{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T11:27:34Z","timestamp":1790767654829,"version":"4.1.0"},"reference-count":55,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T00:00:00Z","timestamp":1624233600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Minority Health and Health Disparities","award":["5G12MD007579"],"award-info":[{"award-number":["5G12MD007579"]}]},{"name":"National Institute of Minority Health and Health Disparities","award":["U54MD007579"],"award-info":[{"award-number":["U54MD007579"]}]},{"name":"Minority Health and Health Disparities","award":["R21MD013674"],"award-info":[{"award-number":["R21MD013674"]}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U54CA163071"],"award-info":[{"award-number":["U54CA163071"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["U54CA163068"],"award-info":[{"award-number":["U54CA163068"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["R21CA253555"],"award-info":[{"award-number":["R21CA253555"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000054","name":"National Cancer Institute","doi-asserted-by":"publisher","award":["F31CA232622"],"award-info":[{"award-number":["F31CA232622"]}],"id":[{"id":"10.13039\/100000054","id-type":"DOI","asserted-by":"publisher"}]},{"name":"National Institute of General Medicine Sciences","award":["R25GM082406"],"award-info":[{"award-number":["R25GM082406"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medical Sciences"],"abstract":"<jats:p>Background: Mounting data suggest that exposure to chronic stress is associated with worse breast cancer outcomes. This study aimed to explore the impact of social environmental adversity (SEA, e.g., child abuse, crime, sexual, and physical violence), depressive symptomatology, and anxiety on immune cell infiltration into the breast tumor microenvironment. Methods: Participants (n = 33) completed a series of surveys assessing depression and anxiety symptoms, adverse childhood events (ACE), and trauma history. Tumor-associated macrophages (CD68+), B cells (CD19+), and T cells (CD3+) were identified by immunohistochemical analyses of formalin-fixed paraffin-embedded tumor samples and quantified. Spearman rank tests were used to explore the relationships between the variables studied. Results: Exposure to SEA was high (ACE = 72%, exposure to crime = 47%, and exposure to physical\/sexual assault = 73%) among participants. Moreover, 30% reported a comorbid history of depression and ACE; 39% reported one or more traumatic events, and clinically significant depression symptomatology, while 21% reported trauma history and significant anxiety symptomatology. Increased tumor-infiltrating B cells were significantly correlated with exposure to crime, anxiety symptoms, and exposure to an ACE. The ACE plus anxiety group presented the highest infiltration of B cells, T cells, and macrophages. Conclusion: These findings support a role for SEA, anxiety symptoms, and depression as potential modulators of the immune tumor microenvironment in breast cancer.<\/jats:p>","DOI":"10.3390\/medsci9020046","type":"journal-article","created":{"date-parts":[[2021,6,21]],"date-time":"2021-06-21T22:40:37Z","timestamp":1624315237000},"page":"46","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Depression, Anxiety, and Social Environmental Adversity as Potential Modulators of the Immune Tumor Microenvironment in Breast Cancer Patients"],"prefix":"10.3390","volume":"9","author":[{"given":"Eida M.","family":"Castro-Figueroa","sequence":"first","affiliation":[{"name":"Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA"},{"name":"Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karina I.","family":"Acevedo","sequence":"additional","affiliation":[{"name":"Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3495-5991","authenticated-orcid":false,"given":"Cristina I.","family":"Pe\u00f1a-Vargas","sequence":"additional","affiliation":[{"name":"Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA"},{"name":"Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Normarie","family":"Torres-Blasco","sequence":"additional","affiliation":[{"name":"Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA"},{"name":"Division of Mental Health, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Idhaliz","family":"Flores","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s Health, Ponce Research Institute, Ponce, PR 00716, USA"},{"name":"Division of Microbiology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0157-8261","authenticated-orcid":false,"given":"Claudia B.","family":"Col\u00f3n-Echevarria","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lizette","family":"Maldonado","sequence":"additional","affiliation":[{"name":"Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zindie","family":"Rodr\u00edguez","sequence":"additional","affiliation":[{"name":"Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexandra N.","family":"Aquino-Acevedo","sequence":"additional","affiliation":[{"name":"Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7353-3711","authenticated-orcid":false,"given":"Heather","family":"Jim","sequence":"additional","affiliation":[{"name":"Department of Health Outcomes and Behavior, H. Lee Moffitt Cancer Center and Research Institute, Tampa, FL 33612, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mar\u00eda I.","family":"Lazaro","sequence":"additional","affiliation":[{"name":"Clinical Psychology Program, School of Behavioral and Brain Sciences, Ponce Health Sciences University, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9081-5339","authenticated-orcid":false,"given":"Guillermo N.","family":"Armaiz-Pe\u00f1a","sequence":"additional","affiliation":[{"name":"Division of Women\u2019s Health, Ponce Research Institute, Ponce, PR 00716, USA"},{"name":"Division of Pharmacology, Department of Basic Sciences, School of Medicine, Ponce Health Sciences University, Ponce, PR 00716, USA"},{"name":"Division of Cancer Biology, Ponce Research Institute, Ponce, PR 00716, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2021,6,21]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"394","DOI":"10.3322\/caac.21492","article-title":"Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries","volume":"68","author":"Bray","year":"2018","journal-title":"CA Cancer J. 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