Systemic cortisol correlates with poor prognosis parameters in women with breast cancer and excessive body fat

Introduction

Excessive body fat can lead to systemic hormonal deregulation associated with poor cancer prognosis. This study analyzed the relationship between systemic cortisol levels and clinicopathological parameters in breast cancer patients categorized by body mass index (BMI).

Material and methods

Peripheral blood samples were collected from 223 women with or without breast cancer to investigate daytime cortisol levels. Circulating cortisol was measured using an enzyme immunoassay kit and correlated with clinicopathological data. The Cancer Genome Atlas (TCGA) data were collected to visualize cortisol axis-related gene expression in breast tumors (n = 1215).

Results

No significant difference in cortisol levels was found concerning breast cancer diagnosis. However, when breast cancer patients were stratified by BMI, cortisol levels were significantly higher in obese patients compared to eutrophics. Eutrophic patients exhibited lower cortisol levels when they had Luminal A tumors compared to those with HER2-amplified tumors. Obese patients with Luminal B tumors had higher cortisol levels than those carrying Luminal A, HER2, or triple-negative tumors. Additionally, lymph node metastasis correlated with high cortisol levels and obesity, as did the presence of blood clots.

Conclusions

These findings suggest that obesity and systemic cortisol levels in breast cancer patients should be further explored to understand their relationship with clinicopathological parameters.