Nitric oxide (NO) and malondialdehyde (MDA) play a significant role in DNA
damage, sister-chromatid exchanges (SCEs) and carcinogenesis. Here, we dete
rmine plasma NO and MDA to evaluate their role in carcinogenesis and their
effect on the frequency of SCEs in 45 female breast cancer patients and in
35 age- and sex-matched controls. Plasma NO (P < 0.01) and MDA (P < 0.001)
was significantly higher in the breast cancer group, and a direct correlati
on were found between plasma NO and MDA concentration and tumour grade. Pat
ients with stage II disease showed the highest levels of both NO and MDA, c
ompared with controls. Simultaneously, SCE frequency per lymphocyte in the
breast cancer group was found to be significantly (P < 0.001) higher; the g
reatest increase being found in patients with stage IV disease. Positive co
rrelation was found between SCEs and both NO and MDA in the breast cancer g
roup; however, both NO and MDA production decreased with increasing severit
y of the disease. Lower NO production in stage IV disease may be due to low
er expression of nitric oxide synthase (NOS), further facilitating, the pro
duction of superoxide anions (O-2. (-)). The reaction between NO and O-2. (
-) results in peroxynitrite (OONO-) formation, which works efficiently at t
he molecular level and may induce higher SCE frequency. This work suggests
that further cytogenetic and molecular study is required to provide definit
e answers for the therapeutic use of NO in breast cancer.