Proximal and distal stress in myeloid cells in women with breast cancer

Abstract

Diagnosis with breast cancer is a major life stressor. Stress is associated with changes to immune cell populations, including alterations in myeloid lineage cells. These changes may have implications for cancer outcomes; indeed, the ratio of myeloid to lymphoid lineage cells has been prospectively associated with cancer-related mortality, and specific monocyte subsets may contribute to cancer recurrence. In this study, we examined how proximal (cancer-related stress) and distal (childhood maltreatment) stressors may have implications for myeloid lineage cells (granulocytes, monocytes, and monocyte subtypes) in women recently diagnosed with early-stage breast cancer. We used flow cytometry to quantify cell populations in 110 women following cancer diagnosis and before the onset of any adjuvant chemo- or radiation therapy. In unadjusted bivariate analyses, childhood maltreatment was associated with having fewer granulocytes, F(1,108) = 5.35, p = 0.023, and a lower ratio of granulocytes to lymphocytes, F(1,108) = 4.82, p = 0.030, but no differences in monocytes, ps > 0.24. Higher cancer-related stress was associated with a smaller percentage of classical monocytes (CD14+/CD16−) in the leukocyte population, r = −0.23, p = 0.016. Psychosocial factors may have important implications for myelopoietic processes in the aftermath of cancer diagnosis, and may constitute risk factors for long-term health outcomes in women with breast cancer.