2D:4D Finger Ratio and Breast Cancer in Women

Evaluation Of The Relationship Between Finger 2d-4d Ratios And Cancer In Breast Cancer Patients. A Randomized Controlled Trial

This prospective study aims to evaluate the 2D:4D finger ratio in women diagnosed with breast cancer compared to healthy controls and to examine its potential association with tumor markers, including carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3).

A total of 132 women are included in the study, comprising 79 patients with breast cancer and 53 healthy controls. Participants are recruited from a breast clinic setting. Finger lengths are measured to calculate 2D:4D ratios, and serum CEA and CA 15-3 levels are recorded. Statistical analyses are performed to assess correlations between finger morphometry and tumor marker levels.

The study seeks to explore whether finger length patterns and 2D:4D ratios are associated with breast cancer status and selected tumor markers, and to evaluate their potential relevance as non-invasive indicators related to hormonal exposure history.

Study Overview

• Status: Completed
• Conditions: Breast Cancer; Females; Anthropometric Measurements

Detailed Description

Breast cancer is one of the most common malignancies among women worldwide. Prenatal hormonal exposure has been proposed as a potential factor influencing the development of hormone-related cancers. The second-to-fourth digit (2D:4D) ratio is considered an indirect marker of prenatal androgen and estrogen exposure and has been investigated in relation to various health conditions.

This prospective study is designed to evaluate differences in 2D:4D finger ratios between women diagnosed with breast cancer and healthy controls and to examine potential associations between digit ratios and tumor markers, including carcinoembryonic antigen (CEA) and cancer antigen 15-3 (CA 15-3).

A total of 132 women are included in the study, consisting of 79 breast cancer patients and 53 healthy controls recruited from a breast clinic setting. Finger lengths of both hands are measured to calculate 2D:4D ratios. Serum CEA and CA 15-3 levels are recorded as part of routine clinical evaluation.

Statistical analyses are conducted to assess correlations between finger measurements, digit ratios, and tumor marker levels. The study aims to explore whether finger morphometry may provide additional insight into hormonal exposure patterns and their potential relevance in breast cancer assessment.

• Study Type: Observational
• Enrollment (Actual): 132

Contacts and Locations

Study Locations

• Turkey (Türkiye)
  • Central
    • Malatya, Central, Turkey (Türkiye), 44100
      • Malatya Turgut Ozal University

Participation Criteria

Eligibility Criteria

• Ages Eligible for Study: Adult; Older Adult
• Accepts Healthy Volunteers: Yes

• Sampling Method: Probability Sample

Study Population

Women aged 18 years and older who attended the breast clinic during the study period, including patients with histopathologically confirmed breast cancer and age-matched healthy controls.

Description

Inclusion Criteria:

• Women aged 18 years and older with histopathologically confirmed primary breast cancer who were evaluated and/or treated at the breast clinic during the study period and who provided written informed consent were included in the study.

Exclusion Criteria:

• Individuals with hand deformities, a history of finger fractures, or finger deformities were excluded from the study during finger measurements

Study Plan

How is the study designed?

Number of groups / cohorts

2

Cohorts and Interventions

Group / Cohort
Breast Cancer Patients; Women aged 18 years and older with histopathologically confirmed breast cancer.
Healthy Controls; Age-matched women without a history of breast cancer or other malignancies.

What is the study measuring?

