The role of Renin angiotensin aldosterone system in women with breast cancer before and after treatment

Abstract

Background: Cancer is an abnormal proliferation of cells in a tissue or organ that causes the cells to change their nature, eventually producing a lump or mass and spreading to other body regions in most cases. This study aims to evaluate the serum level of ACE, plasmin, renin, kallikrein, and bradykinin in breast cancer patients and determine their relationship to the proliferation of breast cancer. This study has investigated 90 women (75 patients and 15 controls) aged between (35-76) years. The patients were referred to three main facilities, Kirkuk Oncology Center, consultation of early detection of breast tumors in Azadi Teaching Hospital, and Kirkuk General Hospital from November 2021 to March 2022. The individuals of this study were divided into six groups: The first group was newly diagnosed patients with malignancy breast tumor n (15); the diagnosis was made by the consult of medical staff, which was based on a triple assessment technique (physical breast examination, ultrasonography, with or without mammography and fine-needle aspiration cytology). The second group was patients of surgical interference n (15), who submitted to local surgical removal of the suspected tumor in the breast (lumpectomy) or complete removal of the breast (mastectomy). The third group was who received the first chemotherapy dose n (15). The fourth group was those who received the second chemotherapy dose n (15). The fifth group was those who received the third chemotherapy dose n (15). The sixth group was healthy women with an adverse family history of breast cancer. They were included in this study as a control group, and their ages were comparable to that of the women with breast cancer. This study shows the mean of Angiotensin-converting enzyme (ACE) was observed in breast cancer women (1.16±0.36U/L) as compared with the healthy control group (0.75±0.15U/L). The difference was highly significant at a P. value of 0.0004. The mean and standard deviation of angiotensin-converting enzyme, plasmin, renin, bradykinin, and kallikrein in women with breast cancer (before treatment, before mastectomy, after one dose, after 2 doses, and after doses) in comparison with healthy women. It was concluded that the levels of ACE, Plasmin, Kallikrein, and Bradykinin were significantly elevated in breast cancer women compared with healthy women, while decreased renin level compared with healthy control. Keywords: ACE; Plasmin; bradykinin, renin, kallikrein.