• Exploring the Interplay of Hematological Parameters in Breast Cancer: An In-Depth Review of Emerging Research
  • Shiva Dianaty,1,* Zahra Purmajnun,2
    1. Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran
    2. Department of Clinical Sciences, Faculty of Veterinary Medicine, Shahrekord University, Shahrekord, Iran


  • Introduction: Breast cancer is a malignant neoplasm characterized by uncontrolled growth and proliferation of abnormal cells within the breast tissue, most commonly occurring in the mammary ducts or lobules. As a public health concern, it manifests in various histological subtypes, requiring multimodal diagnostic and therapeutic methods. Multifactorial factors influence the etiology of breast cancer, including genetic mutations (like BRCA1 and BRCA2), environment, hormones, and lifestyle. Genetic mutations, such as oncogene or tumor suppressor gene variants, exposure to carcinogens, hormonal imbalances, and inherited genetic predispositions, initiate and promote abnormal cell growth within breast tissue. Metastasizing, or spreading, to other parts of the body, is a devastating aspect of breast cancer physiology. During metastasis, cancer cells invade nearby tissues, enter the bloodstream, and establish secondary tumors in distant organs. There is no doubt that breast cancer is the number one cancer among women worldwide, and early detection is key. Early detection tools like mammography are widely used. There are several types of treatment available, such as lumpectomy, mastectomy, radiotherapy, chemotherapy, hormonal therapy, and immunotherapy. Using hematological factors for diagnosis is a reliable paraclinical method. A patient's hematopathology and follow-up treatment can predict their severity, mortality, and survival.
  • Methods: Pubmed, Google Scholar and Scopus databases were searched for related studies in the literature.
  • Results: Several hematological parameters can reflect breast cancer's aggressiveness. Neutrophophil-to-lymphocyte ratios (NLR) and platelet-to-lymphocyte ratios (PLR) have been linked with aggressive tumors. A higher level of these ratios indicates a heightened inflammatory response, which may correlate with advanced disease stages and a less favorable prognosis. During recent studies, platelets, lymphocytes, monocytes, and basophil counts did not differ significantly between breast cancer patients and non-patients. Patients with higher breast cancer stages had higher PLT counts. Patients also had higher mean WBC, RDW, and MPV. A breast cancer patient's mean RBC, Hb, HCT, MCV, and MCH values were lower than those of a non-patient. Hematological parameters can distinguish breast cancer patients from healthy individuals. Several hematological parameters, including elevated levels of markers like C-reactive protein (CRP), particularly in cases of advanced or metastatic disease, or elevated levels of erythrocyte sedimentation rate (ESR), may indicate inflammation or an underlying malignancy, which should be investigated further. Breast cancer patients may be susceptible to infection or immunosuppression during treatment, which may indicate elevated or decreased WBC counts. It is possible that elevated Erythrocyte Sedimentation Rate (ESR) levels can be a non-specific sign of inflammation, which may be linked to cancer or other health issues. Cancer progression and a poorer prognosis are often linked to chronic inflammation. Certain hematological parameters can be used to predict cancer recurrence. Indicators of recurrence, such as lactate dehydrogenase (LDH) or CA 15-3, are associated with breast cancer. The presence of high LDH levels can indicate tumor growth, metastasis, or tissue damage. In these patients, anemia is a common hematological finding. Cancer-related anemia can be the result of the tumor's adverse effect on the bone marrow as well as chronic inflammation caused by the disease. The inflammatory response of tumors can be a target for treatment. By analyzing peripheral blood, leukocytes, neutrophils, lymphocytes, monocytes, platelets, and derived NLRs (dNLRs), PLRs, and LMRs, many malignant cells show an inflammatory state. Breast cancer can cause paraneoplastic syndromes by secreting substances that affect blood cell production. Hematological abnormalities can be associated with paraneoplastic syndromes, including thrombocytosis (high platelet counts) and leukemia (excessive WBC production). Hematological parameters may be affected by breast cancer treatments, such as chemotherapy. Chemotherapy may result in myelosuppression (suppression of bone marrow) as well as anemia and neutropenia.
  • Conclusion: As a result, hematological parameters are not only useful in diagnosing breast cancer but can also be used to monitor treatment responses, assess disease progression, and predict prognosis in addition to the initial diagnosis. Comprehensive diagnostics and monitoring can improve the quality of life and outcomes for patients with breast cancer by including these parameters. As an example, a decrease in hemoglobin levels or an increase in platelet counts may indicate metastasis or tumor growth, which indicates a poor prognosis for the patient. To ensure the best possible outcome for breast cancer patients, regular monitoring of these parameters allows healthcare providers to make informed decisions regarding treatment adjustments and supportive care.
  • Keywords: breast cancer, hematological parameters, breast cancer diagnosis