Impact of Neutrophil to Lymphocyte Ratio on Pathological Response to Neoadjuvant Chemotherapy in Nonmetastatic Breast Cancer

B reast cancer is the mostly seen cancer in women [1] Neo- adjuvant chemotherapy (NAC) is the widely accepted treatment strategy for locally advanced and some early stage breast cancer.[2] Neoadjuvant chemotherapy provides some advantages.Firstly it could led to breast conserving therapy who was unsuitable at diagnosis, secondly decreasing amount of tissue resection so it could give cosmetic advantages.[3] Also neoadjuvant chemotherapy provides positive effects on probability of pathological complete response.Pathological complete response is associated with increased survival.[4] Recent reports showed an association between cancer progression and systemic inflammatory response.[5][6][7] Elevated levels of neutrophils is a marker of systemic in-Objectives: Recent reports showed an association between tumor progression and systemic inflammatory response.It was suggested that increased neutrophil lymphocyte ratio were associated with reduced pathological complete response rates after neoadjuvant chemotherapy.We aimed to investigate the relationship between pretreatment NLR and pathological response rates in nonmetastatic breast cancer patients who received neoadjuvant chemotherapy.Methods: We retrospectively reviewed 67 patients who were diagnosed with breast cancer and received neoadjuvant chemotherapy at Kayseri City Hospital.NLR was calculated before neoadjuvant chemotherapy and we determined a cut off value.Low and high NLR were compared according to general characteristics.And the factors that predict complete response analysed using logistic regression analysis.Results: There were no statistically significant difference among NLR low and high groups according to general characteristics.Both the univariate and multivariate analyses revealed that histological subtype, grade, hormone receptor status, HER2 status were correlated with complete response.Conclusion: In this study there were no relationship between NLR and pathological complete response rate.As expected we showed that the histological subtype, grade, hormone receptor status, HER2 status were independent markers to predict complete response.