Monocyte distribution width in breast cancer: Results from a retrospective exploratory pilot study

Despite the therapeutic breakthroughs achieved over the years, breast cancer (BC) continues to rank as the deadliest tumor among women worldwide. Therefore, preven‑ tion and screening programs remain crucial for the successful recovery of patients with BC. Monocyte distribution width (MDW) is a novel hematological parameter provided along with the complete blood count by DxH haematology analyzers. Variations in MDW have been associated with diagnostic and prognostic significance in sepsis, viral infections and other inflammation‑related diseases. However, the potential role of MDW remains largely unknown in malignant disorders, including BC. Using a retrospective approach, patients with BC were included in the present study to examine the MDW levels at diagnosis in relation to controls. MDW was also assessed with respect to the histopathological features of BC. Either Welch's t‑test or Brown‑Forsythe and Welch ANOVA were used to estimate significance, while receiver operating characteristic curves and the area under the curve were used to evaluate the overall performance of MDW in BC. MDW levels were higher in patients with BC than in controls (P<0.0001), while no changes were recorded in the absolute monocytes count. With respect to the histopathological features, an elevated MDW was typically detected in BC presenting as invasive ductal carcinoma (P=0.0002), and expressing either estrogen (P<0.0001) or progesterone receptors (P<0.0001). Higher MDW levels were also observed in patients with BC scoring as grade III, as well as in those presenting lymph node involvement (N1‑3), suggesting a possible association with the progression of BC. Overall, the present retrospective explor‑ atory pilot study proposed MDW as a possible biomarker in BC, indicating future perspectives for the diagnosis, stratifica‑ tion and prognosis of this deadly disease.