Figure 1:

Figure 2:

Figure 3:

Figure 4:

Figure 5:

Figure 6:

Figure 7:

Figure 8:

Clinical characteristics of breast cancer patients_
| Characteristic | Untreated BC | |
|---|---|---|
| Age Median (range) | 46 (30–75) | |
| T stage | T1 | 8 (13.55%) |
| T2 | 30 (50.84%) | |
| T3 | 8 (13.55%) | |
| T4 | 8 (13.55%) | |
| ND | 5 (8.47%) | |
| N stage | N0 | 20 (33.89%) |
| N1 | 28 (47.45%) | |
| N2 | 5 (8.47%) | |
| N3 | 1 (1.69%) | |
| ND | 5 (8.47%) | |
| Stage disease | IA | 2 (3.39%) |
| IIA | 21 (35.59%) | |
| IIB | 17 (28.81%) | |
| IIIA | 6 (10.17%) | |
| IIIB | 8 (13.55%) | |
| IIIC | 1 (1.69%) | |
| ND | 4 (6.78%) | |
| Laterality of tumor | Right breast | 24 (40.67%) |
| Left breast | 35 (59.32%) | |
| Histological classification | CCI | 49 (83.05%) |
| CLI | 4 (6.78%) | |
| Mixte | 5 (8.47%) | |
| colloid | 1 (1.69%) | |
| SBR classification | I | 1 (1.69%) |
| II | 35 (59.32%) | |
| II/III | 2 (3.39%) | |
| III | 20 (33.89%) | |
| ND | 1 (1.69%) | |
| Molecular classification | Lum A | 6 (10.17%) |
| Lum B | 24 (40.67%) | |
| Lum B-like | 7 (11.86%) | |
| HER2+ | 9 (15.25%) | |
| TNBC | 8 (13.55%) | |
| Lum A or B | 5 (8.47%) | |
| Treatment | Chemotherapy | 58/59 |
| Radiotherapy | 51/59 | |
| Hormonotherapy | 36/42 | |
| Anti-HER2 | 16/16 | |
Baseline hematological values_
| Blood values | Population |
|---|---|
| Mean white blood cell† (± SD) | 6.926 (± 1.720) |
| Mean neutrophils† (± SD) | 4.152 (± 1.307) |
| Mean lymphocytes† (± SD) | 2.180 (± 0.6109) |
| Mean monocytes†‡ (± SD) | 0.4483 (± 0.2294) |
| Mean platelets† (± SD) | 264.553 (± 63.215) |
| Mean MLR‡ (± SD) | 0.2256 (± 0.1675) |
| Mean NLR (± SD) | 2.021 (± 0.7890) |
| Mean PLR (± SD) | 130.8 (± 59.11) |
| Mean SIRI‡ (± SD) | 0.8649 (±0.4827) |
| Mean SII (± SD) | 530.5 (±209.3) |
Clinicopathological characteristics of breast cancers according to inflammatory markers for RFS and DMFS_
| Subgroups | N | SII | P value | N | NLR | P value | N | MLR | P value | N | SIRI | P value | ||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Low | High | Low | High | Low | High | Low | High | |||||||||
| Recurrence-free survival | ||||||||||||||||
| Age | 59 | 0.601 | 59 | 0.7787 | 42 | 0.3357 | 42 | 0.3357 | ||||||||
| ≤ 46 | 14 | 16 | 20 | 10 | 6 | 16 | 6 | 16 | ||||||||
| > 46 | 11 | 18 | 21 | 8 | 9 | 11 | 9 | 11 | ||||||||
| T staging | 55 | 0.5648 | 55 | 0.2127 | 39 | 1 | 39 | 0.7281 | ||||||||
| T1+T2 | 16 | 23 | 29 | 10 | 10 | 16 | 11 | 15 | ||||||||
| T3+T4 | 8 | 8 | 9 | 7 | 5 | 8 | 4 | 9 | ||||||||
| N staging | 55 | 1 | 55 | 0.7630 | 39 | 1 | 39 | 1 | ||||||||
| N0 | 9 | 11 | 13 | 7 | 4 | 7 | 4 | 7 | ||||||||
| N+ | 15 | 20 | 25 | 10 | 11 | 17 | 10 | 18 | ||||||||
| Clinical staging | 55 | 1 | 55 | 0.1892 | 39 | 1 | 39 | 0.7281 | ||||||||
| I+II | 17 | 23 | 30 | 10 | 10 | 16 | 11 | 15 | ||||||||
| III+IV | 7 | 8 | 8 | 7 | 5 | 8 | 4 | 9 | ||||||||
| SBR classification | 58 | 0.2661 | 58 | 1 | 41 | 1 | 41 | 0.1703 | ||||||||
| I+II | 18 | 20 | 26 | 12 | 9 | 18 | 7 | 20 | ||||||||
| III | 6 | 14 | 13 | 7 | 5 | 9 | 7 | 7 | ||||||||
| Laterality of tumor | 59 | 0.7897 | 59 | 1 | 42 | 0.2072 | 42 | 1 | ||||||||
| Right breast | 11 | 13 | 16 | 8 | 4 | 13 | 6 | 11 | ||||||||
| Left breast | 14 | 21 | 24 | 11 | 11 | 14 | 9 | 16 | ||||||||
| Distant metastasis-free survival | ||||||||||||||||
