title: Blood hemoglobin level and treatment outcome of early breast cancer.
abstract: OBJECTIVE
  To determine whether the blood hemoglobin concentration correlates with the prognosis of patients with early breast cancer and, if so, whether this is restricted to treatment modality.
  
  
  METHODS
  Data were collected retrospectively from patients with early breast cancer (T1,2 N0-2 M0) who underwent either breast-conserving surgery followed by adjuvant radiotherapy (BCS-RT; n=96) or a modified radical mastectomy (MRM; n=194). The effect of preoperative blood hemoglobin level, nodal status, histological grading and hormone receptor status on disease-free survival was determined for both treatment modalities using a Cox regression model and visualized by Kaplan-Meier plots.
  
  
  RESULTS
  The blood hemoglobin concentration significantly correlated with disease-free survival of patients receiving BCS-RT (relative risk [RR]: 0.67 per g/dl; p=0.007). This was independent of other known risk factors for breast cancer patients, as determined by multivariate analysis. By contrast, the blood hemoglobin level had no prognostic significance when patients were treated with MRM.
  
  
  CONCLUSIONS
  Blood hemoglobin concentration seems to affect the prognosis of patients with early breast cancer when a treatment schedule that includes radiotherapy is applied. Reduced radiosensitivity due to diminished tumor oxygenation may be the underlying cause. Confirmative trials and studies intended to elucidate the underlying mechanism are warranted.
authors.affiliation: Department of Radiotherapy, Radiological University Clinic, University Freiburg, Germany. henke@uni-freiburg.de
authors.forename: Michael
authors.initials: M
authors.lastname: Henke
authors.forename: Florian
authors.initials: F
authors.lastname: Sindlinger
authors.forename: Hans
authors.initials: H
authors.lastname: Ikenberg
authors.forename: Thomas
authors.initials: T
authors.lastname: Gerds
authors.forename: Martin
authors.initials: M
authors.lastname: Schumacher
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001940:Breast / Q000473:pathology; D001943:Breast Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D044584:Carcinoma, Ductal / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006452:Hemoglobinometry; D006801:Humans; D008207:Lymphatic Metastasis; D015411:Mastectomy, Modified Radical; D015412:Mastectomy, Segmental; D008875:Middle Aged; D009367:Neoplasm Staging; D009376:Neoplasms, Hormone-Dependent / Q000188:drug therapy / Q000473:pathology / Q000532:radiotherapy* / Q000601:surgery; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D011960:Receptors, Estrogen / Q000032:analysis; D011980:Receptors, Progesterone / Q000032:analysis; D012189:Retrospective Studies
chemical_list: D011960:Receptors, Estrogen; D011980:Receptors, Progesterone