Diagnostic and Risk Stratification Value of Serum 8-Hydroxy-2-Deoxyguanosine in Women with Suspected Breast Carcinoma in Bangladesh: A Cross-Sectional Analytical Study.

Abstract

Breast carcinoma is a leading cause of carcinoma-related morbidity and mortality among women worldwide, with a rising burden in low- and middle-income countries. Early differentiation between malignant and benign breast lesions remains a major challenge in resource-constrained settings, where access to imaging and histopathology is often limited. Oxidative DNA damage plays a key role in carcinogenesis and serum 8-hydroxy-2-deoxyguanosine (8-OHdG) has emerged as a potential non-invasive biomarker; however, evidence from Bangladesh is scarce. The objective of this study was to evaluate the diagnostic value of serum 8-hydroxy-2-deoxyguanosine and its association with clinicodemographic and histopathological characteristics among women with suspected breast carcinoma. This cross-sectional analytical study was conducted among 81 women presenting with clinically suspected breast lumps at Bangladesh Medical University, Dhaka, Bangladesh from July 2023 to June 2024. Participants underwent histopathological examination and were classified into breast carcinoma (n=42) and benign breast disease (n=39) groups. Serum 8-OHdG levels were measured using an enzyme-linked immunosorbent assay. Diagnostic performance was assessed using receiver operating characteristic analysis. Associations between 8-OHdG and clinical variables were examined using correlation analysis and multivariable logistic regression. The mean age of participants was higher in the breast carcinoma group compared with the benign group (44.33±9.03 vs 35.59±10.43 years; p=0.0003). Serum 8-OHdG levels were significantly elevated in breast carcinoma (7.40±1.57 ng/mL) compared with benign disease (5.16±1.53 ng/mL; p<0.001. At a cut-off value of 6.0 ng/mL, serum 8-OHdG showed a sensitivity of 71.4% and specificity of 69.2%, with an overall diagnostic accuracy of 70.4%. Increasing age, postmenopausal status and family history were significantly associated with malignancy. Serum 8-OHdG is significantly elevated in breast carcinoma and demonstrates good sensitivity for differentiating malignant from benign breast lesions. It may serve as a practical, non-invasive biomarker for diagnostic triage, particularly in resource-limited settings.