Serum high sensitivity C-reactive protein in breast cancer patients

Shilpa Balaji Asegaonkar, Unmesh Vidyadhar Takalkar, Pushpa Kodlikeri, Avinash Pagdhune, Virendrakumar Bonduliya, Anand Pandurang Thorat


Background:Breast cancer, second commonest malignancy in women is a multifactorial disease. Key role of chronic low grade inflammation has been linked with pathophysiology of breast cancer. High sensitivity C-Reactive Protein (hsCRP) is an acute phase reactant proinflammatory protein synthesized in hepatocytes. Present case control study was aimed with primary objective of estimation of serum hsCRP levels in newly diagnosed breast cancer patients and to correlate them with the staging of the disease.  

Methods:We enrolled 60 newly histologically diagnosed cases of breast cancer and 60 healthy age matched controls. Demographic features, anthropometric measures were recorded. After overnight fast, blood samples were collected and analyzed for serum hsCRP levels.

Results:We observed significant differences between cases and controls in anthropometric parameters BMI and waist: hip (P <0.05) and hsCRP levels (P <0.001).  Depending of the stage, serum hsCRP levels were associated with advanced stage. In stage I, association of hsCRP was not significant with disease while in stage II and III there was significant association. In stage IV patients with distant metastasis, serum hsCRP values were highly significantly raised compared to stage II and III. This suggests significant association of state of inflammation with stage of breast cancer.

Conclusion:Inflammatory component plays key role in all stages of tumourigenesis from initiation of the tumor, infiltration, local and systemic invasion. Estimation of hsCRP may be simple, inexpensive and useful tool for risk assessment, screening of high risk individuals and to predict outcome in diagnosed cases.



Breast cancer, hsCRP, Low grade chronic inflammation

Full Text:



Balkwill F, Mantovani A. Inflammation and cancer: back to Virchow? Lancet. 2001;357:539-45.

Lithgow D, Covington C. Chronic inflammation and breast pathology: a theoretical model. Biol Res Nurs. 2005;7:118-29.

Das RL, Pathangey LB, Tinder TL, Schettini JL, Gruber HE, Mukherjee P. Breast-cancer-associated metastasis is significantly increased in a model of autoimmune arthritis. Breast Cancer Res. 2009;11:R56.

Yong-Zhong Guo, Lei Pan, Chang-Jun Du, Dun-Qiang Ren, Xiao-Mei Xie. Association between C-reactive protein and risk of cancer: a meta-analysis of prospective cohort studies. Asian Pac J Cancer Prev. 2013;14(1):243-8.

DeNardo DG, Coussens LM. Inflammation and breast cancer. Balancing immune response: crosstalk between adaptive and innate immune cells during breast cancer progression. Breast Cancer Res. 2007;9:212.

Heikkila K, Ebrahim S, Lawlor DA. A systematic review of the association between circulating concentrations of C-reactive protein and cancer. J Epidemiol Community Health. 2007;61:824-33.

Allin KH, Bojesen SE, Nordestgaard BG. Baseline C-reactive protein is associated with incident cancer and survival in patients with cancer. J Clin Oncol. 2009;27:2217-24.

P. Ravishankaran, R. Karunanithi. Clinical significance of preoperative serum interleukin-6 and C-reactive protein level in breast cancer patients. World J Surg Oncol. 2011;9:18.

Schmid M, Schneitter A, Hinterberger S, Seeber J, Reinthaller A, Hefler L. Association of elevated C-reactive protein levels with an impaired prognosis in patients with surgically treated endometrial cancer. Obstet Gynecol. 2007;110:1231-6.

Polterauer S, Grimm C, Tempfer C, Sliutz G, Speiser P, Reinthaller A, et al. C-reactive protein is a prognostic parameter in patients with cervical cancer. Gynecol Oncol. 2007;107:114-7.

O’Dowd C, McRae LA, McMillan DC, Kirk A, Milroy R. Elevated preoperative C-reactive protein predicts poor cancer specific survival in patients undergoing resection for non-small cell lung cancer. J Thorac Oncol. 2010;5:988-92.

Kristine H. Allin, Børge G. Nordestgaard, Henrik Flyger, Stig E. Bojesen. Elevated pre-treatment levels of plasma C-reactive protein are associated with poor prognosis after breast cancer: a cohort study. Breast Cancer Res. 2011;13:R55.

Stephan Polterauer, Christoph Grimm, Clemens Tempfer, Gerhard Sliutz, Paul Speiser, Alexander Reinthaller, et al. C-reactive protein is a prognostic parameter in patients with cervical cancer. Gynecol Oncol. 2007;107:114-7.

Zhang SMM, Lin J, Cook NR, Lee IM, Manson JE, Buring JE, et al. C-reactive protein and risk of breast cancer. J Natl Cancer Inst. 2007;99:890-4.