Blood cadmium levels associated with short distant metastasis-free survival time in invasive breast cancer

Distant metastasis is strongly associated with poor prognosis of breast cancer. Cadmium (Cd) exposure was previously found associated with breast cancer incidence. We explored the associations of blood cadmium levels (BCLs) and clinicopathologic characteristics with invasive breast cancer distant metastasis. Blood samples were collected and analyzed for BCLs by graphite-furnace atomic absorption spectrometry. Clinicopathologic characteristics, including basic clinical information and tumor characteristics, were obtained from medical records. Breast cancer distant metastasis-free survival (DMFS) time was calculated at follow-up. The associations of BCLs and clinicopathologic characteristics with DMFS time were examined by Kaplan–Meier method and Cox regression analysis, and associations between BCLs and tumor characteristics were also explored. Blood Cd level was positively associated with distant metastasis, clinical stage, BMI, and age. On univariate analysis, older age at diagnosis, family history of breast cancer, high N classification and clinical stage, positivity for human epidermal growth factor receptor 2, and high BCLs were associated with short DMFS time. On multivariate analysis model, older age at diagnosis, family history of breast cancer, high N classification, and BCLs were predictors for breast cancer distant metastasis. BCLs were a risk factor for short DMFS time of invasive breast cancer. BCLs and some clinicopathologic factors affect breast cancer distant metastasis, which needs further epidemiological and experimental studies to confirm.