Published date: Sep 06 2017

Journal Title: Sudan Journal of Medical Sciences

Issue title: Sudan JMS: Volume 12 (2017), Issue No. 3

Pages: 119-132

DOI: 10.18502/sjms.v12i3.915

Rufaida Mustafa Ahmed Mustafarufaida8882@gmail.comSudan University of Science and TechnologyDepartment of Haematology

Nazik Elmalaika Obaid Seid Ahmed Husainnazikhusain@gmail.comOmdurman Islamic UniversityDepartment of Pathology

Background:Iron is a vital constituent of cells but in excess may be harmful and is associated with a raised risk for some malignant diseases including breast cancer. We aimed to study changes in iron profile in Sudanese females newly diagnosed with breast cancer.

Methods: A case- control study in which serum iron, Total Iron Binding Capacity (TIBC), and transferrin saturation percent were measured for fifty females with breast cancer referred to Khartoum Oncology Hospital and seventy apparently healthy females, using manual method (IRON-FERROZINE).  

Results: Mean age was 47years and 42years in cases and control, respectively and the mean of parity was 4 in both groups. Mean of serum iron ±SD in case group was 244.30 ± 151.598(µg/dL)and in control group was 57.59 ± 43.191(µg/dL) (P. value = 0.000). Mean of TIBC ±SD in cases was 412.98 ± 177.460(µg/dL)and in controls it was 403.71 ± 168.765(µg/dL) (P.value = 0.838). The mean of transferrin saturation percent ± SD in cases was 61.08 % ±41.523 and in controls was 223.23 % ±149.195 (P.value=0.000). The mean of TIBC in grade I 343.00(µg/dL), 467.10(µg/dL) in grade II and 321.25(µg/dL) in grade III (P.value 0.019).

Conclusion: There is a statistically significant increase in the mean of serum iron and decrease in transferrin saturation percent in women with breast cancer. TIBC vary significantly according to histopathological grade. Serum iron and transferrin saturation percent may be helpful as biochemical risk markers for breast cancer and TIBC may act as a predictor of disease grade.

1. Siegel RL, Miller KD, Fedewa SA, Ahnen DJ, Meester RG, Barzi A, et al. Colorectal cancer statistics, 2017. CA: a cancer journal for clinicians. 2017;67(3):177-93. http://onlinelibrary.wiley.com/doi/10.3322/caac.21387/abstract

