A Meta-Analysis of the Efficacy of Albumin Paclitaxel versus Docetaxel in the Treatment of Breast Cancer

Objective. To use meta-analysis to systematically compare the efficacy and adverse reaction rates of albumin paclitaxel and docetaxel in the treatment of breast cancer. Methods. This study included Chinese and English literature studies on clinical controlled studies of albumin paclitaxel and docetaxel in the treatment of breast cancer by searching CNKI, Weipu, Wanfang, PubMed, Embase, and Cochrane Library. Two researchers participated in the screening of the literature, used the inclusion and exclusion criteria as reference indicators, extracted relevant data, and used the software RevMan5.3 to conduct quality evaluation and meta-analysis of the literature. Results. 4 literature stuides were retrieved that met the inclusion criteria, with 243 study subjects. The included literature had a lower risk of bias. Meta-analysis results showed that compared with the docetaxel group, the protein paclitaxel group had significant differences in objective effective rate (ORR) (OR = 1.56, 95% CI (0.80, 3.03), P = 0.19 ), complete remission (CR) (OR = 1.79, 95% CI (0.96, 3.35), P = 0.07 ), partial remission (PR) (OR = 0.88, 95% CI (0.53, 1.47), P = 0.62 ), nausea (OR = 0.87, 95% CI (0.51, 1.74), P = 0.84 ), and vomiting (OR = 0.62, 95% CI (0.45, 1.78) P = 0.76 ). The reason may be that the number of literatures included in this study is small or the sample size is insufficient. However, it had an advantage in the incidence of neutropenia (OR = 0.38, 95% CI (0.16, 0.88), P = 0.02 ), and the difference between the two groups was statistically significant. Conclusion. Albumin paclitaxel treatment can better reduce the incidence of neutropenia in breast cancer patients and is of great significance to the safety of breast cancer patients.

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Metformin May Block the Way Breast Cancer Metastasis: A Meta-analysis and Mechanism Review

10.21203/rs.3.rs-56326/v1 ◽

2020 ◽

Author(s):

Ming Yang ◽

Yueyuan Wang ◽

Zhihao Zhang ◽

Jingyu Peng ◽

Xiao Xie ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Distant Metastasis ◽

Retrospective Cohort ◽

Cancer Metastasis ◽

Meta Analysis ◽

Random Effect ◽

Breast Cancer Metastasis ◽

Cochrane Library ◽

Breast Cancer Patients

Abstract Background Metformin, which is cheap and easy to get, is a first-line anti-hyperglycemia drug. Recently, its anti-tumor effect has been revealed. Here we performed a meta-analysis to summarize previous studies and a narrative review to gather the mechanisms involved in the potential relationship. Methods We searched related articles in database of Pubmed, EMbase, Web of science, the Cochrane Library, China National Knowledge Infrastructure (CNKI), the Wanfang and Sinomed and obtained 8 clinic trials that investigated the connection between metformin and breast cancer metastasis, containing 2 randomized controlled trials (RCTs) and 6 retrospective cohort studies. We evaluated each retrospective cohort study by Newcastle-Ottawa Scale (NOS), while RCT by Chcorane Risk of Bias tool. Pooled hazard ratios (HRs), risk ratios (RRs) and we calculated associated 95% confidence intervals (CIs) with a random-effect, generic inverse variance method. We also collected the possible mechanisms of cancer metastasis inhibition from metformin. Results A total of 8 studies containing 13919 breast cancer patients without distant metastasis before they got anticancer treatment. The result showed that adjuvant metformin in treatment of local breast cancer facilitated to suppress metastasis (HR = 0.69, 95% CI = 0.57–0.82, p < 0.0001, I2 = 0%), and the result was consistent with the subgroup of breast cancer patients with type 2 diabetes mellitus (T2DM) (HR = 0.68, 95% CI = 0.57–0.82, p < 0.0001, I2 = 0%). Conclusion The meta-analysis suggested metformin might repress the metastasis and be benefit to distant metastasis-free survival (DMFS) when added to systemic breast cancer therapy, supporting anti-tumor effects of metformin on breast cancer.

