NEUTROPHIL-TO-LYMPHOCYTE RATIO AND PLATELET-TO-LYMPHOCYTE RATIO IN PREDICTING THE PATHOLOGICAL COMPLETE RESPONSE IN PATIENTS WITH BREAST CANCER RECEIVING NEO-ADJUVANT CHEMOTHERAPY

Abstract

Objective: To determine the predictive value of baseline neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for pathological complete response (pCR) in breast cancer patients receiving neoadjuvant chemotherapy (NACT).

Study Design: Prospective observational study.

Place and Duration of Study: Oncology Department, Fauji Foundation Hospital, Rawalpindi, from March 2024 to January 2025.

Methodology: A total of 74 biopsy-proven breast cancer patients receiving NACT were enrolled using consecutive non-probability sampling. Baseline clinical data and hematological parameters were recorded prior to chemotherapy. NLR and PLR were calculated from complete blood counts. Following NACT, patients underwent definitive surgery, and pCR was assessed histopathologically.

Results: The median age of patients was 52.5 years, with the majority presenting with stage III disease (62.2%). Pathological complete response was achieved in 33.8% of patients. The mean total leukocyte count was 8.36 ± 2.0 ×10³/µL, neutrophil count 5.13 ± 1.97 ×10³/µL, lymphocyte count 2.46 ± 0.68 ×10³/µL, and platelet count 286.3 ± 87.2 ×10³/µL. There was no statistically significant difference in NLR (p=0.437) or PLR (p=0.414) between pCR and non-pCR groups. Logistic regression analysis also demonstrated no significant association of NLR (OR=0.7, p=0.170) or PLR (OR=1.001, p=0.927) with pCR.

Conclusion: Baseline NLR and PLR are not significant predictors of pathological complete response in breast cancer patients receiving neoadjuvant chemotherapy and should not be used as standalone biomarkers in clinical practice.