Prognostic significance of serum iron panel in breast carcinoma: correlation with histopathological grading and molecular immunophenotypes

Breast carcinoma is the most common malignancy in women globally, with prognosis significantly impacted by histopathological grading and molecular immunophenotypes. Iron metabolism dysregulation plays a crucial role in cancer progression, and serum iron panel components have emerged as potential prognostic biomarkers, aiding in disease assessment and management. This review aims to explore the prognostic significance of the serum iron panel in breast carcinoma and its correlation with histopathological grading and molecular immunophenotypes. A thorough literature review was performed using peer-reviewed articles from PubMed, Scopus, and Web of Science. Studies examining the relationship between serum iron parameters (serum iron, ferritin, transferrin saturation, and total iron-binding capacity) and breast carcinoma subtypes, histopathological grading, and molecular immunophenotypes were analyzed for inclusion. Serum iron parameters are altered in breast carcinoma but the results are heterogeneous. High ferritin levels are indicative of higher tumor grade, as well as increased tumor burden and poor outcomes. Transferrin saturation and TIBC exhibit different patterns. More aggressive subtypes, most notably triple-negative breast cancer, show greater iron dysregulation, suggesting a connection between iron metabolism and tumor characteristics despite inconsistencies in findings. Serum iron biomarkers, such as ferritin, could indicate cancer aggressiveness and subtype in breast cancer. However, the evidence is inconsistent and mostly observational. These markers may be viewed as adjuncts rather than definitive prognostic tools and would benefit clinically best from validation via large-scale prospective studies.