LDL-c as a predictor of hormonal status and determining factor for therapy of breast cancer patients

Background: Immunohistochemical testing is important in determining clinical diagnosis and therapy, and is useful as a prognostic and predictive factor, but it is not easy to do and is not always available. Breast cancer patient with higher low-density-lipoprotein cholesterol [LDL-c]. level tends to have larger tumor size, higher grade, higher proliferation rate, positive Human Epidermal growth factor Receptor-2 (HER2-neu) and occasionally come at late stage. High LDL-c receptors are found on the surface of breast cancer cells, where cancer cells will take up cholesterol in serum, and a metabolite of 27-hydroxycholesterol cholesterol will affect Estrogen Receptor-α.

Methods: Analytical observational study by cross sectional method, during July 2020 – November 2020, at Oncology Clinic Dr. Soetomo Hospital Surabaya with a total sample size of 42. The data obtained were analyzed using the SPSS version 23.0 program, regression test and Chi-Square were performed for characteristic analysis and Chi-Square Fischer’s Exact Test were performed for correlation test between lipid profiles with hormonal status.

Results: The mean value of LDL-c was 117.88 ± 33.89 mg/dL. In the analysis of the correlation between LDL-c and hormonal status, it was found that the majority of patients who had positive hormonal status had LDL-c levels of ≤160 mg/dL with p value = 0.049. ROC analysis shown LDL-c cut-off point of 132 mg/dL, p value = 0.034 (OR 5.031, 95% CI 1.159-21.848), sensitivity 46.7% and specificity 83.35%.

Conclusion: There is a statistically significant relationship between LDL-c levels and hormonal status with the cut-off point of 132 mg/dL. The increase in LDL-c in serum increases the tendency of negative hormonal status, therefore LDL-c levels can be considerate in determining the therapy for breast cancer patients.