To investigate the effect of preoperative fibrinogen to albumin ratio(FAR)on prognosis of operable breast cancer patients.

According to the inclusion and exclusion criteria, 520 patients with stage Ⅰ to Ⅲ operable breast cancer in the Peking Union Medical College Hospital, Chinese Academy of Medical Sciences from January to December 2013 were involved in this retrospective study. Serum levels of fibrinogen and albumin were measured before operation. FAR was defined as the concentration ratio of fibrinogen and albumin multiplied by 100. Subjects were divided into two groups according to the cutoff value determined by the receiver operating characteristic curve: high FAR group(FAR>6.99)(147 patients)and low FAR group(FAR≤6.99)(343 patients). DFS and OS in two groups were assessed using the Kaplan-Meier method and log-rank test. Cox proportional hazard regression model was used to identify the influencing factors of DFS and OS.

The log-rank test showed that high FAR group had significantly lower DFS and OS compared with low FAR group (χ²=32.885, 16.320, both P<0.001). The univariate and multivariate analyses showed that high FAR was an independent risk factor of DFS (HR=4.092, 95%CI: 2.425-6.903, P<0.001; HR=4.226, 95%CI: 2.476-7.212, P<0.001)and OS (HR=3.907, 95%CI: 1.913-7.978, P<0.001; HR=4.320, 95%CI: 2.087-8.942, P<0.001).

The patients with preoperative high FAR are prone to short progression-free survival and low OS rate, so preoperative FAR is a potential prognostic factor of breast cancer.