Can Axillary Positivity Be Predicted Using Hemogram Parameters in Patients with Breast Cancer at the Time of Diagnosis?

Background: Axillary lymph node status is a key prognostic factor in breast cancer and guides treatment decisions. Sentinel lymph node biopsy (SLNB) is the standard staging method in clinically node-negative patients; however, it remains invasive. Inflammatory indices derived from complete blood counts, including neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), and lymphocyte-to-monocyte ratio (LMR), have been investigated as potential markers of nodal involvement. Aim: This study aimed to evaluate the predictive performance of NLR, PLR, and LMR for axillary lymph node positivity and SLNB outcomes in breast cancer. Methods: This single-center retrospective study included 203 female patients with histopathologically confirmed invasive breast cancer. All patients underwent preoperative axillary ultrasonography, and suspicious lymph nodes were evaluated using fine-needle aspiration biopsy. SLNB was performed in 91 patients with imaging-negative axillae. Preoperative hemogram parameters were recorded, and NLR, PLR, and LMR were calculated. These indices were compared between axillary lymph node (ALN)-positive and ALN-negative patients, and between SLNB-positive and SLNB-negative subgroups. Results: NLR and LMR values were significantly higher, whereas PLR values were significantly lower ( P P Conclusion: Hemogram-derived inflammatory indices are associated with axillary nodal positivity but are insufficient to predict low-volume nodal disease detected by SLNB and should be considered complementary tools in axillary staging.