title: Impact of preoperative anemia on relapse and survival in breast cancer patients.
abstract: BACKGROUND
  Previous studies have shown that preoperative anemia is correlated with the prognoses of various solid tumors. This study was performed to determine the effect of preoperative anemia on relapse and survival in patients with breast cancer.
  
  
  METHODS
  A total of 2960 patients with breast cancer who underwent surgery between 2002 and 2008 at the Sun Yat-sen University Cancer Center (Guangzhou, PR China) were evaluated in a retrospective analysis. A total of 2123 qualified patients were divided into an anemic group [hemoglobin (Hb) < 12.0 g/dL, N = 535)] and a nonanemic group (Hb ≥ 12.0 g/dL, N = 1588). The effects of anemia on local relapse-free survival (LRFS), lymph node metastasis-free survival (LNMFS), distant metastasis-free survival (DMFS), relapse-free survival (RFS), and overall survival (OS) were assessed using Kaplan-Meier analysis. Independent prognostic factors were identified in the final multivariate Cox proportional hazards regression model.
  
  
  RESULTS
  Among the 2123 women who qualified for the analysis, 535 (25.2%) had a Hb level < 12.0 g/dL. The Kaplan-Meier curves showed that anemic patients had worse LRFS, LNMFS, DMFS, RFS, and OS than nonanemic patients, even in the same clinical stage of breast cancer. Cox proportional hazards regression model indicated that preoperative anemia was an independent prognostic factor of LRFS, LNMFS, DMFS, RFS, and OS for patients with breast cancer.
  
  
  CONCLUSIONS
  Preoperative anemia was independently associated with poor prognosis of patients with breast cancer.
authors.forename: YingJun
authors.initials: Y
authors.lastname: Zhang
authors.forename: YuYang
authors.initials: Y
authors.lastname: Chen
authors.forename: DongTai
authors.initials: D
authors.lastname: Chen
authors.forename: Yu
authors.initials: Y
authors.lastname: Jiang
authors.forename: Wan
authors.initials: W
authors.lastname: Huang
authors.forename: HanDong
authors.initials: H
authors.lastname: Ouyang
authors.forename: Wei
authors.initials: W
authors.lastname: Xing
authors.forename: MuSheng
authors.initials: M
authors.lastname: Zeng
authors.forename: XiaoMing
authors.initials: X
authors.lastname: Xie
authors.affiliation: Anesthesiology Department, State Key Laboratory in South China, Sun Yat-Sen University Cancer Center, 651 Dongfeng East Road, Guangzhou, PR China. zengwa@mail.sysu.edu.cn.
authors.forename: Weian
authors.initials: W
authors.lastname: Zeng
mesh_terms: D000328:Adult; D000368:Aged; D000740:Anemia / Q000150:complications*; D001943:Breast Neoplasms / Q000150:complications* / Q000453:epidemiology* / Q000473:pathology / Q000601:surgery; D005260:Female; D006801:Humans; D008875:Middle Aged; D009026:Mortality; D060787:Neoplasm Grading; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D057234:Preoperative Period; D015995:Prevalence; D011379:Prognosis; D012307:Risk Factors; D016896:Treatment Outcome