Optimizing patient care protocols: importance of nutritional management as part of comprehensive breast cancer treatment

Aim – to assess the influence of neoadjuvant chemotherapy (NAC) on nutritional status in breast cancer patients by analyzing changes in the prognostic nutritional index (PNI), serum albumin, and neutrophil-to-lymphocyte ratio (NLR) at standardized clinical time points. A retrospective study of 121 patients treated in 2008 and 2018 was conducted. Nutritional indicators were evaluated at baseline, before surgery, and seven days postoperatively. Baseline characteristics, including age, body mass index (BMI), albumin, NLR, and PNI1, did not differ significantly between groups. NAC significantly reduced preoperative PNI2 levels (48.70±6.73 vs. 51.61±3.99; p=0.0072), while no significant differences were found at baseline or postoperative PNI3 (p>0.05). A weak negative correlation was observed between age and PNI2 (r= -0.1817; p=0.0461). BMI, chemotherapy regimen, and treatment-related complications did not correlate with PNI values (p>0.05). Generalized Linear Model analysis showed no independent effect of treatment year, BMI, or NAC protocol on PNI1–PNI3, whereas albumin and NLR were significantly associated with PNI across all time points, consistent with the PNI formula. Analysis of the 2018 cohort confirmed a significant decrease in PNI2 among NAC patients (p=0.0076) with no postoperative differences (p=0.9916). The results indicate that NAC causes a transient decline in nutritional reserves confined to the pre-surgical period, emphasizing the need for targeted nutritional assessment and support during NAC in breast cancer care.