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Evaluating the Association Between Allostatic Load and Malignancy on Image-Guided Breast Biopsy
Lily Kwak1, Saloni Patel1, Gayane Yenokyan2
1Department of Radiology, Johns Hopkins University, Baltimore, Maryland.
Journal of the American College of Radiology : JACR
|November 16, 2025
Summary
Higher allostatic load (AL), a measure of stress, is linked to increased odds of malignant breast pathology in women undergoing image-guided biopsies. This finding may inform personalized cancer screening strategies.
Area of Science:
- Oncology
- Physiology
- Biostatistics
Background:
- Allostatic load (AL) quantifies physiologic dysregulation from chronic stress.
- Understanding AL's role in breast cancer pathology is crucial for risk assessment.
Purpose of the Study:
- To investigate the association between allostatic load (AL) and malignant pathology in women undergoing image-guided breast biopsy.
Main Methods:
- Retrospective cohort study of 253 women (≥18 years) undergoing image-guided breast biopsy.
- AL calculated from cardiovascular, immune, metabolic, and renal biomarkers.
- Multivariable logistic regression analyzed the association between AL and malignant/high-risk pathology.
Main Results:
- Higher AL was associated with a 22% increased odds of malignant breast pathology (OR 1.22, 95% CI 1.03-1.44) after adjusting for demographics and area deprivation.
- This association lost significance when adjusted for the Gail 5-year risk score.
- No significant association was found between AL and high-risk breast pathology.
Conclusions:
- Increased allostatic load may be associated with malignant findings in image-guided breast biopsies.
- These findings suggest potential for AL in personalized breast cancer screening.
- Further research is needed to clarify AL's role and impact on cancer disparities.
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