CPT1A is a rate-limiting enzyme in fatty acid oxidation and is upregulated in high-risk breast cancer. Obesity and menopausal status' relationship with breast cancer prognosis is well established, but its connection with fatty acid metabolism is not. We performed an observational study on anonymized RNA sequencing data in the Xena Functional Genomics Explorer, to explore CPT1A's effect on breast cancer patients' survival probability. Using [18F]-fluorothymidine positron emission tomography-computed tomography images from The Cancer Imaging Archive, we segmented these analyses by obesity and menopausal status. In 1214 patients, higher CPT1A expression is associated with lower breast cancer survivability. We confirmed a previously observed protective relationship between obesity and breast cancer in pre-menopausal patients and supported this data using two-sided Pearson correlations. Taken together, these analyses using open-access, deidentified databases bolster the potential role of CPT1A-dependent fatty acid metabolism as a pathogenic factor in breast cancer.

The authors have declared no competing interest.

This study was supported in part by a Pilot Grant from the Yale Cancer Center.

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All data analyzed are available online at The Cancer Imaging Archive (TCIA). No new data were generated for this study.