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What is the Current Effectiveness of Olaparib for Breast Cancer Patients with a BRCA Mutation? A Systematic Review

The Open Nursing Journal ◽

10.2174/1874434601913010039 ◽

2019 ◽

Vol 13 (1) ◽

pp. 39-59

Author(s):

Polly Marsh ◽

Graham R Williamson

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Clinical Trials ◽

Cancer Patients ◽

Brca Mutation ◽

Meta Analysis ◽

Grey Literature ◽

Gene Mutations ◽

Cochrane Library ◽

Breast Cancer Patients

Background:The Poly (ADP-ribose) polymerase inhibitor olaparib, acts against cancer cells in people with breast cancer pre-disposition gene mutations (BRCAm). Despite US and EU approval as a therapy for ovarian cancer patients with BRCAm, but research into olaparib therapy for breast cancer patients with BRCAm is in its infancy.Objective:As no systematic review has yet been undertaken to synthesise clinical trials looking at olaparib as a therapy for breast cancer patients with BRCAm, this systematic review aims to establish the current effectiveness of olaparib as a treatment for these patients.Methods:CINAHL, MEDLINE, Royal College of Nursing, Cochrane Library, Joanna Briggs Institute, Centre for Reviews and Dissemination, Internurse, Embase, Google Scholar and PubMed databases were searched, supplemented by a grey literature search, hand searching and cross-referencing. Authors independently reviewed and graded the studies also using Kmetet al. scoring system.Results:One long-term case study and six clinical trials were included. Heterogeneity prevented statistical meta-analysis, meaning only narrative synthesis was possible. The overall clinical benefit of olaparib appears to be greater and longer lived in BRCAm carriers compared to BRCAwt, and also when compared to standard chemotherapy treatments.Conclusion:Implications for nursing: nurses working in this field should be aware that the most compelling results were found in the subset of patients who harbour a BRCA mutation, meaning that olaparib should be regarded as a clinically effective potential therapy for these patients. Larger, longer-term trials including comparator arms are required to demonstrate benefits including overall survival, adverse effects and quality of life.

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A Meta-Analysis: Intervention Effect of Mind-Body Exercise on Relieving Cancer-Related Fatigue in Breast Cancer Patients

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2021/9980940 ◽

2021 ◽

Vol 2021 ◽

pp. 1-8

Author(s):

Cong Liu ◽

Man Qin ◽

Xinhu Zheng ◽

Rao Chen ◽

Jianghua Zhu

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Meta Analysis ◽

Combined Effect ◽

Assessment Tools ◽

Cochrane Library ◽

Control Group ◽

Breast Cancer Patients ◽

Intervention Effect ◽

Cancer Related Fatigue

Objective. This paper aims to systematically evaluate the intervention effect of mind-body exercise on cancer-related fatigue in breast cancer patients. Methods. Databases including PubMed, the Cochrane Library, Embase, Web of Science, CNKI, Wanfang Data, and SINOMED were retrieved to collect randomized controlled trials on the effects of mind-body exercise on relieving cancer-related fatigue in breast cancer patients. The retrieval period started from the founding date of each database to January 6, 2021. Cochrane bias risk assessment tools were used to evaluate the methodological quality assessment of the included literature, and RevMan 5.3 software was used for meta-analyses. Results. 17 pieces of researches in 16 papers were included with a total of 1133 patients. Compared with the control group, mind-body exercise can improve cancer-related fatigue in breast cancer patients. The combined effect size SMD = 0.59, 95% CI was [0.27, 0.92], p < 0.00001 . Doing Tai Chi for over 40 minutes each time with an exercise cycle of ≤6 weeks can improve cancer-related fatigue in breast cancer patients more significantly. Sensitivity analysis shows that the combined effect results of the meta-analysis were relatively stable. Conclusion. Mind-body exercise can effectively improve cancer-related fatigue in breast cancer patients.

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Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: A systematic review and meta-analysis

10.21203/rs.2.12666/v1 ◽

2019 ◽

Author(s):

Yang He ◽

Jianhua Zhang ◽

Guofang Shen ◽

Lin Liu ◽

Qingwei Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Aromatase Inhibitors ◽

Cardiovascular Events ◽

Meta Analysis ◽

Group Analysis ◽

Cochrane Library ◽

Breast Cancer Patients ◽

Treatment Regimens ◽

Tumor Types

Abstract Objective Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. Methods Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs, ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seventeen studies, which included 44411 subjects, were included in our analyses.The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15%–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545-1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR=1.1564, 95% CI: 1.0656-1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. Conclusions These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.

