Biochemical and hematological tests in patients with breast carcinoma: correlations with extent of disease, sites of relapse, and prognosis.

The value of serial biochemical and hematological tests of blood in differentiating stages and in detecting recurrence of breast carcinoma was studied in 500 patients. Patients who had mastectomy and were with no evidence of disease (NED group) had higher hemoglobin, albumin, total protein, and lower LDH than patients with any amount of breast carcinoma. These four tests became more abnormal in patients with metastatic disease (group IV). In addition, peripheral lymphocyte count was significantly decreased, and SGOT, AP, alpha-1 globulin, and CEA significantly increased, when patients developed recurrent or metastatic disease. Patients with disseminated soft tissue or lung metastasis had less abnormality of such blood tests than those with metastasis in bone or other visceras. Immunoglobulins (IgG, IgA, IgM) were not different between early or late stages, nor specific sites of metastatic involvement. Among patients with a greater amount of loco-regional disease (group III) and patients with metastatic disease (group IV), those who had hemoglobin greater than or equal to 12.5 gm%, lymphocyte count of 15-2,500/cmm, albumin greater than or equal to 4 gm%, AP less than or equal to 25 units, or LDH less than or equal to 400 units had significantly better 5-year survival rates.