Exploring Rdw As a Predictive Marker for 5-Year Overall and Progression-Free Survival in Breast Cancer; a Retrospective, Diagnostic Cohort Study Publisher



Mir A ; Lashkari M ; Habibi E
Source: Immunopathologia Persa Published:2026

Abstract

Introduction: Red cell distribution width (RDW), a parameter traditionally used to assess anemia, has emerged as a potential prognostic biomarker in various cancers, including breast cancer. Studies suggested that elevated RDW levels are associated with worse outcomes in terms of overall survival (OS) and progression-free survival (PFS). Objectives: This study aims to explore the utility of RDW as a predictive marker for 5-year OS and PFS in breast cancer patients. Patients and Methods: This retrospective cohort study investigated the prognostic significance of RDW as a predictive marker for 5-year OS and PFS in breast cancer patients. Conducted on 144 women treated at Shariati hospital and the cancer institute of Imam Khomeini hospital in Tehran, Iran, between 2011 and 2016, the study collected demographic, clinical, and pathological data from patient records and pathology reports. RDW values were derived from routine blood tests, while survival outcomes were assessed through phone interviews with patients or their families. The primary outcome focused on the association between RDW levels and 5-year OS, while the secondary outcome examined its correlation with 5-year PFS. Results: The results revealed that higher RDW was significantly associated with poorer outcomes of both OS and PFS, with an odds ratio (OR) of 1.89 and 1.41, respectively. The receiver operating characteristic (ROC) curve analysis indicated that, for patients with no 5-year OS, RDW demonstrated an area under the curve (AUC) of 0.783, ranging from 0.671 to 0.895. Similarly, for patients with no 5-year PFS, RDW showed an AUC of 0.679 (0.576–0.783). Conclusion: These findings highlight RDW as a potential prognostic biomarker for breast cancer survival outcomes, with higher RDW values correlating with poorer prognosis in terms of both OS and PFS. © 2026 The Author(s); Published by Nickan Research Institute. This is an open-access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.