Is serum albumin an independent predictor of survival in patients with breast cancer?

Abstract

BACKGROUND: The medical literature shows several examples of an inverse relationship between serum albumin levels and survival in patients with advanced cancer. METHODS: We investigated the effect of baseline serum levels on 180 consecutively treated patients who were diagnosed with breast cancer from March 1993 to December 1999 at our institution. We investigated the effect of low levels of serum albumin (<3.5 g/dL) using univariate and the multivariate Cox regression model. RESULTS: Demographically, the median age of these patients was 51 years of age, with a range of 28 to 88 years. In this series, 28 patients have died and 9 have developed a recurrence of tumor. The patient distribution by tumor stage was 53, stage 1; 47, stage 2A; 29, stage 2B; 11, stage 3; 13, stage 4A; and 21, stage 4B. In this cohort, the overall 5-year survival was 69%. The Cox regression analysis found that normal levels of albumin (>3.5 g/dL) reduced the risk of death by 72% (p = .0033). Only tumor stage had a larger impact on survival (p < .0000). Other factors achieving statistical significance were overexpression of the HER2/Neu antigen (p = .0167) and breast antigen (p = .0116). CONCLUSION: Univariate statistical analysis found that low levels of serum albumin adversely affected survival by a statistically significant level for all stages of breast cancer. We found that a baseline serum albumin level was a powerful prognostic variable, which accounted for 7.35% of the variation in patient survival time.

Newly diagnosed breast cancer patients with low levels of baseline serum albumin have less than expected survival. Only tumor stage had a significantly greater prognostic impact on survival. Low serum albumin identifies patients who have a higher risk of premature death for all stages of breast cancer.