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

Q: What is the main research question of the study?

Whether pretreatment neutrophil-to-lymphocyte ratio (NLR) predicts pathological complete response (pCR) in Egyptian breast cancer patients treated with neoadjuvant chemotherapy.

Q: How was NLR calculated and when was it measured?

A complete blood count was performed at baseline before starting neoadjuvant chemotherapy, and NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count.

Q: What did the results show about NLR and pCR?

Patients with low NLR (NLR < 1.76) had substantially higher pCR rates than those with high NLR (NLR ≥ 1.76), with an odds ratio of 18.1 and p = 0.046.

Sep 23, 2026

Uploaded by Liam

Background and objectives: The neutrophil-to-lymphocyte ratio (NLR) as a predictor of response in breast cancer after neoadjuvant chemotherapy remains controversial. This study investigates the relationship between NLR and pathological complete response (pCR) in Egyptian breast cancer patients receiving neoadjuvant chemotherapy. Materials and methods: Forty-six patients received preoperative neoadjuvant chemotherapy and underwent surgery; baseline complete blood counts were used to calculate NLR. Results: Low NLR (NLR < 1.76) was associated with markedly higher pCR rates (OR 18.1; p = 0.046). Conclusions: Pretreatment NLR is an important predictor of pCR in this population.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages11

Reading Time28 min

AccessFree to download

Abstract

Introduction

Breast cancer burden in Egypt

Role of neoadjuvant chemotherapy

Pathological complete response as a prognostic marker

Need for accessible predictive factors

Article Is the Neutrophil-to-Lymphocyte Ratio a Predictive Factor of Pathological Complete Response in Egyptian Breast Cancer Patients Treated with Neoadjuvant Chemotherapy? Naglaa F. Ebaid 1, Khaled S. Abdelkawy 2, Amira S. A. Said 3, Mohamad M. Al-Ahmad 3, Mohamed A. Shehata 4, Heba F. Salem 5 and Raghda R. S. Hussein 6, * Academic Editor: DineshK. Thekkinkattil Received: 6 December 2024 Revised: 1 February 2025 Accepted: 10 February 2025 Published: 13 February 2025 Citation: Ebaid, N.F.; Abdelkawy, K.S.; Said, A.S.A.; Al-Ahmad, M.M.; Shehata, M.A.; Salem, H.F.; Hussein, R.R.S. Is the Neutrophil-to-Lymphocyte Ratio a Predictive Factor of Pathological Complete Response in Egyptian Breast Cancer Patients Treated with Neoadjuvant Chemotherapy? Medicina 2025, 61, 327 . [https://doi.org/10.3390/](https://doi.org/10.3390/)[ ](https://doi.org/10.3390/)medicina61020327 Copyright: © 2025 by the authors. Published by MDPI on behalf of the Lithuanian University of Health Sciences. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license ([https://creativecommons.org/](https://creativecommons.org/)[ ](https://creativecommons.org/)[licenses/by/4.0/](licenses/by/4.0/)) . 1 Clinical Pharmacy Department, Faculty of Pharmacy, Menoufia University, Menoufia 32511, Egypt; [naglafathy81@gmail.com](naglafathy81@gmail.com) 2 Clinical Pharmacy Department, Faculty of Pharmacy, Kafrelsheikh University, Kafr El Sheikh 33516, Egypt; [ksibrahi@ualberta.ca](ksibrahi@ualberta.ca) 3 Department of Clinical Pharmacy, College of Pharmacy, Al Ain University, Al Ain P.O. Box 64141, United Arab Emirates; [amira.ahmed@aau.ac.ae](amira.ahmed@aau.ac.ae) (A.S.A.S.); [mohammad.alahmad@aau.ac.ae](mohammad.alahmad@aau.ac.ae) (M.M.A.-A.) 4 Clinical Oncology and Nuclear Medicine Department, Faculty of Medicine, Menoufia University, Menofia 32511, Egypt; mohaboulfetouh@yahoo.com 5 Pharmaceutics and Industrial Pharmacy Department, Beni-Suef University, Beni-Suef 62574, Egypt; [heba_salem2004@yahoo.co.uk](heba_salem2004@yahoo.co.uk) 6 Clinical Pharmacy Department, Faculty of Pharmacy, Beni-Suef University, Beni-Suef 62574, Egypt * Correspondence: [raghda.hussien@pharm.bsu.edu.eg](raghda.hussien@pharm.bsu.edu.eg); Tel.: +20-1010647666 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. Keywords: breast cancer; neoadjuvant chemotherapy; pathological complete response; neutrophil-to-lymphocyte ratio 1. Introduction Breast cancer is one of the most widespread cancers affecting women throughout the world. According to the estimates of the American Cancer Society, in 2024, there will be 310,720 new cases

FAQs

What is the main research question of the study?

Whether pretreatment neutrophil-to-lymphocyte ratio (NLR) predicts pathological complete response (pCR) in Egyptian breast cancer patients treated with neoadjuvant chemotherapy.

How was NLR calculated and when was it measured?

A complete blood count was performed at baseline before starting neoadjuvant chemotherapy, and NLR was calculated as the absolute neutrophil count divided by the absolute lymphocyte count.

What did the results show about NLR and pCR?

Patients with low NLR (NLR < 1.76) had substantially higher pCR rates than those with high NLR (NLR ≥ 1.76), with an odds ratio of 18.1 and p = 0.046.

Sep 23, 2026

Uploaded by Liam