Significance of serum colony-stimulating factor-1 as a breast cancer marker

Abstract

11071 Background: A specific and sensitive biomarker that indicates the presence of breast cancer is highly desirable, yet available markers are of limited value. Colony-stimulating factor-1 (CSF-1) is involved in mammary gland development and mediates breast cancer progression. Earlier work indicated correlation of serum CSF-1 with breast cancer staging, and a recent report suggests that CSF-1 is a potential breast cancer marker, however the data reported so far await validation. Methods: In a prospective study in 799 women with no history of malignant disease undergoing surgery, serum CSF-1 levels were measured by a commercially available ELISA. In this cohort, 312 patients had breast cancer and 487 age-matched women had benign tumors. The tumor size, nodal and metastasis status, histological tumor type, hormone and human epidermal growth factor receptor 2 (HER2) and menopausal status were evaluated. Mean CSF-1 serum concentrations were compared between the patient groups by non-parametric Wilcoxon two-sample and Kruskal-Wallis test. The area under the receiver operating characteristic curve was calculated by logistic regression. Results: Mean serum CSF-1 concentrations were significantly higher in all patients with malignant tumors (502±429 pg/mL) as compared to those with benign tumors (382±344 pg/mL) (p<0.0001, Wilcoxon). Increased CSF-1 concentrations were significantly related to malignant versus non-malignant disease in logistic regression and receiver operating characteristic analysis (p<0.0001, AUC=0.6). Increased CSF-1 levels in patients with malignant tumors were associated with postmenopausal (p=0.0038) but not premenopausal (p=0.94) status (Wilcoxon). Serum CSF-1 concentrations did not correlate significantly with tumor size, nodal and metastasis status, hormone receptor and HER2 status of patients (Kruskal-Wallis). Conclusions: Our data suggest that serum CSF-1 could serve as a breast cancer marker in postmenopausal women. While its serum levels are not related to breast cancer stage at diagnosis, they might be useful for breast cancer screening in postmenopausal women. No significant financial relationships to disclose.