Metastasis is the one main causes of mortality in solid cancers, including breast cancer recently predictive biomarkers based on molecular finding have been developed but still unaffordable especially in developing countries. There are several alternative to molecular biomarkers and white blood cell profile count emerged as affordable and practical markers of cancer progression. However, there are not many studies that focus on their direct application. Therefore, this study aimed to determine the correlation between white blood cell profile count as predictive factors of metastasis in invasive ductal carcinoma breast cancer.
A retrospective cross-sectional study was conducted using breast cancer patient data obtained at Sanglah General Hospital (2016-2020). Complete blood count (CBC) and histopathological records of the patients were collected and the white blood cell profile (WBC, ABC, AMC, AEC, ANC and ALC) were calculated. Distant metastasis was classified into M0 and M1.
267 invasive ductal carcinoma breast cancer patient data were used in this study with mean age 49.1 ± 9.474. Metastatic disease of the patients accounted for 50 patients (18.7%) of all patients. Patients with metastatic disease had higher median of AMC compared to patients without metastasis (0.61 ± 0.307, p=0.022. The AUC (sensitivity and specificity) of ABC, AMC and ANC in predicting metastasis were 0.528 (24%; 90%), 0.604 (56%; 72%) and 0.539 (40%; 74%), respectively. In univariate risk analysis model, patient with metastasis of invasive ductal carcinoma breast cancer was found in high ABC (OR: 2.779; 95%CI=1.277-6.134; p=0.008), AMC (OR: 1.203; 95%CI=0.661-2.189; p<0.001) and ANC (OR: 1.917; 95%CI=1.008-3.643; p=0.045).
Pre-treatment white blood cell profile count are potential predictive markers for metastasis. However, these findings need to be validated in larger study with more comprehensive design.
Medical Faculty Udayana University.
Has not received any funding.
All authors have declared no conflicts of interest.