Clinical and Translational Oncology

, Volume 20, Issue 4, pp 476–483 | Cite as

Usefulness of lymphocyte-to-monocyte, neutrophil-to-monocyte and neutrophil-to-lymphocyte ratios as prognostic markers in breast cancer patients treated with neoadjuvant chemotherapy

  • C. Marín Hernández
  • A. Piñero Madrona
  • P. J. Gil Vázquez
  • P. J. Galindo Fernández
  • G. Ruiz Merino
  • J. L. Alonso Romero
  • P. Parrilla Paricio
Research Article



Nowadays, neoadjuvant chemotherapy (nCT) in breast cancer is more and more standardized, not only in advanced tumours but also in those for which there is an attempt to achieve breast-conserving surgery. In literature, we can find evidences of the relationship between several types of tumours and systemic inflammatory response. Our objective is to analyse the prognostic value of blood parameters (lymphocytes, neutrophils, monocytes, lymphocyte-to-monocyte ratio (LMR), neutrophil-to-monocyte ratio (NMR) and neutrophil-to-lymphocyte ratio (NLR) in breast cancer (BC) patients treated with nCT.


A retrospective cohort of 150 breast cancer patients treated with nCT and subsequently with surgery was analysed. Data about the patients, histology, response to chemotherapy and peripheral blood values of lymphocytes, monocytes and neutrophils was collected, and used to calculate the LMR, NMR and NLR. Univariate and multivariate analyses were performed for the variables to see the relationship of the ratios to disease-free survival (DFS) and overall survival (OS).


Patients with high LMR (≥5.46) and low NLR (<3.33) were associated with a lower percentage of relapse (P = 0.048 and P = 0.015, respectively) and, above all, NLR was associated with a better survival (P = 0.024), being those factors that predict a good progress.


High LMR and low NLR can be considered as favourable prognostic factors in BC patients treated with nCT.


Neoadjuvant chemotherapy Breast cancer Lymphocyte-to-monocyte ratio Neutrophil-to-lymphocyte ratio Neutrophil-to-monocyte ratio 


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

All patients signed informed consent prior to treatment. All of them were informed and in accordance with medical practise.


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Copyright information

© Federación de Sociedades Españolas de Oncología (FESEO) 2017

Authors and Affiliations

  1. 1.Breast Unit, Service of General SurgeryUniversity Hospital Virgen de la ArrixacaMurciaSpain
  2. 2.Department of SurgeryUniversity Hospital Virgen de la ArrixacaMurciaSpain

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