Primary Outcome Measures

Outcome Measure	Measure Description	Time Frame
only description measurement	The lengths of the second (index) and fourth (ring) digits were measured on both hands of all participants to calculate the 2D:4D digit ratio. Measurements were obtained using a digital caliper with a precision of 0.01 mm. Each digit was measured from the midpoint of the basal crease (proximal flexion crease) to the tip of the finger, with the hand placed flat and fully extended on a stable surface.	1 patientt's measurements have taken nearly 20 minutes

Collaborators and Investigators

• Sponsor: Malatya Turgut Ozal University

Publications and helpful links

General Publications

• 1. Li C, Li H, Zhong H, Li X. Association of 25-hydroxyvitamin D level with survival outcomes in female breast cancer patients: A meta-analysis. The Journal of Steroid Biochemistry and Molecular Biology. 01 Eylül 2021;212:105947. 2. Bidard FC, Hajage D, Bachelot T, Delaloge S, Brain E, Campone M, vd. Assessment of circulating tumor cells and serum markers for progression-free survival prediction in metastatic breast cancer: a prospective observational study. Breast Cancer Res. 13 Şubat 2012;14(1):R29. 3. Falzarano R, Viggiani V, Michienzi S, Longo F, Tudini S, Frati L, vd. Evaluation of a CLEIA automated assay system for the detection of a panel of tumor markers. Tumour Biol. Ekim 2013;34(5):3093-100. 4. Hasan D. Diagnostic impact of CEA and CA 15-3 on chemotherapy monitoring of breast cancer patients. J Circ Biomark. 2022;11:57-63. 5. Manning J, Kilduff L, Cook C, Crewther B, Fink B. Digit ratio (2D: 4D): a biomarker for prenatal sex steroids and adult sex steroids in challenge situations. Frontiers in endocrinology. 2014;5:9. 6. Manning JT, Churchill AJG, Peters M. The Effects of Sex, Ethnicity, and Sexual Orientation on Self-Measured Digit Ratio (2D:4D). Arch Sex Behav. Nisan 2007;36(2):223-33. 7. Bağci Uzun G, İnceoğlu F. Association of 2D:4D finger length ratio of People Working in different professions with personality traits. Heliyon. Haziran 2024;10(11):e32332. 8. Fonseca C de AD, Martelli DRB, Maia CMF, Dias VO, Carvalho AA, Júnior HM. Digital biomarker 2D:4D as a predictor of cancer: A systematic review. Early Hum Dev. Ocak 2022;164:105521. 9. Swift-Gallant A, Aung T, Salia S, Breedlove SM, Puts D. Sexual orientation is associated with 2D:4D finger length ratios in both sexes: an updated and expanded meta-analysis. Front Psychol. 2025;16:1559158. 10. Muller DC, Baglietto L, Manning JT, McLean C, Hopper JL, English DR, vd. Second to fourth digit ratio (2D:4D), breast cancer risk factors, and breast cancer risk: a prospective cohort study. Br J Canc

Study record dates

Study Major Dates

• Study Start (Actual): April 1, 2024
• Primary Completion (Actual): July 2, 2024
• Study Completion (Actual): August 7, 2025

Study Registration Dates

• First Submitted: February 21, 2026
• First Submitted That Met QC Criteria: February 21, 2026
• First Posted (Actual): February 27, 2026

Study Record Updates

• Last Update Posted (Actual): February 27, 2026
• Last Update Submitted That Met QC Criteria: February 21, 2026
• Last Verified: March 1, 2024

More Information

Terms related to this study

• Keywords: breast cancer; Anthropometry; Anatomy; CEA; CA 15-3; 2D:4D Ratio
• Additional Relevant MeSH Terms: Neoplasms by Site; Neoplasms; Skin Diseases; Breast Diseases; Skin and Connective Tissue Diseases; Breast Neoplasms; Medullary cystic kidney disease 1
• Other Study ID Numbers: B.270 (Other Grant/Funding Number: Malatya Turgut Ozal University Ethical Commitee)

Plan for Individual participant data (IPD)

• Plan to Share Individual Participant Data (IPD)?: NO
• IPD Plan Description: Individual participant data will not be publicly shared to protect patient confidentiality and in accordance with institutional ethics committee policies. De-identified aggregate data may be available upon reasonable request.

Drug and device information, study documents

• Studies a U.S. FDA-regulated drug product: No
• Studies a U.S. FDA-regulated device product: No