The Neutrophil to Lymphocyte Ratio has a High Negative Predictive Value for Pathologic Complete Response in Locally Advanced Breast Cancer Patients Receiving Neoadjuvant Chemotherapy

Background: The neutrophil-to-lymphocyte ratio (NLR) is a strong predictor of mortality in patients withpancreatic, colorectal, lung, gastric cancer and renal cell carcinoma. The aim of this study was to determine therelationship between pathological complete response (pCR) and pretreatment NLR values in locally advancedbreast cancer (BC) patients receiving neoadjuvant chemotherapy (NACT). Materials and
Methods: Datawerecollected retrospectively from the Akdeniz University School of Medicine Database for locally advanced BCpatients treated with NACT between January 2000- December 2013.
Results: A total of 78 patients were analyzed.Sixteen (20%) patients achieved pCR. Estrogen receptor (ER) positivity was lower in pCR+ than pCR- cases(p=0.011). The median NLR values were similar in both arms. The optimum NLR cut-off point for BC patientswith PCR+ was 2.33 (AUC:0.544, 95%CI [0.401- 0.688], p=0.586) with sensitivity, specificity, positive predictivevalue and negative predictive value (NPV) of 50%, 51,6%, 21,1%, and 80%, respectively.
Conclusions: This studyshowed no relationship between the pCR and pretreatment NLR values. Because of a considerable high NPV,in the patients with higher NLR who had luminal type BC in which pCR is lower after NACT, such treatmentmay not be recommended.