Systemic inflammation markers and axillary involvement in early breast cancer: A retrospective cross-sectional study

Aim This study aimed to evaluate the predictive value of preoperative systemic inflammation indices—Systemic Immune-Inflammation Index (SII), Neutrophil-to-Lymphocyte Ratio (NLR), Platelet-to-Lymphocyte Ratio (PLR), and Monocyte-to-Lymphocyte Ratio (MLR)—for axillary lymph node involvement in patients with early-stage breast cancer. Methods In this retrospective, cross-sectional study, data from 334 patients who underwent surgery for early breast cancer between January 2015 and January 2023 were analyzed. Preoperative hematologic parameters and postoperative axillary status were collected. ROC analysis and logistic regression were used to assess the diagnostic performance and predictive value of each marker. Results Among the evaluated markers, only SII was found to be an independent predictor of axillary metastasis in multivariate analysis (OR: 1.00, 95% CI: 1.00– 1.03, P = .002). NLR showed significance in univariate analysis but lost statistical relevance after adjustment (P = .741). PLR and MLR did not demonstrate predictive utility. ROC analysis revealed limited discriminatory power for all markers (AUC < 0.50). Conclusion SII appears to be an independent predictor of axillary lymph node metastasis in early-stage breast cancer, whereas NLR, PLR, and MLR showed limited prognostic value. These findings highlight the potential role of SII in preoperative risk assessment and warrant further validation in large-scale prospective studies.