Platelet-To-Lymphocyte Ratio in Blood in Early Breast Cancer Patients

Background: Breast cancer is the most prevalent malignancy among women globally and remains a leading cause of morbidity and mortality. This study aimed to assess the platelet-to-lymphocyte ratio (PLR) as a prognostic and predictive marker in early breast cancer. Methods: A cross-sectional study was conducted on 100 female breast cancer patients at the Hemato-Oncology Unit, Benha University Hospitals. Patients were divided into two groups based on PLR: Group I (n=57) with high PLR (>150) and Group II (n=43) with low PLR (<150). All underwent pathological evaluation, immunohistochemistry, molecular subtyping, PLR analysis, and assessment of response to neoadjuvant chemotherapy. Results: Tumor-node-metastasis (TNM) staging significantly differed between the two groups (P<0.001 for T, N, and M). Tumor size was significantly larger in the high PLR group both pre- and post-treatment (P=0.002, <0.001, respectively). Metastasis occurred more frequently in patients with high PLR (P<0.001). High PLR was associated with aggressive tumor features, including advanced stage, higher Ki-67 expression, HER2 positivity, and increased incidence of distant metastases. Conclusion: PLR is a valuable prognostic and predictive marker in early breast cancer. Elevated PLR (>150) correlates with more aggressive tumor characteristics and poorer outcomes. It may reflect a heightened systemic inflammatory response, potentially contributing to disease progression. These findings support incorporating PLR into routine clinical assessment to improve prognostication and therapeutic decision-making.