Abstract
Multiple studies have found the neutrophil to lymphocyte ratio (NLR) to be associated with adverse breast cancer (BC) prognosis and survival. Very limited data exist on the role of NLR and risk of BC. The BREOGAN study is a population-based case–control study conducted in Galicia, Spain. We examined the WBC- and NLR-BC relationships. The risk of BC increased with increasing levels of neutrophils percentage (NE%) (multivariable OR for the highest category (95% CI) = 2.14 (1.39–3.32), P-trend < 0.001) and of the NLR (multivariable OR for the highest category (95% CI) = 1.93 (1.26–2.97), P-trend < 0.001). Lymphocytes absolute (L#) and percentage (L%) were associated with a decreased risk of BC (multivariable OR for the highest category (95% CI) = 0.54 (0.35–0.83), and 0.51 (0.33–0.79), P-trend = 0.001 and < 0.001, respectively). The NLR-BC association was more pronounced among Luminal A BC (multivariable OR for the highest category (95% CI) = 2.00 (1.17–3.45), P-trend < 0.001), HER2-negative BC (multivariable OR for the highest category (95% CI) = 1.87 (1.16–3.02), P-trend < 0.001), and those with high total cholesterol and low H2O2 levels.
Highlights
In 2018, 32,825 new breast cancer cases were diagnosed in Spain, representing 12% of all cancer cases, and 29% of all cancers in w omen[1]
Our findings indicate that breast cancer risk increased with increasing NE% and neutrophil to lymphocyte ratio (NLR) among Luminal A, and HER2 negative breast cancers, and in both, pre- and postmenopausal women, it was more pronounced among postmenopausal women
We found elevated NLR to be associated with increased risk of breast cancer, principally Luminal A and HER2negative breast cancer
Summary
In 2018, 32,825 new breast cancer cases were diagnosed in Spain, representing 12% of all cancer cases, and 29% of all cancers in w omen[1]. Several previous studies have found that higher NLR was associated with more advanced or aggressive breast c ancer[3,7,10,11] For this reason, the ratios between neutrophils in blood and other leukocytes, as the NLR, have been suggested as a prognostic value in cancer[3,12,13]. NLR, a simple and inexpensive biomarker, has been introduced as a significant prognostic factor in many tumour types[3] It has not been accepted in many clinical settings since neutrophilia can be the result of elevated granulopoiesis and, may not be an adverse sign for cancer progression[3]. This finding was consistent with the other two studies[7,18], suggesting that NLR could be an independent risk factor for breast cancer
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