Assessing the Prognostic Utility of the HALP Score in Breast Cancer and Its Association with Axillary Lymph Node Involvement

Background: The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has recently gained fame as a novel prognostic marker for predicting clinical outcomes in different cancers. Data regarding its applicability in breast cancer is rare. This study aimed to evaluate the prognostic utility of the HALP score in breast cancer, specifically its correlation with clinicopathological features and its effectiveness in predicting axillary lymph node involvement. Methods: This cross-sectional study was performed in the Breast Surgery Unit, Liaquat National Hospital, Pakistan during Jan-Sep 2023. HALP score was calculated in patients who planned to undergo surgery for breast cancer. Included in the study were 180 patients who underwent surgical treatment for breast cancer. HALP values were obtained by taking the product of hemoglobin, albumin, and lymphocytes and dividing it by the platelet count. The Area Under the Curve (AUC) was calculated to determine the predictive ability of the HALP score. The young index was computed. Two groups were formed using the threshold value and compared using the Chi-square of the Fisher exact test. Results: 180 patients were studied with a median age of 53.5 (IQR=22-85) years. Lymph node involvement was seen in 32.2% of patients. Median HALP score was 5.7 (IQR=4-7.2). The receiver operative characteristic curve showed an AUC of 0.544 (p=0.338). Youden index showed 5.95 to be the cut-off value. 53.3% of patients had a HALP score of <5.95. None of the patients’ features were found to be significantly different between those with HALP scores of <5.95 and ≥5.95. Conclusion: The study did not find a link between the HALP score and the clinicopathological characteristics of breast cancer. However, younger patients and those with positive lymph nodes tend to have higher HALP scores.