Relationship Between Red Cell Distribution Width (RDW)  and Histopathological Grading and Metastasis in Breast  Cancer Patients at Wahidin Sudirohusodo Hospital, Makassar,  Indonesia

Andi Ichsan Makkawaru; John Pieter Jr.; M. Ihwan Kusuma; Salman Ardi Syamsu; Nilam Smaradhania; Elridho Sampepajung; Muhammad Faruk

doi:10.31557/apjcb.2025.10.3.719-724

Authors

Andi Ichsan Makkawaru Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia.
John Pieter Jr. Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Tadjuddin Chalid Hospital, Makassar, Indonesia. https://orcid.org/0000-0002-4407-9668
M. Ihwan Kusuma Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia. 5Hasanuddin University Hospital, Makassar, Indonesia. https://orcid.org/0000-0002-5414-1859
Salman Ardi Syamsu Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Hasanuddin University Hospital, Makassar, Indonesia. https://orcid.org/0000-0002-7162-8845
Nilam Smaradhania Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Hasanuddin University Hospital, Makassar, Indonesia. https://orcid.org/0000-0002-7578-9937
Elridho Sampepajung Division of Oncology, Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Dr. Wahidin Sudirohusodo Hospital, Makassar, Indonesia. https://orcid.org/0000-0003-1031-0822
Muhammad Faruk Department of Surgery, Faculty of Medicine, Hasanuddin University, Makassar, Indonesia. Hasanuddin University Hospital, Makassar, Indonesia.

DOI:

https://doi.org/10.31557/apjcb.2025.10.3.719-724

Keywords:

Breast Cancer, Red Cell Distribution Width, Histopathological Grading, Metastasis

Abstract

Background: Breast cancer (BC) is a significant global health concern with an increasing incidence. Identifying simple and affordable prognostic indicators for early detection and treatment guidance is crucial. Red Cell Distribution Width (RDW), a hematologic parameter reflecting erythrocyte volume variation, has the potential to indicate systemic inflammation and cancer progression. This study aimed to explore the role of RDW as a prognostic factor in BC patients.

Methods: This cross-sectional study involved secondary data from 517 BC patients. The data included age, RDW values, histopathological grade, and metastasis status. Statistical analysis utilized independent T-tests, ANOVA, linear regression, correlation analysis, and Receiver Operating Characteristic (ROC) curves, with a significance level set at ρ<0.05.

Results: The mean RDW was 15.4 ± 9.3%. Significant differences in RDW were observed across histopathological grades (Grade 1: 13.29 ± 1.62; Grade 2: 14.53 ± 6.90; Grade 3: 18.28 ± 14.03; ρ<0.001) and between patients with metastasis (16.49 ± 10.0) and without metastasis (15.02 ± 9.01; ρ=0.001). A 1% increase in RDW was associated with a 0.012 increase in histopathological grade (95% CI: 0.006-0.017; ρ=0.001) and a 1.016 times increased odds of metastasis (OR: 1.016; 95% CI: 1.001-1.039; ρ=0.001). The Area Under the Curve (AUC) of the ROC curve for the highest histopathological grade was 0.841 (sensitivity 83.8%, specificity 78.1%), and for metastasis prediction, the AUC was 0.624 (sensitivity 80.6%, specificity 28.7%).

Conclusion: RDW demonstrates a significant positive correlation with histopathological grade and metastasis in BC patients, suggesting its potential as an accessible prognostic indicator.