Mehmet Furkan SAĞDIÇ, Eda GÜNER, Can Yahya BOZTUĞ, Ferit AYDIN, Ahmet KARAYİĞİT, Cihangir ÖZASLAN
Acta Haematologica Oncologica Turcica - 2026;59(1):6-14
Aim: This study aimed to investigate the association between pre- and post-neoadjuvant chemotherapy (NAC) inflammatory indices and pathological complete response (pCR) in breast cancer patients. Methods: In this retrospective study, we reviewed the medical records of 412 patients with breast cancer who received NAC between January 2013 and January 2023. We recorded the following indices: pan-immune systemic inflammatory index (PIV), systemic immune-inflammation index (SII), prognostic nutritional index; neutrophil-to-lymphocyte, platelet-to-lymphocyte, and lymphocyte-to-monocyte ratios; hemoglobin and counts of white blood cells, neutrophils, platelets, monocytes, and lymphocytes; and pre-NAC-to-post-NAC ratios of these parameters. Pre-NAC and post-NAC values and their ratios were analyzed. Receiver operating characteristic analysis was used to explore optimal cut-off values. Univariate and multivariate logistic regression analyses were performed to identify factors associated with pCR. Results: 119 (29%) patients achieved pCR. Cut-off values were explored for the pre-NAC/post-NAC ratios of PIV, SII, neutrophil/lymphocyte ratio, platelet/lymphocyte ratio, neutrophil, and hemoglobin. Multivariate analysis showed that HER2 positivity, hormone receptor negativity, earlier T stages, and elevated pre-NAC/post-NAC platelet-to-lymphocyte ratios and hemoglobin levels were independently associated with pCR. Conclusion: The pre-NAC-to-post-NAC ratios of inflammatory markers were statistically associated with pCR following NAC in breast cancer patients. In addition to established clinicopathological factors such as HER2 positivity, hormone receptor negativity, and earlier T-stage, higher pre-NAC and post-NAC platelet-to-lymphocyte and hemoglobin ratios were associated with pCR. However, the discriminative performance of these markers was limited, as reflected by relatively low area under the curve values. Therefore, these findings represent statistical associations rather than predictive capability, and these markers should not be interpreted as standalone predictive biomarkers. Instead, they may serve only as complementary parameters alongside established clinicopathological factors.