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Efficacy and Safety of Cinobufacin Combined with Chemotherapy for Advanced Breast Cancer: A Systematic Review and Meta-Analysis

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/4953539 ◽

2020 ◽

Vol 2020 ◽

pp. 1-13

Author(s):

Jing Xu ◽

Dongyun Li ◽

Kexin Du ◽

Jing Wang

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Patients ◽

Meta Analysis ◽

Efficacy And Safety ◽

Breast Cancer Patients ◽

Chemotherapy Group ◽

Liver And Kidney ◽

The Difference ◽

Liver And Kidney Damage

Background. Cinobufacin is a Chinese patent medicine widely used for breast cancer in China. However, no systematic review and meta-analysis have been published to validate its effects in breast cancer treatment. We, therefore, summarize the efficacy and safety of Cinobufacin combined with chemotherapy in order to provide rigid evidence for its clinical application. Methods. By searching multiple databases incepted to December 2019, the RCTs of breast cancer patients treated with Cinobufacin were screened according to the inclusion criteria, and the meta-analysis and sensitivity analysis were conducted using RevMan5.3. Results. A total of 1163 articles were retrieved, and 16 studies were included. The total sample size was 1331 cases, including 666 cases in the treatment group receiving Cinobufacin combined with chemotherapy and 665 cases in the control group receiving chemotherapy alone. Our study found that the ORR (overall response rate) (RR = 1.35, 95% CI: [1.23, 1.49], P<0.00001), CBR (clinical benefit rate) (RR = 1.14, 95% CI: [1.08, 1.21], P<0.00001), KPS scores (RR = 1.98, 95% CI: [1.45, 2.68], P<0.0001), and pain relief rate (RR = 1.34, 95% CI: [1.01, 1.78] P=0.04 of the Cinobufacin combined with chemotherapy group were better than those of the chemotherapy group, and the difference was statistically significant. Our study also discovered that the tumor markers (CA125, CA153, and CEA) in the Cinobufacin combined with chemotherapy group were lower than those in the chemotherapy group, which heterogeneity was derived from the low-quality literature included in the study, but the results were robust. In addition, in terms of safety, we found that the incidences of gastrointestinal reactions (RR = 0.58, 95% CI: [0.48, 0.70], P<0.00001), liver and kidney damage (RR = 0.57, 95% CI: [0.38, 0.84], P=0.004), and hair loss (RR = 0.61, 95% CI: [0.40, 0.92], P=0.02) in the Cinobufacin combined chemotherapy group were lower than those in the chemotherapy group, and the difference was statistically significant, but the incidences of peripheral neurotoxicity (RR = 0.69, 95% CI: [0.26, 1.85], P=0.46) and myelosuppression (RR = 0.78, 95% CI: [0.46, 1.34], P=0.37) in the combined group were similar to those of the chemotherapy group, and the difference was not statistically significant. Conclusions. Cinobufacin combined with chemotherapy can improve the clinical efficacy of breast cancer patients, enhance the quality of life of the patients, reduce the value of tumor markers such as CA125, CA153, and CEA, and lower the occurrence of adverse reactions such as gastrointestinal reactions, liver and kidney damage, and hair loss.

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Acupuncture for Arthralgia Induced by Aromatase Inhibitors in Patients with Breast Cancer: A Systematic Review and Meta-analysis

Integrative Cancer Therapies ◽

10.1177/1534735420980811 ◽

2021 ◽

Vol 20 ◽

pp. 153473542098081

Author(s):

Xiaomeng Liu ◽

Jing Lu ◽

Guoxin Wang ◽

Xiu Chen ◽

Haiping Xv ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Aromatase Inhibitors ◽

