Breast cancer is a major public health problem in both developed and developing countries. Its incidence is rapidly increasing (1-3). In general, different sociodemographic and hematologic characterizations are very important and should be considered in order to maximize treatment success and patient survival. In this study, the majority, 54.3 % of the study participants were less than 40 years of age. This finding is comparable with a study conducted on the prevalence of estrogen receptor-negative breast cancer patients in Ethiopia, where 35% of the study participants were between 30–39 years old (23). On the other hand, our finding is not comparable with a study conducted in Iraq which indicated that 58.4% of the participants were found to be between 50 and 59 years (18). This difference could be due to lifestyle, diet, genetic, population characteristics of the countries and related factors.
Even though breast cancer occurrence is believed to be higher in above 50 years of age, in this study r, 15.2% of cases were found to be less than 30 years old, which is comparable with another study done in Ethiopia (23). However, this study is incomparable with a study done in India, which indicated that there is no breast cancer case in those less than 30 years of age; this difference could be due to life style, genetic factors and the population distribution of the country (19). In general, this study revealed that the majority, 76.5% of breast cancer cases were less than 50 years old. This finding is somehow comparable with study done in Pakistan, Sindh, which indicated that, 61.67% of the cases were less than 50 years (24).
Regarding educational status, majority, 43.3% of the cases were illiterate, which is lower than the study conducted in Sindh which indicated that 71.7% were illiterate; this difference could be due to smaller sample size and study setting (24). In general, large number, (34.3%), of cases as opposed to 12.6% of the controls had a monthly income of less than 1000 Ethiopian Birr. However, based on another study, the distribution of cancer was noted to be more on socioeconomically better individuals, presumably owing to lifestyle risks they are exposed to (25). Regarding marital status, majority, 76.1% of the cases were married. That appears to be comparable with studies conducted in different countries (6, 24).
Hematological parameters are tests which are routinely available, cost effective, standardized and provide valuable information regarding different types of diseases, including cancer (18). In this study, the mean hemoglobin, PCV, RBCs, values were significantly lower in patients compared to controls. This finding is comparable with studies conducted in Iraq (18), Nigeria (16), Sindah (Pakistan) (24).
Since HB and PCV are used as guides to diagnose anemia and anemia is one of the major problems for most of cancer patients, those parameters are usually lower compared to healthy controls (16, 24). This low level of hematological parameters may be associated with bone marrow suppression or immune suppression, as a result of the cancer itself, (26). The other possible reason could be if the patient condition were on pre or post-surgery, these parameters can be significantly reduced. In addition, nutritional status and clinical conditions of patients could also play the most important role in the reduction of such values (26, 27). Regarding red cell indices, the mean MCV and MCHC were significantly lower among cases, whereas the MCH was almost similar for cases and controls. This finding is comparable with study done in Nigeria (17). With the exception of MCH, it is also supported by a study done in India, which indicated that the overall mean MCV, MCH, MCHC of cases were lower than the controls (28).
The mean WBC value of the cases and controls was almost the same. The mean platelet count was significantly higher among patients than controls (323.4+ 108.1 versus 282.0+ 70.0). This finding is comparable with a similar study done in Nigeria, Lagos which revealed that mean platelet count was 291.5+103.4 and 228.8+ 75.6 for cases and controls, respectively (17). This study is also supported by a similar study conducted in India, which indicated that mean platelet count was higher among cases compared with controls (14). This increment could be explained by the reactive thrombocytosis among most breast cancer patients as a result of cancer induced anemia. However, this finding is incomparable with similar study conducted in Iraq which indicated that the mean platelet and, WBC counts are significantly lower in cases than in controls (18). This difference could be due to small sample size, clinical characteristics, and demographic of differences of the study participants.
Regarding differential WBC count, there was a significantly higher mean value among cases compared with the controls. In this study, the mean neutrophil and lymphocyte count was 55.2+1.9% and 29.6 + 11.2% for cases and 36.4+19.3% and 24.6 + 8.4% for controls, respectively. This finding is comparable with a study conducted in Nigeria, which indicated a significantly higher mean value of neutrophil and lymphocytes counts, 54.8+ 13.1%, and 38.2+12.8% for cases versus 44.4+ 8.9%, 8.8+16.0% for controls, respectively (17). This increment could be explained by neoplasm of cancer cells.
A pretreatment anemia or lecocytosis can serve as a useful marker to predict outcome of cancer. In this study, it was observed that anemia was found in 20.4% of cases and 5.6% of controls, which is comparable with a study done in Tikur Anbessa Specialized Hospital among patients with solid tumor, where the prevalence of anemia was 23% (29). It is also similar with a study done among breast cancer patients in China, which indicated that 25.3% of patients were anemic before treatment (30).
In contrast to the current study, researchers from India reported that 60% of pre chemotherapy breast cancer patient were anemic (26). This difference could be due to smaller sample size of the later study, which were 51 cases and controls. It could be also due to the study setup, the background of the study participants, and the stage of the disease. This study also indicated that leukopenia was found in 5.7% of cases and 3.9% of controls, this nearly comparable with study done in India (31). Thrombocytosis was observed among 23.5% of the cases and 7.8% of controls. This study was nearly was nearly comparable with study done among pretreatment breast cancer patients were 18.2 % of the cases were with thrombocytosis (32).This difference could be due to difference in stage of disease and the study participants.
Limitation; since this study is a hospital based study; it may not be representative for the general population. However, in the absence of sufficient data in the country, this study from the only cancer treatment center of the country during the study period highlights the situation.