Pre- and Post-chemotherapy Laboratory Evaluation in Women with Stage IIIB Breast Cancer

Liana, Phey; Waruwu, Yolanda Paulina; Roflin, Eddy; Umar, Mulawan; Rosya, Reni Apriani; Umar, Tungki Pratama

doi:10.33091/amj.2025.159232.2198

	Pre- and Post-chemotherapy Laboratory Evaluation in Women with Stage IIIB Breast Cancer
Al- Anbar Medical Journal
Volume 21, Issue 4, October 2025, Pages 242-247 PDF (499.71 K)
Document Type: Original articles
DOI: 10.33091/amj.2025.159232.2198
Authors
Phey Liana^* ¹; Yolanda Paulina Waruwu²; Eddy Roflin³; Mulawan Umar⁴; Reni Apriani Rosya⁵; Tungki Pratama Umar²
¹Department of Clinical Pathology, Faculty of Medicine, Universitas Sriwijaya-Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia
²Department of Medical Profession, Faculty of Medicine, Universitas Sriwijaya, Palembang, South Sumatera, Indonesia
³Department of Public Health, Faculty of Medicine, Universitas Sriwijaya, Palembang, South Sumatera, Indonesia
⁴Department of Surgical Oncology, Faculty of Medicine, Universitas Sriwijaya-Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia
⁵Central Laboratory Unit, Mohammad Hoesin General Hospital, Palembang, South Sumatera, Indonesia
Abstract
Background: Chemotherapy is a modality for breast cancer (BC) treatment, particularly to reduce cancer size within the affected breast and lymph nodes before surgery. It employs anti-cancer (cytotoxic) medicines to kill cancer cells; however, it has significant adverse effects, including hematological disturbance, renal disorder, and hepatotoxicity. Laboratory evaluation is an important component for ensuring chemotherapeutic safety for BC patients. Objectives: To assess the laboratory parameters features before and after chemotherapeutic treatment in type IIIB BC patients. Materials and methods: This laboratory-based retrospective study included medical record data of 90 adult female BC stage IIIB patients who had chemotherapy at a tertiary-level hospital. Laboratory results were collected from each patient before and after the chemotherapy procedure, which included hematological and clinical chemistry parameters. From the hematological parameters, several inflammatory hematological ratios were calculated. Statistical analysis was performed to compare laboratory parameters before and after chemotherapy intervention using the Paired T-test or the Wilcoxon test based on data distribution. Results: Following chemotherapy, there are significant drops in leukocytes (P-value = 0.002) and erythrocytes (P-value < 0.001), and hemoglobin (P-value < 0.001). In addition, the leukocyte differential count revealed a decrease in the percentage of eosinophils (P-value = 0.006) and an increase in the percentage of monocytes (P-value < 0.001). Upon an inflammatory hematological ratio investigation, we discovered monocyte-to-lymphocyte ratio and platelet-to-lymphocyte ratio elevation (P-value = 0.003 and 0.030, respectively) and neutrophil-to-monocyte ratio reduction (P-value = 0.002) following chemotherapy. Creatinine and aspartate transaminase were the blood chemistry parameters that differed significantly before and after chemotherapy (P-value = 0.028 and P-value = 0.038, respectively). Conclusion: Following BC chemotherapy, several laboratory changes, including bicytopenia, shifted leukocyte differentials, hematological inflammatory ratio change, and altered renal and hepatic function indices, were observed.
Keywords
Breast Cancer; Chemotherapy; Clinical Chemistry; Hematological Indices; Laboratory

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