Meta Analysis ◽

Cochrane Library ◽

Common Side Effect ◽

Clinical Effects ◽

Breast Cancer Patients ◽

Placebo Effects ◽

China National Knowledge Infrastructure

Background: Aromatase inhibitor-induced arthralgia (AIA) is the most common side effect of aromatase inhibitors (AIs) used in breast cancer patients and is related to the rate of adherence to AIs. The clinical effects of acupuncture on AIA have been assessed by some randomized controlled trials (RCTs). However, some studies reported that acupuncture was effective, while others claimed that it was ineffective. To clarify the clinical and placebo effects of acupuncture in treating AIA, we conducted this meta-analysis. Methods: Two reviewers (XL and GW) independently searched for RCTs in 5 English databases (PubMed, Web of Science, Embase, Springer, Cochrane Library) and 4 Chinese databases (China National Knowledge Infrastructure Database (CNKI), SinoMed, VIP and Wanfang Database) from their inception to 30 November 2019. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, this meta-analysis was performed by fixed or random-effects models, and data were pooled with mean differences (MDs). Results: Seven trials involving 603 patients were reviewed. The primary outcome, the Brief Pain Inventory (BPI) score, significantly differed between the acupuncture and control groups [pain-related interference: MD = −1.89, 95% confidence interval (CI) [−2.99, −0.79], Z = 3.36 ( P = .008 < .05), pain severity: MD = −1.57, 95% CI [−2.46, −0.68], Z = 3.45 ( P = .0006 < .05), worst pain: MD = −2.31, 95% CI [−3.15, −1.48], Z = 5.47 ( P < .0001 < .05)]. No severe adverse events were reported in any study. Conclusion: This meta-analysis showed that acupuncture is a safe and effective treatment for breast cancer patients with AIA. Additional research with improved blinding methods is warranted to further explore the nature of non-specific and placebo effects in true and sham acupuncture.

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Age at Diagnosis of Breast Cancer in Iran: A Systematic Review and Meta-Analysis

Iranian Journal of Public Health ◽

10.18502/ijph.v50i8.6802 ◽

2021 ◽

Author(s):

Mahasti Alizadeh ◽

Morteza Ghojazadeh ◽

Reza Piri ◽

Mohammad Mirza-Aghazadeh-Attari ◽

Sahar Mohammadi ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Patients ◽

Meta Analysis ◽

Age At Diagnosis ◽

Cochrane Library ◽

Breast Cancer Patients ◽

Female Patients ◽

Wide Range ◽

The Mean

Background: Breast cancer is responsible for up to 25% of all cancers in Iran. The age at diagnosis of Iranian breast cancer patients starts a decade earlier than most of developed countries. This study aimed to evaluate the mean age at diagnosis of Iranian breast cancer patients. Methods: In this systematic review and meta-analysis, the mean age at diagnosis of Iranian breast cancer patients and its pattern between 2008 and 2017, were evaluated. All papers with age at diagnosis of histopathological verified breast cancer patients were considered eligible to enter to the analysis. We used databases including Medline/PubMed, Scopus, Embase, Cochrane Library, Iranmedex and SID for the search process. The meta-analysis was performed only on studies with separate data for female patients, using random-effects model, Mantel and Haenszel method and the Comprehensive Meta-analysis software. Results: Finally, 92 studies with 19,784 patients (both-genders) were included. The mean age at diagnosis had increased from 47.93 (2008) to 49.91 (2016) years. The meta-analysis was done on 78 studies containing of 15,071 female patients and the mean age at diagnosis was 46.76±1.19. There was a wide range of age at diagnosis within different provinces. The mean age at Hamadan and Khuzestan provinces were the lowest and highest, respectively (42.48±7.96 vs. 51.00±11.47). The heterogeneity of studies was statistically significant (I2=99.744). Conclusion: Mean age at diagnosis of Iranian women with breast cancer was 46.76±1.19. There was an increasing pattern in mean age of diagnosis at breast cancer patients within the past 10 years.

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Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: A systematic review and meta-analysis

10.21203/rs.2.12666/v2 ◽

2019 ◽

Author(s):

Yang He ◽

Jianhua Zhang ◽

Guofang Shen ◽

Lin Liu ◽

Qingwei Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Aromatase Inhibitors ◽

Cardiovascular Events ◽

Meta Analysis ◽

Group Analysis ◽

Cochrane Library ◽

Breast Cancer Patients ◽

Treatment Regimens ◽

Tumor Types

Abstract Background : Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. Methods: Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs ,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results: Seventeen studies, which included 44411 subjects, were included in our analyses.The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15%–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs . The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545 -1.1562 ). Under sub-gro up analysis, the incidence of CVEs related to exemestane was high er than that of controls (OR=1.1564, 95% CI: 1.0656-1.2549) , but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. Conclusions: These results suggest that p atients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs . Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.

