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Higher baseline platelet and preoperative platelets to lymphocytes ratio was associated with a higher incidence of axillary node pathologic complete response after neoadjuvant chemotherapy in HER2-low breast cancer: a retrospective cohort study

  • 0Department of Breast Surgery, Harbin Medical University Cancer Hospital, Harbin, China.
Frontiers in Oncology +

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March 31, 2025

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March 31, 2025

View abstract on PubMed

Summary

This summary is machine-generated.

This study found that higher baseline platelet counts and preoperative platelet-to-lymphocyte ratio (PLR) predict a greater chance of axillary pathological complete response (pCR) in HER2-low breast cancer patients receiving neoadjuvant chemotherapy (NAC). These findings aid in predicting treatment outcomes for HER2-low breast cancer.

Area Of Science

  • Oncology
  • Biomarkers
  • Breast Cancer Research

Background

  • HER2 expression is crucial in breast cancer, with HER2-low subtypes representing a significant portion of cases.
  • Neoadjuvant chemotherapy (NAC) is a key treatment for HER2-low breast cancer (BC).
  • Immune-inflammatory markers show potential in predicting BC prognosis, though results vary.

Purpose Of The Study

  • To investigate the predictive value of blood-based immune-inflammatory markers and clinicopathologic features for axillary pathological complete response (pCR) after neoadjuvant treatment (NAT) in HER2-low BC.
  • To identify key predictors for treatment response in this patient population.

Main Methods

  • Retrospective analysis of 998 HER2-low BC patients treated between 2012-2018.
  • Evaluation of baseline and preoperative complete blood cell counts to calculate immune-inflammatory markers: neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), lymphocyte-to-monocyte ratio (LMR), and systemic immune-inflammation index (SII).
  • Logistic regression analysis and ROC curves to identify independent predictors of axillary pCR.

Main Results

  • 35.6% of patients achieved axillary pCR after NAC.
  • Multivariate analysis identified Estrogen receptor (ER) status, pathology type, baseline platelet count, and preoperative PLR as significant independent predictors of ypN0 (axillary pCR).
  • Higher baseline platelet and preoperative PLR were associated with increased likelihood of axillary pCR.

Conclusions

  • Estrogen receptor status, pathology type, baseline platelet count, and preoperative PLR are significant predictors of axillary pCR in HER2-low BC patients undergoing NAC.
  • Elevated baseline platelet count and preoperative PLR are associated with a higher incidence of axillary pCR, suggesting their utility in treatment response prediction.

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