# Is the Neutrophil-to-Lymphocyte Ratio a Predictive Factor of Pathological Complete Response in Egyptian Breast Cancer Patients Treated with Neoadjuvant Chemotherapy?

## TL;DR

This study investigates if a blood test called NLR can predict how well Egyptian breast cancer patients respond to pre-surgery chemotherapy.

## Contribution

The study identifies NLR as a novel predictive factor for pathological complete response in Egyptian breast cancer patients.

## Key findings

- Low NLR (<1.76) was associated with 18-fold higher rates of pathological complete response.
- Pretreatment NLR is a significant predictor of response to neoadjuvant chemotherapy in Egyptian patients.

## Abstract

Background and Objectives: The role of the neutrophil-to-lymphocyte ratio (NLR) as a predictor of response in breast cancers after neoadjuvant chemotherapy is controversial. This study aims to explore the relationship of NLR with pathological complete response (pCR) in a cohort of Egyptian breast cancer patients who received neoadjuvant chemotherapy. Materials and Methods: Forty-six breast cancer females received preoperative neoadjuvant chemotherapy and then underwent surgery. All resected tumors were evaluated to determine the pathologic effect of the neoadjuvant chemotherapy. A complete blood count was carried out at baseline before beginning the neoadjuvant chemotherapy. The absolute count of neutrophils was divided by the absolute count of lymphocytes to calculate the NLR. Results: Of the study patients, 18 (39.1%) were considered to have a low NLR (NLR < 1.76), and 28 (60.9%) were considered to have a high NLR (NLR ≥ 1.76). Patients with a low NLR had 18-fold higher rates of pCR when compared to patients with a high NLR (OR 18.1; 95% CI (1.058–310.757); p = 0.046). Conclusions: Our findings indicate that the pretreatment NLR is a pivotal predictor factor of the pathological complete response in Egyptian breast cancer patients treated with neoadjuvant chemotherapy.