Elevated CSF-1 serum concentrations to predict lymph node metastasis and overall survival in women with early breast cancer.

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11032 Background: Colony-stimulating factor-1 (CSF1) is a key modulator of tissue macrophages and contributes to the physiological function of the mammary gland. It has, however, also been associated with breast cancer since expression of its receptor CSF-1R is a strong predictor of poor outcome in early breast cancer and results in tumor cell invasiveness and pro-metastatic behavior in vitro. Methods: We have prospectively measured circulating CSF-1 with ELISA in 572 women with early breast cancer and in 688 women with benign breast lesions; and correlated these values with overall survival, nodal status and other clinical and histological parameters. Results: Serum CSF-1 concentrations were significantly elevated in patients with early breast cancer when compared to those with benign tumors (p<0.0001). Within breast cancer patients, CSF-1 was higher in women with involved axillary lymph nodes (p=0.04). CSF-1 concentrations were correlated with tumor size (p=0.002), age (p<0.001), and Ki67 expression (p=0.006). Log CSF-1 serum concentrations were predictive of poor survival in both univariate (HR: 3.77, CI: 1.65-8.65, p=0.002) and multivariate analyses (HR: 3.1, CI: 1.03-9.33, p=0.04). Post- but not premenopausal women with CSF-1 serum concentrations >873 pg/ml experienced a significantly poorer outcome (p=0.004 log rank test). Conclusions: CSF1 serum concentrations are elevated in women with malignant breast tumors. In early breast cancer, elevated serum CSF-1 is associated with nodal involvement, and in postmenopausal women also with poor overall survival.