Prognostic factors of disease-free survival in patients with breast cancer

Abstract

Background Breast cancer is the second most common malignancy globally and a leading cause of cancer death in women. Analysis of factors related to disease-free survival (DFS) has improved understanding of the disease and characteristics related to recurrence. The aim of this study was to investigate the predictors of DFS in patients with breast cancer to enable the identification of patients at high risk who may benefit from prevention interventions.Methods We retrospectively analyzed 559 women with breast cancer who underwent treatment between 2004 and 2022. The study endpoint was DFS (including local recurrence, regional recurrence, secondary breast cancer, or death from any cause). Baseline tumor-related characteristics, treatment-related characteristics, sociodemographic and biochemical data were analyzed using Cox proportional hazards analysis and receiving operating characteristic curves. The median DFS was 45 months (range, 2 to 225 months).Results Breast cancer recurred in 86 patients (15.4%). Regression analysis showed that age, body mass index, surgery type, T3-T4 clinical tumor stage, tumor grade 3, American Joint Committee on Cancer (AJCC) stage III, Ki67 ≥ 14%, estrogen receptor-negative, progesterone receptor-negative, chemotherapy, carcinoembryonic antigen, CA153, red cell distribution width (RDW)-standard deviation (SD), aspartate aminotransferase, estimated glomerular filtration rate, albumin, hemoglobin, RDW-coefficient of variation, and platelet, white blood cell, neutrophil and monocyte count were associated with DFS. Multivariate Cox regression analysis showed that AJCC stage III, Ki67 ≥ 14%, albumin, platelet, and RDW-SD were independently associated with DFS. Furthermore, Kaplan-Meier analysis showed that albumin ≤ 4.1 g/dl, platelet ≥ 253 10^3/µl, RDW-SD ≥ 44 fL were significantly reduced DFS in patients with breast cancer.Conclusions In addition to the traditional prognostic factors such as AJCC stage III and Ki67 ≥ 14%, preoperative a cutoff albumin value of ≤ 4.1 g/dl, a cutoff platelet value of ≥ 253 10^3/µl, and a cutoff RDW-SD value of ≥ 44 fL could significantly predict DFS in patients with breast cancer.