Salivary biomarkers to monitor osteopenia and stress levels in breast cancer survivors

Aims: The aim of this study is to assess salivary biomarkers, i.e. cortisol, calcium, phosphate, osteocalcin, vitamin D and estradiol levels, to monitor osteopenia and stress levels in post-treatment breast cancer patients. Methods: The salivary biomarkers of forty-five female breast cancer survivors aged between 30 to 48 years were compared against twenty-eight disease-free, healthy female subjects, which act as the reference values in our study. Saliva collection was done by resting/drooling collection method (minimal oral movements). The independent unpaired t-test was used to compare the differences between the parameters of control group and patient group. Results: The salivary flow rate and the amount of saliva were not significantly different between both groups. The concentration of salivary cortisol in breast cancer survivors was significantly higher compared to healthy controls ( P <0.01). The mean concentrations of salivary calcium ( P <0.01), phosphate ( P <0.05), osteocalcin ( P <0.001), vitamin D ( P <0.001) and estradiol ( P <0.05) in the breast cancer survivor group were significantly lower than those in the control group. Conclusion: Our findings suggest that the measurement of salivary biomarkers can be considered as a useful method to monitor osteopenia and stress levels in breast cancer survivors.