Impact of preoperative anemia on relapse and survival in breast cancer patients

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, (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.