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Aromatase inhibitors and risk of cardiovascular events in breast cancer patients: a systematic review and meta-analysis

BMC Pharmacology and Toxicology ◽

10.1186/s40360-019-0339-1 ◽

2019 ◽

Vol 20 (1) ◽

Cited By ~ 1

Author(s):

Yang He ◽

Jianhua Zhang ◽

Guofang Shen ◽

Lin Liu ◽

Qingwei Zhao ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Aromatase Inhibitors ◽

Cardiovascular Events ◽

Meta Analysis ◽

Group Analysis ◽

Cochrane Library ◽

Breast Cancer Patients ◽

Treatment Regimens ◽

Tumor Types

Abstract Background Cardiovascular events (CVEs) was considered as one of the primary cause to reduce the quality of life in breast cancer patients with aromatase inhibitors (AIs) treatment, which has not been sufficiently addressed. The aim of this study was to assess the correlation between risk of CVEs and AIs in patients with breast cancer. Methods Included studies were obtained from the databases of Embase, Pubmed, Cochrane Library, Clinical Trials.gov, and reference lists. The main outcome measures were overall incidence, odds ratios (ORs), and 95% confidence intervals (CIs). Furthermore, the association and the risk differences among different tumor types, AIs,ages,or treatment regimens were conducted. Fixed-effect or random-effect models were applied in the statistical analyses according to the heterogeneity. Our analysis was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement. Results Seventeen studies, which included 44,411 subjects, were included in our analyses. The overall incidence of CVEs in AIs group was 13.02% (95% CI: 8.15–20.17%) and almost all of the high-grade CVEs occurred in patients treated with AIs. The pooled ORs of CVEs was 0.9940 (95% CI: 0.8545–1.1562). Under sub-group analysis, the incidence of CVEs related to exemestane was higher than that of controls (OR = 1.1564, 95% CI: 1.0656–1.2549), but no statistical differences in risk of CVEs were found in other sub-group analysis. No evidence of publication bias was found for incidence of CVEs in our meta-analysis by a funnel plot. Conclusions These results suggest that patients with breast cancer treated with AIs do not have a significant risk of developing CVEs in comparison with the controls, and exemestane might not be considered as the alternative AI to the breast cancer patients from the perspective of CVEs. Further studies are recommended to investigate this association and the risk differences among different tumor types, AIs or treatment regimens.

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Diagnostic value of serum HER2 levels in breast cancer: a systematic review and meta-analysis

BMC Cancer ◽

10.1186/s12885-020-07545-2 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Amir Shamshirian ◽

Amir Reza Aref ◽

George W. Yip ◽

Majid Ebrahimi Warkiani ◽

Keyvan Heydari ◽

...

Keyword(s):

Breast Cancer ◽

Systematic Review ◽

Cancer Patients ◽

Likelihood Ratio ◽

Predictive Value ◽

Meta Analysis ◽

Cochrane Library ◽

Breast Cancer Patients ◽

Diagnostic Screening ◽

Her 2

Abstract Background Measurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels might play an essential role as a diagnostic/screening marker for the early selection of therapeutic approaches and predict prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focusing on the diagnostic/screening value of serum HER-2 levels in comparison to routine methods. Methods We performed a systematic search via PubMed, Scopus, Cochrane-Library, and Web of Science databases for human diagnostic studies reporting the levels of serum HER-2 in breast cancer patients, which was confirmed using the histopathological examination. Meta-analyses were carried out for sensitivity, specificity, accuracy, area under the ROC curve (AUC), positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR), and negative likelihood ratio (NLR). Results Fourteen studies entered into this investigation. The meta-analysis indicated the low sensitivity for serum HER2 levels (Sensitivity: 53.05, 95%CI 40.82–65.28), but reasonable specificity of 79.27 (95%CI 73.02–85.51), accuracy of 72.06 (95%CI 67.04–77.08) and AUC of 0.79 (95%CI 0.66–0.92). We also found a significant differences for PPV (PPV: 56.18, 95%CI 44.16–68.20), NPV (NPV: 76.93, 95%CI 69.56–84.31), PLR (PLR: 2.10, 95%CI 1.69–2.50) and NLR (NLR: 0.58, 95%CI 0.44–0.71). Conclusion Our findings revealed that although serum HER-2 levels showed low se nsitivity for breast cancer diagnosis, its specificity, accuracy and AUC were reasonable. Hence, it seems that the measurement of serum HER-2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation.

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