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Abstract

Breast cancer (BC) remains one of the most common malignancies in women, with its development strongly influenced by hormonal and growth factor signaling. The insulin-like growth factor 1 (IGF1) and its receptor (IGF1-R) are increasingly recognized as key contributors to breast carcinogenesis, particularly in relation to estrogen receptor (ER) status. This study aimed to evaluate circulating IGF1 and IGF1-R levels among Iraqi women with BC and to explore their diagnostic and biological relevance. A total of 90 participants were enrolled, including 65 patients with histologically confirmed BC (41 ER-positive and 24 ER-negative) and 25 healthy controls. Serum concentrations of IGF1 and IGF1-R were measured using ELISA, and statistical analyses were performed with ANOVA, correlation testing, and receiver operating characteristic (ROC) curve assessment. The results demonstrated that both IGF1 and IGF1-R levels were significantly elevated in ER-positive BC patients compared to ER-negative BC patients and healthy controls, whereas no significant differences were observed between ER-negative cases and controls. ROC analysis confirmed the discriminatory potential of these biomarkers, with IGF1 achieving an AUC of 0.8679 when distinguishing ER-positive from ER-negative tumors, while IGF1-R exhibited high specificity (97.44%) at optimal cut-off values. Moreover, a moderate positive correlation was observed between IGF1 and IGF1-R in ER-positive patients, suggesting coordinated regulation within this subgroup. These findings highlight the subtype-specific role of the IGF axis in BC and support the potential clinical utility of IGF1 and IGF1-R as diagnostic indicators and risk-related factors for ER-positive BC. Elevated IGF1 and IGF1-R levels, were observed even in stage I cases, indicating their potential as early biomarkers that could complement mammography in the detection of ER-positive BC.

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