Blood cellular markers of inflammation in Breast Cancer and response to Neoadjuvant Chemotherapy

Background: Breast cancer is the most common female malignancy in Nigeria. Neoadjuvant chemotherapy is the first line treatment for locally advanced breast cancer. The advancement of many cancers is accompanied by inflammation, and inflammatory cells play an essential role in the progression. Objective: To determine if haematological parameters can predict the responsiveness of breast cancer to neoadjuvant chemotherapy regime. Method: A prospective cohort study of all breast cancer patients who had neoadjuvant chemotherapy between July 2017 and December 2018 was carried out. Haematological parameters of red cell count (RCC), white cell count(WCC), neutrophil count (NC), lymphocyte count (LC), platelet count (PC), red cell distribution width (RCDW), mean platelet volume (MPV), neutrophil-lymphocyte ratio (NLR) and platelet-lymphocyte ratio (PLR) were measured. Response to chemotherapy was assessed by measuring the longest diameter of the lump and largest lymph node and applying the UICC criteria. Results: Thirty-five females with breast cancer with the age range of 33-82 years and mean age of 48 ± 11 years were studied. The overall clinical response rate was 80% consisting of 40% complete clinical response, 40% partial clinical response, 8.6% stable disease and 11.4% progressive disease. Eleven (78.6%) with PLR values below average had good clinical response while 21.4% of those with PLR value above average had a good clinical response (χ2 = 8.4, p = 0.006) Conclusion:  The study showed that PLR is associated with complete clinical response to neoadjuvant chemotherapy and should be used as part of routine assessment before chemotherapy.