| Age | 59 | 0.601 | 59 | 1 | 42 | 1 | 42 | 0.3357 | ||||||||
| ≤ 46 | 14 | 16 | 8 | 22 | 17 | 5 | 6 | 16 | ||||||||
| > 46 | 11 | 18 | 8 | 21 | 16 | 4 | 9 | 11 | ||||||||
| T staging | 55 | 0.5648 | 55 | 0.3263 | 39 | 0.1938 | 39 | 0.7281 | ||||||||
| T1+T2 | 16 | 23 | 9 | 30 | 23 | 3 | 11 | 15 | ||||||||
| T3+T4 | 8 | 8 | 6 | 10 | 9 | 4 | 4 | 9 | ||||||||
| N staging | 55 | 1 | 55 | 0.5308 | 39 | 1 | 39 | 1 | ||||||||
| N0 | 9 | 11 | 4 | 16 | 9 | 2 | 4 | 7 | ||||||||
| N+ | 15 | 20 | 11 | 24 | 23 | 5 | 10 | 18 | ||||||||
| Clinical staging | 55 | 1 | 55 | 0.7348 | 39 | 0.1938 | 39 | 0.7281 | ||||||||
| I+II | 17 | 23 | 10 | 30 | 23 | 3 | 11 | 15 | ||||||||
| III+IV | 7 | 8 | 5 | 10 | 9 | 4 | 4 | 9 | ||||||||
| SBR classification | 58 | 0.2661 | 58 | 0.5413 | 41 | 0.6925 | 41 | 0.1703 | ||||||||
| I+II | 18 | 20 | 11 | 27 | 20 | 7 | 7 | 20 | ||||||||
| III | 6 | 14 | 4 | 16 | 12 | 2 | 7 | 7 | ||||||||
| Laterality of tumor | 59 | 0.7897 | 59 | 0.1518 | 42 | 0.2708 | 42 | 1 | ||||||||
| Right breast | 11 | 13 | 9 | 15 | 15 | 2 | 6 | 11 | ||||||||
| Left breast | 14 | 21 | 7 | 28 | 18 | 7 | 9 | 16 | ||||||||
Univariate Cox regression analysis for DMFS_
| HR | 95% CI | P | |
|---|---|---|---|
| Age | 0.820 | 0.323–2.079 | 0.676 |
| T staging | 1.380 | 0.518–3.680 | 0.519 |
| N staging | 0.751 | 0.291–1.942 | 0.555 |
| SBR classification | 0.834 | 0.297–2.342 | 0.730 |
| NLR | 1.822 | 0.718–4.625 | 0.207 |
| SII | 3.118 | 1.023–9.501 | 0.045 |
| MLR‡ | 5.556 | 1.707–18.085 | 0.004 |
| SIRI‡ | 7.261 | 0.935–56.366 | 0.058 |
Optimal cutoff values of preoperative NLR, PLR, SII, MLR, SIRI for predicting RFS, DMFS, and OS in breast cancers_
| Subgroups | Cutoff value | AUC | Sensitivity (%) | Specificity (%) | Youden index | 95% CI of AUC | P-value |
|---|---|---|---|---|---|---|---|
| Recurrence-free survival | |||||||
| NLR | 2.11 | 0.568 | 41.4 | 76.7 | 0.181 | 0.425–0.712 | 0.35 |
| PLR | 291.81 | 0.440 | 6.9 | 100 | 0.069 | 0.295–0.585 | 0.419 |
| SII | 472 | 0.578 | 69 | 53.3 | 0.223 | 0.434–0.722 | 0.287 |
| MLR‡ | 0.16 | 0.693 | 85.7 | 57.1 | 0.428 | 0.538–0.847 | 0.014 |
| SIRI‡ | 0.6888 | 0.741 | 85.7 | 57.1 | 0.428 | 0.598–0.885 | 0.001 |
| Distant metastasis-free survival | |||||||
| NLR | 1.6 | 0.59 | 88.9 | 34.1 | 0.23 | 0.434–0.746 | 0.258 |
| PLR | 128.33 | 0.497 | 50 | 63.4 | 0.134 | 0.334–0.660 | 0.974 |
| SII | 472 | 0.634 | 77.8 | 51.2 | 0.29 | 0.49–0.779 | 0.069 |
| MLR‡ | 0.28 | 0.657 | 41.7 | 86.7 | 0.284 | 0.485–0.829 | 0.074 |
| SIRI‡ | 0.6888 | 0.722 | 91.7 | 46.7 | 0.384 | 0.569–0.875 | 0.004 |
| Overall survival | |||||||
| NLR | 2.85 | 0.508 | 42.9 | 90.4 | 0.333 | 0.208–0.808 | 0.957 |
| PLR | 119.52 | 0.404 | 57.1 | 50 | 0.071 | 0.174–0.633 | 0.412 |
| SII | 712 | 0.544 | 42.9 | 80.8 | 0.237 | 0.295–0.793 | 0.730 |
| MLR‡ | 0.11 | 0.559 | 100 | 18.9 | 0.189 | 0.3–0.819 | 0.653 |
| SIRI‡ | 1.3823 | 0.605 | 40 | 86.5 | 0.265 | 0.346–0.865 | 0.426 |
Univariate Cox regression analysis for RFS_
| HR | 95% CI | P | |
|---|---|---|---|
| Age | 1.237 | 0.596–2.568 | 0.569 |
| T staging | 1.318 | 0.611–2.845 | 0.482 |
| N staging | 1.265 | 0.56–2.858 | 0.572 |
| SBR classification | 1.055 | 0.478–2.328 | 0.894 |
| NLR | 1.532 | 0.73–3.217 | 0.26 |
| SII | 2.263 | 1.022–5.014 | 0.044 |
| MLR‡ | 4.311 | 1.262–14.729 | 0.020 |
| SIRI‡ | 3.845 | 1.116–13.246 | 0.033 |