Salivary CA125, Mucin-1, VEGF, and sFasL as Non-Invasive Biomarkers for Breast Cancer Detection and Prognosis: A Case-Control Study from Kirkuk, Iraq

Abstract

Background: Breast cancer continues to be one of the most common and deadly cancers affecting women worldwide, including in Iraq. Conventional diagnostic methods like mammography and tissue biopsy, although efficacious, are intrusive, expensive, and constrained in resource-limited environments. In recent years, saliva has become a viable non-invasive diagnostic sample owing to its simplicity of collection and molecular composition that indicates systemic alterations.

Objective: This study aims to assess the clinical efficacy of salivary CA125, Mucin-1 (MUC-1), VEGF, and sFasL as non-invasive biomarkers for the early identification and prognosis of breast cancer in women in Kirkuk, Iraq.

Methods: A case-control study was done in a hospital setting from December 2024 to April 2025. Saliva specimens from 200 breast cancer patients at different stages and 40 healthy female controls were examined utilizing ELISA. Comparative and inferential statistics were employed to evaluate biomarker levels.
Results: All four biomarkers (CA125, MUC-1, VEGF, and sFas) exhibited statistically significant increases associated with cancer stages (p < 0.01). ROC analysis demonstrated elevated diagnostic accuracy, with AUC values nearing or reaching 1.0 for combined markers.
Conclusion: Salivary biomarkers present a promising, non-invasive method for the identification and monitoring of breast cancer progression, especially in resource-constrained environments.