Assessment of Hormonal Imbalance and Diagnostic Accuracy with Renal Function Parameters in Women with Breast Cancer: A Correlation Study

Abstract

Reduced kidney function significantly influences breast cancer (BC) pathophysiology by disrupting hormone metabolism, leading to elevated systemic exposure to endogenous estrogens and their metabolites. This study aimed to investigate the relationships among estradiol (E2), progesterone (P4), and CA15, as well as renal function parameters (Urea and Creatinine) in women diagnosed with BC.

A total of 160 Iraqi women participated and were categorized into Group A (n=40, BC with normal renal function), Group B (n=40, BC with renal dysfunction), and Group C (n=80, healthy controls). CA15.3 was measured using a Cobas automated analyzer (Roche). Estradiol (E2) and Progesterone (P4) levels were determined using ELISA kits provided by BioCompare. Urea and Creatinine (Cr) were determined using spectrophotometric techniques. 

The findings revealed statistically significant differences (P < 0.001) in E2, P4, Cr, urea, and CA15.3 between the patient and healthy groups. CA15.3, E2, and P4 demonstrated the highest discriminative ability (P<0.001), whereas Cr showed the strongest diagnostic performance, with an AUC of 0.868 (P<0.001). Pearson correlation analysis revealed that CA15.3 was negatively correlated with both E2 and P4 (p<0.001). In addition, a strong negative correlation was found between Estradiol (E2) and both Urea and Creatinine (r = -0.5728, r = -0.5728, p<0.001). Moreover, strong negative correlations were found between Progesterone (P4) and both Urea and Creatinine (r = -0.4831, r = -0.5212, p < 0.001).

Reduced kidney function establishes a complex, tumor-promoting environment that greatly affects the pathophysiology of BC. The association is fueled by a mix of hormonal imbalance, ongoing inflammation, and modified toxin metabolism, which collectively encourage cancer development and progression.