Detection of crown-like structures in breast adipose tissue and clinical outcomes among African-American and White women with breast cancer

Maret L. Maliniak, Aswathy Miriam Cheriyan, Aswathy Miriam Cheriyan, Mark E. Sherman, Yuan Liu, Yuan Liu, Keerthi Gogineni, Keerthi Gogineni, Jiaqi Liu, Jiabei He, Uma Krishnamurti, Jasmine Miller-Kleinhenz, Ryan Ashiqueali, Jinjing He, Rami Yacoub, Lauren E. McCullough, Lauren E. McCullough

Research output: Contribution to journalArticlepeer-review

3 Scopus citations


Background: Crown-like structures in breast adipose tissue (CLS-B), composed of necrotic adipocytes encircled by macrophages, are associated with obesity and hypothesized to worsen breast cancer prognosis; however, data are sparse, particularly in multi-racial populations. Methods: We assessed specimens for CLS-B from 174 African-American and 168 White women with stage I-III breast cancer treated by mastectomy. Benign breast tissue from an uninvolved quadrant was immunohistochemically stained for CD68 to determine CLS-B presence and density (per cm2 of adipose tissue). Demographic and lifestyle factors, collected via medical record review, were analyzed for associations with CLS-B using logistic regression. Multivariable Cox proportional hazards models were used to compute hazard ratios (HRs) and 95% confidence intervals (CIs) for associations between CLS-B and overall (OS) or progression-free (PFS) survival. Results: Detection of any CLS-B was similar between African-American (32%) and White (29%) patients with no evidence of an association between race and CLS-B in multivariable models (OR = 0.82, 95% CI = 0.49-1.36). Detection of CLS-B was associated with obesity (OR = 4.73, 95% CI = 2.48-9.01) and age ≥ 60 years at diagnosis (OR = 1.78, 95% CI = 0.99-3.21). There was some evidence of associations with parity and current smoking status. Detection of CLS-B was not associated with OS (HR = 1.02, 95% CI = 0.55-1.87) or PFS (HR = 0.99, 95% CI = 0.59-1.67). Conclusions: Our results show a strong, positive association between BMI and CLS-B in non-tumor tissue similar to previous findings. Detection of CLS-B did not vary by race and was not associated with worse OS or PFS.

Original languageEnglish (US)
Article number65
JournalBreast Cancer Research
Issue number1
StatePublished - Jun 17 2020


  • Breast adipose tissue
  • Breast cancer outcome disparity
  • Crown-like structures
  • Obesity
  • Progression-free survival

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


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