IGF1 and breast carcinoma: At a lower HCT level, oxygen transport decreases due to the reduced oxygen carrying capacity, which further contributing to the development of hypoxia[38].In addition, Shamseddine et al [39]reported that a significant drop in mean HCT with a significant decline in insulin-like growth factor-1 (IGF-1) levels was noted at the end of the non-nephrotoxic chemotherapy treatment in breast cancer patients.