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The interplay of adiposity, metabolic factors, and tumor infiltrating lymphocytes in an East Asian breast cancer cohort.

e14207 Background: Breast cancer is rapidly emerging in East Asian countries in recent 2 decades. Unlike western countries in which obesity are quite prevalent and contributes to BC patients, the body mass index (BMI) of BC patients in East Asian countries are usually normal to no more than overweight. In our previous study, we noticed a 30% incidence of crown-like structure of breast (CLS-B) in our BC patients. Despite a lower BMI in this East Asian cohort than the US cohort, the body fat percentage (BF%) is significantly higher in the East Asian The roles of tumor infiltrating lymphocytes (TILs) in BC are inconslusive in different disease contexts. This study aims to decipher the interplay of adiposity, metabolic factors, and TILs in a BC cohort from an East Asian country. Methods: Breast cancer patients from National Taiwan University Hospital were prospectively enrolled into the protocol. Clinicopathologic factors were collected from electronic medical records. Fasting serum collected prior to surgery was used to quantify metabolic factors, including lipid and glucose profiles. Adiposity, including BF% and BMI were quantified by bioimpedance analysis method prior to surgery. Immunohistochemical staining from formalin-fixed, paraffin-embedded BC tumor samples were done to profile TILs by pathologist. CLS-B was stained and interpreted by pathologists. The correlation of TILs with different clinicopathologic factors, adiposity, or relapse-free survival (RFS) were analyzed. Results: 72 BC patients were included in this analysis. The density of CLS-B positively correlates with tumor infiltrating lymphocyte (TIL) percentage ( p = .042), higher BF% correlates with higher regulatory T cells ( p = .026) and tumor associated macrophages (TAM, p = .010), high glucose level is associated with higher CD56 ( p = .040) and higher TAMs ( p < 0.0001). Higher BMI is also associated with higher TAMs ( p= .005). In multivariate analysis, TAMx M2 macrophage is an independent predictor for RFS. Higher TAM level is associated with shorter RFS. Conclusions: Higher TAMs are associated with metabolic alterations such as higher adiposity, higher glucose level, and higher BMI. This result suggests a potential interplay between higher TAMs, altered metabolic factors, and worse RFS.