Follow up study of Biochemical parameters of Sri Lankan breast cancer patients from selected centers - A comparison with normal healthy individuals

Abstract

Attached

Breast cancer (B C) is the commonest cancer among women in Sri Lanka and the incidence is increasing. Various biochemical parameters and risk factors are known to be associated with B C incidence but the exact etiology remains unexplained. Thus the study attempted to analyze selected biochemical parameters and risk factors of apparently healthy females, inorder to compare the findings of a study with the same factors of newly diagnosed BC patients. Further a questionnaire based study was conducted to gather data on studied risk factors on B C patients already on treatment. Consent obtained, age matched apparently healthy females (n=75) participated for the study. Serum lipid profile, serum LD H and uric acid concentrations, thyroid profile, serum ferritin, sex hormone concentrations were measured using biochemical and immune assays. Information on risk factors was gathered using interviewer administered questionnaire and anthropometric measures were taken by the researcher of apparently healthy females and breast cancer patients already on treatment(n=100, Ethical approval 28/14). Average ages at menarche and menopause of apparently healthy females were 13 and 50 years respectively and were not significantly different when compared with B C women on treatment. Majority of B C and healthy women was married (98%) and has given birth to >one child and more than 85% of women has breast feed for more than one year. Among healthy using oral contraceptives for more than one year was observed among 17% and 83% of all has never experienced an abortion. However, the incidence was significantly high among B C women. None of the healthy women or B C women have used hormone replacement therapies. Mean BM I, waist circumference (W C), hip circumference (HC), waist to hip ratio (W:H) and mid upper arm circumference of apparently healthy women were 23.6 ±2.5 kg/m2, 80.0 ±6.6 cm, 92 ±7.2cm, 0.87 ± 0.1 and 26 ±2.7 cm respectively. Serum total cholesterol (TC), low density lipoprotein cholesterol (LD L-C ), high density lipoprotein cholesterol (H DL-C), triglyceride (TG ) concentrations and TC : H DL-C of premenopausal healthy women were 178±23 mg/dL, lll±23m g/dL, 44±8.3mg/dL, 108±45mg/dL and 4.2±0.9 respectively and were not significantly different when compared to postmenopausal healthy women. Similarly TSH , T3, T4 concentrations were within the normal reference range. Median (IQR) CRP of healthy females were 2.4(2.9) mg/L. Serum ferritine of premenopausal women were significantly lower when compared with postmenopausal healthy women. Mean uric acid, lactate de hydrogenase (LDH ), H bA lc and cortisol concentrations were 257 ± 67 pmol/L, 409 ± 104IU/L, 4.62± 1.05% and 78.4±35.0 ng/Ml respectively. In conclusion the incidence of abortions, usage of oral contraceptive were significantly high among breast cancer patients and age of menarche and menopause, parity, age at first child birth and duration of breast feeding was not significantly different among B C and healthy. Studied biochemical parameters of apparently healthy women were within the normal range though serum ferritin of premenopausal women was significantly low compared to postmenopausal women and was closer to the lower reference range.