Higher Incidence of Anemia and Clinical Utility of Indices of Iron Homeostasis in Newly Diagnosed Breast Cancer Patients: A Cross-Sectional Study from a Regional Oncology Centre of South India

Higher prevalence of anemia in breast cancer may lead to higher morbidity and mortality. The incidence and possible causes of anemia and the clinical value of the indices of iron homeostasis among the Indian breast cancer patients are discussed. Forty-two healthy controls and thirty-nine newly diagnosed breast cancer patients were recruited for the study. Serum hepcidin and high-sensitive C-reactive protein were assayed by ELISA. Ferritin and Iron levels were assessed by chemiluminescence and colorimetric methods in clinical chemistry analysers (Beckman Coulter DXI 600 & AU5811). Statistical analyses were carried out either by independent student T test or by Mann-Whitney U Test as per distribution of the data. Eighty seven percent of the newly diagnosed breast cancer patients were anaemic. Hepcidin, hsCRP, and ferritin were elevated significantly among breast cancer patients. However, levels of ferritin still remained at the lowest level of the normal range among the patients with breast cancer. There was significant reduction in serum iron among breast cancer patients. Serum iron levels were lesser than the normal range among both the healthy control and breast cancer patients. The ROC curve analyses revealed that Hb and hepcidin are useful in the differentiation of breast cancer from healthy control with AUC of 91% and 82% respectively. The higher incidence of anemia among Indian breast cancer patients could be interpreted from the coexistence of anemia of chronic inflammation and nutritional iron deficiency anemia. Hb and hepcidin are useful in the differentiation of breast cancer from healthy control.