Author(s): Assala Raya, Firas Hussein, Atieh Kamis


DOI: 10.52711/0974-360X.2022.00666   

Address: Assala Raya1*, Firas Hussein2, Atieh Kamis3
1Postgraduate Student, Department of Biochemistry and Microbiology, Faculty of Pharmacy, Tishreen University, Lattakia, Syria.
2Assistant Professor, Department of Internal Medicine and Hematology, Faculty of Medicine, Tishreen University, Lattakia, Syria.
3Assistant Professor, Department of Biochemistry and Microbiology, Faculty of Pharmacy, Tishreen University, Lattakia, Syria.
*Corresponding Author

Published In:   Volume - 15,      Issue - 9,     Year - 2022

Background: Breast cancer is the most common tumor among women worldwide, and elevated pretreatment serum ferritin levels are a poor prognostic factor in patients with many malignancies, but the relationship between serum ferritin levels and disease prognosis in breast cancer patients remains unclear. Aim: To estimate the relationship between pretreatment serum ferritin, overall survival (OS) and progression-free survival (PFS) in breast cancer patients. Patients and Methods: We evaluated pretreatment serum ferritin in 96 newly diagnosed breast cancer patients who have been followed up for 27months. Statistical analysis was performed using MedCalc (version 19.1.6). A p value <0.05 was considered statistically significant. Results: Among patients with serum ferritin levels less than 146ng/ml, the estimated mean PFS survival was 26.561±0.328 months compared to 15.212?1.396 months for those with serum ferritin levels 146ng/ml or higher (p=0.001). The estimated mean OS survival for patients with serum ferritin levels < 146ng/ml was 27 months, compared to 23.533?1.224 months for patients with serum ferritin levels = 146ng/ml (P=0.002), their 27 months OS survival rates were 68.75% and 27.08%, respectively (p=0.008). Conclusion: Serum ferritin can be useful prognostic factor for PFS and OS in breast cancer patients, and elevated levels of it at 146ng/ml or more are a poor prognostic factor for 27month survival rates.

Cite this article:
Assala Raya, Firas Hussein, Atieh Kamis. The Prognostic value of Serum Ferritin in Breast cancer patients. Research Journal of Pharmacy and Technology. 2022; 15(9):3975-9. doi: 10.52711/0974-360X.2022.00666

Assala Raya, Firas Hussein, Atieh Kamis. The Prognostic value of Serum Ferritin in Breast cancer patients. Research Journal of Pharmacy and Technology. 2022; 15(9):3975-9. doi: 10.52711/0974-360X.2022.00666   Available on:

