Xing CY, Doose M, Qin B, et al. - Researchers investigated how the allostatic load (AL), measured using relevant biomarkers recorded in medical records before breast cancer diagnosis, is associated with tumor clinicopathologic features among Black women. Pre-diagnostic AL was estimated using two measures—AL measure 1 (lipid profile-based - assessed by systolic and diastolic blood pressure [SBP, DBP], high-density lipoprotein, low-density lipoprotein, total cholesterol, triglycerides and glucose levels, waist circumference, and use of diabetes, hypertension, or hypercholesterolemia medication) and AL measure 2 (inflammatory index-based - assessed by SBP, DBP, glucose and albumin levels, estimated glomerular filtration rate, body mass index, waist circumference, and use of medications described above)—in a sample of 409 Black women with non-metastatic breast cancer, who are enrolled in the Women's Circle of Health Follow-Up Study. Outcomes revealed moderate agreement between AL measures 1 and 2. Higher pre-diagnostic AL is identified to be predictive of higher grade (poorly differentiated vs well/moderately differentiated) using AL measure 1 and AL measure 2, and larger tumor size (≥ 2 cm vs < 2 cm) using AL measure 2 only. These findings suggest a possible contribution of elevated pre-diagnostic AL to more unfavorable breast cancer clinicopathology.