Predictive value of platelet/lymphocyte and neutrophil/lymphocyte ratios in prediction of complete axillary response in axilla-positive breast cancer patients receiving neoadjuvant chemotherapy

SUMMARY Objective: Breast cancer is the most common malignity and main cause of cancer death affecting women worldwide. The medical treatment applied prior to surgery in breast cancer and expected to shrink the stage of the tumor is neoadjuvan chemotherapy (NAC). Pathological complete response (PCR) in the axilla and breast to NAC treatment is important to predict the patient's response to treatment protocols. In this study, we wanted to see the relationship between neutrophil/lymphocyte ratio (NLR) and platelet/lymphocyte ratio (PLR) before and after NAC values and axillary PCR. Materials and Methods: Between January 2017 - July 2023, 131 female patients who received NAC and then had surgery due to locally progressing breast cancer at Tokat Gaziosmanpasa University Hospital General Surgery Clinic were considered retrospective. PLR and NLR values of the patients before and immediately after NAC, the patients' age, pathological subtypes, tumor size, being Triple Negative (TN), Luminal A, Luminal B, Her-2 positivity, multifocality, Ki-67≥14 were discussed. For the PLR value, ROC (receiver-operating characteristic) analysis was performed and the area under curve (AUC) and cut-off value were calculated. Univariate analysis was performed. Independent predictive factors were tried to be determined by performing a logistic regression test with the factors that were significant in univariate analysis. Significant p value was considered <0.05. Results: Axillary PCR was observed in 39% (n=51) of the 131 patients included in the study. Her-2 positivity (p=0.016), multifocality (p=0.017), Ki-67≥14 (p<0.001), being Luminal A (p=0.001) and 'PLR value before NAC' were significant. (p<0.001). Conclusion: PLR value in axilla (+) breast cancer patients, immediately before NAC; it can be considered as an effective biomarker in predicting axillary PCR. A low PLR level before NAC shows that the sensitivity to chemotherapy is high. Key Words: Neoadjuvant chemotherapy, axillary pathological complete response, platelet lymphocyte ratio.