1.     Jayashree V, Velraj M. Breast cancer and various prognostic biomarkers for the diagnosis of the disease: A review. Res J Pharm Technol. 2017;10(9):3211-3216. doi:10.5958/0974-360X.2017.00570.4
2.     Hariramani N, Jayanthi S. A Systematic Review of Intrinsic Factors and its Influence in Breast Cancer. Res J Pharm Technol. 2018;11(8):3543. doi:10.5958/0974-360X.2018.00654.6
3.     Al-Shalah MAN, Al-Mosawi HM, Alaawad AS. Comparative study between paired primary and relapsed breast cancer patients based on clinicopathological features and molecular subtypes of breast cancer in Babylon Province. Res J Pharm Technol. 2018;11(6):2365-2371. doi:10.5958/0974-360X.2018.00439.0
4.     Mohammed AJ. Tumor Suppressor Gene Mutations in Iraqi Women with Breast Cancer and Their Relatives. Res J Pharm Technol. 2018;11(10):4467. doi:10.5958/0974-360X.2018.00818.1
5.     Moselmani F, Al-Saleh J. Relation between Serum cyclo oxygenase-2 values and Tumor characteristics in breast cancer patients. Res J Pharm Technol. 2020;13(9):4320. doi:10.5958/0974-360X.2020.00763.5
6.     Asaad RA, Abdullah SS. Breast cancer subtypes (BCSs) classification according to hormone receptor status: Identification of patients at high risk in Jableh-Syria. Res J Pharm Technol. 2018;11(8):3703-3710. doi:10.5958/0974-360X.2018.00680.7
7.     Yi M, Ryu YM. The Effects of Breast Health Education in Women with Breast Cancer. Res J Pharm Technol. 2017;10(7):2295. doi:10.5958/0974-360X.2017.00407.3
8.     Kalpanapriya D, Saravanan M. Detection of Breast Cancer by Ultrasonic Image using Wavelet Transforms. Res J Pharm Technol. 2017;10(3):839. doi:10.5958/0974-360x.2017.00157.3
9.     Mutaz Sabah A, Khdhair Abbas K, Salih SM. The relationship between serum level of ferritin and cardiac troponin T (cTnT) in children with major beta-thalassemia. Res J Pharm Technol. 2019;12(4):1713-1716. doi:10.5958/0974-360X.2019.00285.3
10.     Knovich MA, Storey JA, Coffman LG, Torti S V., Torti FM. Ferritin for the clinician. Blood Rev. 2009;23(3):95-104. doi:10.1016/j.blre.2008.08.001
11.     Wang W, Knovich MA, Coffman LG, Torti FM, Torti S V. Serum ferritin: Past, present and future. Biochim Biophys Acta - Gen Subj. 2010;1800(8):760-769. doi:10.1016/j.bbagen.2010.03.011
12.     Mills RC. Breast Cancer Survivors, Common Markers of Inflammation, and Exercise: A Narrative Review. Breast Cancer Basic Clin Res. 2017;11. doi:10.1177/1178223417743976
13.     Asaad RA. Hormone receptor status and its relation to C-reactive protein and other prognostic factors in breast cancer in Jableh- Syria. Res J Pharm Technol. 2017;10(9):3003-3010. doi:10.5958/0974-360X.2017.00532.7
14.     Matzner Y, Konijn AM, Hershko C. Serum ferritin in hematologic malignancies. Am J Hematol. 1980;9(1):13-22. doi:10.1002/ajh.2830090103
15.     Zhang X-Z, Su A-L, Hu M-Q, Zhang X-Q, Xu Y-L. Elevated serum ferritin levels in patients with hematologic malignancies. Asian Pac J Cancer Prev. 2014;15(15):6099-6101. doi:10.7314/apjcp.2014.15.15.6099
16.     Anderson GJ, Frazer DM. Current understanding of iron homeostasis. In: American Journal of Clinical Nutrition. Vol 106. ; 2017:1559S-1566S. doi:10.3945/ajcn.117.155804
17.     Jacobs A, Jones B, Ricketts C, Bulbrook RD, Wang DY. Serum ferritin concentration in early breast cancer. Br J Cancer. 1976;34(3):286-290. doi:10.1038/bjc.1976.164
18.     Hann HW, Lange B, Stahlhut MW, McGlynn KA. Prognostic importance of serum transferrin and ferritin in childhood Hodgkin’s  disease. Cancer. 1990;66(2):313-316. doi:10.1002/1097-0142(19900715)66:2<313::aid-cncr2820660219>;2-j
19.     Kukulj S, Jaganjac M, Boranic M, Krizanac S, Santic Z, Poljak-Blazi M. Altered iron metabolism, inflammation, transferrin receptors, and ferritin  expression in non-small-cell lung cancer. Med Oncol. 2010;27(2):268-277. doi:10.1007/s12032-009-9203-2
20.     Wang SL, Cao S, Wu R, et al. Serum ferritin predicted prognosis in patients with locally advanced pancreatic cancer. Futur Oncol. 2015;11(21):2905-2910. doi:10.2217/fon.15.186
21.     Alkhateeb AA, Han B, Connor JR. Ferritin stimulates breast cancer cells through an iron-independent mechanism and is localized within tumor-associated macrophages. Breast Cancer Res Treat. 2013;137(3):733-744. doi:10.1007/s10549-012-2405-x
22.     Armitage P, Berry G, Matthews JNS. Statistical Methods in Medical Research, Fourth Edition. Published online February 1, 2008:760-783. doi:10.1002/9780470773666.refs
23.     Bezwoda W, Derman D, Bothwell T, et al. Significance of serum concentrations of carcinoembryonic antigen, ferritin, and calcitonin in breast cancer. Cancer. 1981;48(7):1623-1628. doi:10.1002/1097-0142(19811001)48:7<1623::AID-CNCR2820480725>3.0.CO;2-K
24.     Petekkaya I, Unlu O, Roach EC, et al. Prognostic role of inflammatory biomarkers in metastatic breast cancer. J BUON. 2017;22(3):614-622.
25.     Cozzi A, Corsi B, Levi S, Santambrogio P, Biasiotto G, Arosio P. Analysis of the biologic functions of H- and L-ferritins in HeLa cells by  transfection with siRNAs and cDNAs: evidence for a proliferative role of L-ferritin. Blood. 2004;103(6):2377-2383. doi:10.1182/blood-2003-06-1842
26.     Pham CG, Bubici C, Zazzeroni F, et al. Ferritin heavy chain upregulation by NF-kappaB inhibits TNFalpha-induced apoptosis  by suppressing reactive oxygen species. Cell. 2004;119(4):529-542. doi:10.1016/j.cell.2004.10.017
27.     Ma Y, Ren Y, Dai Z-J, Wu C-J, Ji Y-H, Xu J. IL-6, IL-8 and TNF-α levels correlate with disease stage in breast cancer patients. Adv Clin Exp Med  Off organ Wroclaw Med  Univ. 2017;26(3):421-426. doi:10.17219/acem/62120
28.     Coffman LG, Parsonage D, D’Agostino RJ, Torti FM, Torti S V. Regulatory effects of ferritin on angiogenesis. Proc Natl Acad Sci U S A. 2009;106(2):570-575. doi:10.1073/pnas.0812010106

Recomonded Articles:

Research Journal of Pharmacy and Technology (RJPT) is an international, peer-reviewed, multidisciplinary journal.... Read more >>>

RNI: CHHENG00387/33/1/2008-TC                     
DOI: 10.5958/0974-360X 

56th percentile
Powered by  Scopus

SCImago Journal & Country Rank

Recent Articles


Not Available