Social well-being is associated with less pro-inflammatory and pro-metastatic leukocyte gene expression in women after surgery for breast cancer

Abstract

Purpose: Satisfaction with social resources, or "social well-being," relates to better adaptation and longer survival after breast cancer diagnosis. Biobehavioral mechanisms linking social well-being (SWB) to mental and physical health may involve inflammatory signaling. We tested whether reports of greater SWB were associated with lower levels of pro-inflammatory and pro-metastatic leukocyte gene expression after surgery for non-metastatic breast cancer.

Methods: Women (N = 50) diagnosed with non-metastatic (0-III) breast cancer were enrolled 2-8 weeks after surgery. SWB was assessed with the social/family well-being subscale of the FACT-B. Leukocyte gene expression for specific pro-inflammatory (cytokines, chemokines, and COX-2) and pro-metastatic genes (e.g., MMP9) was derived from microarray analysis.

Results: Multiple regression analyses controlling for age, stage of disease, days since surgery, education, and body mass index (BMI) found higher levels of SWB related to less leukocyte pro-inflammatory and pro-metastatic gene expression (p < 0.05). Emotional well-being, physical well-being, and functional well-being did not relate to leukocyte gene expression (p > 0.05). Greater SWB remained significantly associated with less leukocyte pro-inflammatory and pro-metastatic gene expression after controlling for depressive symptoms.

Conclusions: Results have implications for understanding mechanisms linking social resources to health-relevant biological processes in breast cancer patients undergoing primary treatment.

Clinical trial registration number: NCT01422551.

Keywords: Breast cancer; Inflammation; Leukocyte gene expression; Social support; Social well-being.

Conflict of interest statement

Conflict of interest: The authors declare that they have no conflicts of interest.

Figures

Figure 1

Scatterplots depicting the association between social well-being and pro-inflammatory and pro-metastatic gene expression composites after breast cancer surgery controlling for age, stage of disease, days since surgery, education, and BMI. *p a Scatterplot depicts data after winsorization. Gene expression reported in RNA expression units (log2).

Figure 2

Fold differences in pro-inflammatory and pro-metastatic gene expression in participants with low (N = 25) versus high (N = 25) social well-being determined by median split. a Cytokine Composite consisted of IL1A, IL1B, IL6, TNFSF10, TNFRSF21, and PTGS2/COX-2. Chemokine composite consisted of CCL3, CCL7, CCL20, CCL3L1, CCL4L2, and CXCR7. Pro-metastatic composite consisted of MMP9 and LMNA.