Neutrophil to lymphocyte ratio does not behave as a good predictor of pathological complete response in breast cancer: A retrospective analysis in the neoadjuvant setting

Abstract

The breast cancer scenario now requires new solutions for diagnosis and follow-up. The neutrophil-to-lymphocyte ratio (NLR) has been studied as a possible biomarker for predicting prognosis in solid tumors. Due to the ease of obtaining these values from a blood count, NLR could be useful in clinical practice. Therefore, the aim of this study was to analyze the relation between NLR and pathologic complete response (PCR) in breast cancer patients undergoing neoadjuvant treatment. We performed a cross-sectional retrospective study, including ductal breast cancer patients who underwent neoadjuvant chemotherapy and surgery between 2017 and 2019 at the reference hospital institution (n = 1230). Our data were obtained from medical records and laboratory results, so the study was approved by the research ethics committee of the data-providing hospital. Inclusion and exclusion criteria resulted in a final sample of 114 patients. The area under the curve (ROC) showed no statistically significant area (AUC = 0.546) with a CI95% = 0.417–0.676. No relation between NLR and PCR was observed (p = 0.631), indicating that NLR is not a good biomarker for PCR in this population. Regarding the pattern of NLR for different molecular subtypes, no statistical relation was found (p = 0.929). Thus, our study supports the literature that suggests there is no relationship between NLR and PCR.

Keywords

• Neutrophil to lymphocyte ratio
• Pathological complete response
• Breast cancer
• Biomarker
• ROC curve