Baseline Galectin-3 in Patients with Breast Cancer Scheduled for Anthracycline Therapy: Associations with Cardiac Biomarkers, Left Ventricular Function, and HFA-ICOS Risk Stratification

The clinical role of galectin-3 (Gal-3) as a biomarker in cardio-oncology remains uncertain. This study evaluated baseline Gal-3 concentrations and their associations with established cardiac biomarkers, left ventricular systolic function, and HFA-ICOS cardiovascular risk categories in patients with breast cancer before anthracycline-based chemotherapy. This cross-sectional baseline analysis included 103 patients enrolled in the EMPACT trial. Gal-3 concentrations were evaluated in relation to high-sensitivity cardiac troponin T (hs-cTnT), N-terminal pro-B-type natriuretic peptide (NT-proBNP), left ventricular ejection fraction (LVEF), global longitudinal strain (GLS), HFA-ICOS risk categories, and clinical characteristics. Associations were assessed using Pearson correlation analyses and median regression. Mean baseline Gal-3 concentration was 6.3 ± 2.7 ng/mL. Gal-3 was positively correlated with hs-cTnT (r = 0.384, p < 0.001) and NT-proBNP (r = 0.278, p = 0.006), but not significantly correlated with LVEF or GLS. Gal-3 concentrations did not differ significantly across HFA-ICOS risk categories (p = 0.237). Patients aged ≥65 years had higher Gal-3 concentrations than younger patients (7.1 ± 2.8 vs. 5.7 ± 2.5 ng/mL, p = 0.003). In multivariable median regression, age was the only variable significantly associated with Gal-3 among the covariates included in the model (β = 0.82 ng/mL per 10-year increase, 95% CI 0.21–1.43, p = 0.009). Associations with hs-cTnT and NT-proBNP were no longer statistically significant after adjustment. In patients with breast cancer before anthracycline therapy, baseline Gal-3 concentrations were associated with age after multivariable adjustment, whereas associations with established cardiac biomarkers were attenuated. No significant associations were observed with LVEF or GLS, and Gal-3 concentrations did not differ significantly across HFA-ICOS risk categories in unadjusted analyses.