 2022

Abstract
Background: Mammographic Breast Density (MBD) was known as a risk of breast cancer in either pre or postmenopausal women. The underlined mechanism remain unclear. Aldehyde dehydrogenase 1 (ALDH-1) and CD44+CD24− are the most consistently used biomarkers to identify and characterize breast cancer stem cells (CSCs). However, correlation between expression of CSCs and MBD remains unclear. We aimed to clarify the association between CD44, CD24 or ALDH-1 and the clinical factors including MBD for investigating their effects on overall survival (OS). Method: 159 operable breast cancers were finally included for double immune-histochemical staining of CD44, CD24 and single expression of ALDH-1. MBD was categorized according to the American College of Radiology Breast Imaging Reporting and Data System. Positive expression of CSC was defined when both Aldehyde dehydrogenase 1 (ALDH-1) and CD44+CD24− were expressed. Clinical values were age, co-morbidity (hypertension, hyperlipidemia, Diabetes Mellitus), body mass index, menopausal status. We also examined overall survival (OS) with the log-rank test. Result: Positive expression of BCSC was 33.3% (53/159 patients). It correlated with premenopausal status, high histologic grade, high Ki-67 expression, and low expression of ER or PR (Table 1). During mean 74 months, High BMD was correlated with worse OS in either pre- or postmenopausal patients (p=0.04) and worse OS in patients with co-morbidity (p=0.08). Expression of CSC was not associated with overall survival. In a group with CSC expression, patients of higher MBD(≥ 51%) was worse OS (p=0.046) compared with a group with non-CSC expression. Co-morbidity was significantly correlated with poor DFS in non-expressed group compared with CSC expressed group (p=0.01). In Cox-regression analysis, co-morbidity (HR=0.05, 95% CI: 0.006-0.44, p=0.007) and MBD ( HR= 0.14, 95% CI: 0.02-1.16, p=0.06) increased risk of OS. Conclusion: High MBD could be a prognostic factor in operable breast cancer. Each risk factor of survival was important, but host factors including comorbidity and MBD might be considered.
Table 1.The correlation between BCSC and clinical variables in patient with operable breast cancerCSC(-)CSC(+)Number(%)Number(%)BMINormal68(65.4)36(34.6)0.63Obesity38(69.1)17(30.9)ComorbidityNo57(62.6)34(37.4)0.21Yes49(72.1)19(27.9)MBD≤ 50 %28(77.8)8(22.2)0.13≥ 51 %60(63.8)34(36.2)Age( year)&lt;5040(63.5)23(36.5)0.49≥5066(68.8)30(31.3)MenopausePremenopause46(59.0)32(41.0)0.04Postmenopause60(74.1)21(25.9)HGGrade=116(80.0)4(20.0)0.02Grade=247(75.8)15(24.2)Grade=343(56.6)33(43.4)LVINo73(68.6)33(31.4)0.69Yes33(64.7)18(35.3)ERNegative42(52.5)38(47.5)&lt;0.001Positive64(81.0)15(19.0)PRNegative65(61.3)41(38.7)0.043Positive41(77.4)12(22.6)Her-2/neunot expressed76(63.3)44(36.7)0.14overexpressed29(76.3)9(23.7)Ki-67negative68(80.0)17(20.0)&lt;0.001positive38(51.4)26(48.6)
Citation Format: JungSun Lee, Woo-Gyeong Kim. High Mammographic Breast density was correlated with overall survival of operable breast cancer which expressed CD44+CD24-/ALDH-1+ [abstract]. In: Proceedings of the 2021 San Antonio Breast Cancer Symposium; 2021 Dec 7-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2022;82(4 Suppl):Abstract nr P4-07-24.