2. Saeed IE, Weng HY, Mohamed KH, Mohammed SI. Cancer incidence in Khartoum, Sudan: first results from the Cancer Registry, 2009-2010. Cancer medicine. 2014;3(4):1075-84.
3. Rodak BF, Fritsma GA, Keohane E. Hematology: clinical principles and applications: Elsevier Health Sciences; 2013.
4. Ćujić D, Stefanoska I, Golubović S. Serum ferritin in healthy women and breast cancer patients. Journal of Medical Biochemistry. 2011;30(1):33-7.
5. Liehr JG, Jones J. Role of iron in estrogen-induced cancer. Current medicinal chemistry. 2001;8(7):839-49.
6. Yamane T. Statistics: an introductory analysis-3. 1973. http://www.worldcat.org/title/statistics-an-introductory-analysis/oclc/39121222
7. E Anne Steine-martin. CAL-s, and John A Koepke. Clinical Hematology Principles. Procedures and correlation. Philadelphia, New York, USA: Lippincott; 1998.
8. Das B. Cancer patterns in Haryana: Twenty-one years’ experience. Radiation Oncology. 2005;5(1):22-32.
9. Sauer R. Adjuvant radiotherapy after breast conserving surgery for breast cancer. Pro. European journal of cancer. 2000;36(9):1073-8.
10. Lamy PJ, Durigova A, Jacot W. Iron homeostasis and anemia markers in early breast cancer. Clinica chimica acta; international journal of clinical chemistry. 2014;434:34-40.
11. Marques O, da Silva BM, Porto G, Lopes C. Iron homeostasis in breast cancer. Cancer letters. 2014;347(1):1-14.
12. Kwok JC, Richardson DR. The iron metabolism of neoplastic cells: alterations that facilitate proliferation? Critical reviews in oncology/hematology. 2002;42(1):65-78.
13. Hentze MW, Muckenthaler MU, Galy B, Camaschella C. Two to tango: regulation of Mammalian iron metabolism. Cell. 2010;142(1):24-38.
14. Wang F, Elliott RL, Head JF. Inhibitory effect of deferoxamine mesylate and low iron diet on the 13762NF rat mammary adenocarcinoma. Anticancer Res. 1999;19(1A):445-50.
15. Jiang XP, Wang F, Yang DC, Elliott RL, Head JF. Induction of apoptosis by iron depletion in the human breast cancer MCF-7 cell line and the 13762NF rat mammary adenocarcinoma in vivo. Anticancer research. 2001;22(5):2685-92.
16. Blatt J, Taylor SR, Stitely S. Mechanism of antineuroblastoma activity of deferoxamine in vitro. The Journal of laboratory and clinical medicine. 1988;112(4):433-6.
17. Hoke EM, Maylock CA, Shacter E. Desferal inhibits breast tumor growth and does not interfere with the tumoricidal activity of doxorubicin. Free radical biology & medicine. 2005;39(3):403-11.
18. Zhang S, Chen Y, Guo W, Yuan L, Zhang D, Xu Y, et al. Disordered hepcidin-ferroportin signaling promotes breast cancer growth. Cellular signalling. 2014;26(11):2539-50.
19. Pinnix ZK, Miller LD, Wang W, D'Agostino R, Jr., Kute T, Willingham MC, et al. Ferroportin and iron regulation in breast cancer progression and prognosis. Science translational medicine. 2010;2(43):43ra56.
20. Pusatcioglu CK, Nemeth E, Fantuzzi G, Llor X, Freels S, Tussing-Humphreys L, et al. Systemic and tumor level iron regulation in men with colorectal cancer: a case control study. Nutrition & metabolism. 2014;11:21.
21. Guner G, Kirkali G, Yenisey C, Tore IR. Cytosol and serum ferritin in breast carcinoma. Cancer letters. 1992;67(2-3):103-12.
22. Patil PS, Mohandas KM, Bhatia SJ, Mehta SA. Serum ferritin and the risk of hepatocellular carcinoma in chronic liver disease of viral etiology: a case-control study. Indian journal of gastroenterology : official journal of the Indian Society of Gastroenterology. 2014;33(1):12-8.
23. Fonseca-Nunes A, Jakszyn P, Agudo A. Iron and cancer risk--a systematic review and meta-analysis of the epidemiological evidence. Cancer epidemiology, biomarkers & prevention : a publication of the American Association for Cancer Research, cosponsored by the American Society of Preventive Oncology. 2014;23(1):12-31.
24. Gunel-Ozcan A, Alyilmaz-Bekmez S, Guler EN, Guc D. HFE H63D mutation frequency shows an increase in Turkish women with breast cancer. BMC cancer. 2006;6:37.
25. Kondrashova TV, Neriishi K, Ban S, Ivanova TI, Krikunova LI, Shentereva NI, et al. Frequency of hemochromatosis gene (HFE) mutations in Russian healthy women and patients with estrogen-dependent cancers. Biochimica et biophysica acta. 2006;1762(1):59-65.
26. Graff RE, Cho E, Lindström S, Kraft P, Willett WC, Eliassen AH. Premenopausal plasma ferritin levels, HFE polymorphisms, and risk of breast cancer in the nurses' health study II. Cancer Epidemiology and Prevention Biomarkers. 2014.
27. Higgy NA, Salicioni AM, Russo IH, Zhang PL, Russo J. Differential expression of human ferritin H chain gene in immortal human breast epithelial MCF-10F cells. Molecular carcinogenesis. 1997;20(4):332-9.
28. Shpyleva SI, Tryndyak VP, Kovalchuk O, Starlard-Davenport A, Chekhun VF, Beland FA, et al. Role of ferritin alterations in human breast cancer cells. Breast cancer research and treatment. 2011;126(1):63-71.
29. Wang W, Deng Z, Hatcher H, Miller LD, Di X, Tesfay L, et al. IRP2 regulates breast tumor growth. Cancer research. 2014;74(2):497-507.
30. Yager JD, Liehr JG. Molecular mechanisms of estrogen carcinogenesis. Annual review of pharmacology and toxicology. 1996;36:203-32.
31. Wrighting DM, Andrews NC. Interleukin-6 induces hepcidin expression through STAT3. Blood. 2006;108(9):3204-9.
32. Pavithra V, Sathisha TG, Kasturi K, Mallika DS, Amos SJ, Ragunatha S. Serum levels of metal ions in female patients with breast cancer. Journal of clinical and diagnostic research : JCDR. 2015;9(1):BC25-c7.
33. Dhankhar R AC, Dahiya K, Ghalaut VS, Nityasha, Dhull AK and Khurana A. Role of Iron Metabolism in Breast Cancer Patients. . Cancers Review. 2014;1(2):45-51.
34. C.A. Finch. aHAH. Iron metabolism1986.
35. Wen CP, Lee JH, Tai YP, Wen C, Wu SB, Tsai MK, et al. High serum iron is associated with increased cancer risk. Cancer research. 2014;74(22):6589-97.
36. Gaur A, Collins H, Wulaningsih W, Holmberg L, Garmo H, Hammar N, et al. Iron metabolism and risk of cancer in the Swedish AMORIS study. Cancer Causes & Control. 2013;24(7):1393-402.
37. Gaur A, Collins H, Wulaningsih W, Holmberg L, Garmo H, Hammar N, et al. Iron metabolism and risk of cancer in the Swedish AMORIS study. Cancer causes & control : CCC. 2013;24(7):1393-402.