Neutrophil-Lymphocyte Ratio in Different Stages of Breast Cancer

Despite many advances in the treatment of breast cancer, it is still the second most common cause of death in women in the United States. It has been shown that inflammation plays a major role in the treatment of these cancers and inflammatory factors enhance tumor growth, invasion, metastasis, and vascularization. In this study, we would like to analyze peripheral blood neutrophil-lymphocyte ratio (NLR) in breast cancer patients and its correlation with disease staging. This cross-sectional analytic study was conducted in Imam Hospital, affiliated with Tehran University of Medical Sciences; a total of 195 female patients with breast cancer met the inclusion criteria. All of the patients had a complete blood count with leukocyte differential performed before chemotherapy. Medical records including pathology reports were also available. Data for all patients were collected prior to any surgical intervention. Exclusion criteria included clinical evidence of active infection, presence of hematological disorders, acute as well as chronic inflammatory or autoimmune diseases, or prior steroid therapy. Higher platelet count was significantly associated with the higher stage. The stage was not associated with the hemoglobin level. There was no association between the tumor size and age of patients with NLR. There was a significant relationship between NLR and IDC. There was a significant relationship between IDC and NLRs of less than 8.1 and greater than 3.3. There was a significant relationship between NLR and vascular invasion. There was no association between NLR and estrogen receptor and HER2. There was no significant relationship between the PLR and the cancer stage. In this study, NLR showed a significant relation with the disease staging. As the NLR increases the stage increases as well. Therefore, this ratio may be helpful in the preoperative evaluation of patients with breast cancer

Does Time of Day Affect Quality of Breast Cancer Surgery?

Background: Time of day can affect the outcome of medical procedures and surgical operations. The current study was designed to assess whether time of day can influence the quality of breast cancer surgery or not. Methods: Patients who underwent breast cancer surgery and axillary lymph node dissection in Tehran, Iran between March 2012 and March 2013 were enrolled. Surgeries were categorized into two group based on the time of initiation (before and after 1 pm). We considered the number of dissected lymph node as an indicator of operation quality. In this way, dissection of at least six lymph nodes was considered as an adequate number of lymph node examinations. Results: A total of 134 patients were enrolled. Median start time of surgery was 11 am. Surgeries were performed before and after 1 pm in 105(78.4%) and 29(21.6%) patients, respectively. The association between time and the number of dissected lymph nodes was significant when they were considered either as a categorical (P = 0.002) or continuous variables (P = 0.039). Conclusions: Based on our results, it can be suggested that breast surgeries with later start time might have lower quality

Impact of Age on Survival of Patients with Operable Breast Cancer

Background: Breast cancer arising in young patients (? 40 years) is being considered as a distinct clinical entity with more aggressive tumor features and poorer survival. Our aim was to assess the impact of age on survival among a large group of Iranian women diagnosed with breast cancer. Methods: In a cross-sectional study, demographic and clinicopathological characteristics of patients with breast cancer who were treated in two referral centers in Tehran, Iran during the past 13 years were reviewed and extracted from an electronic database. Patients were divided into two groups based on the age at the time of diagnosis (?40 and >40 years). The association of age with different clinicopathological features and its impact on disease-free survival were assessed. Results: Study population comprised of 353(26.1%) patients who were 40 years old or younger and 1000(73.9%) who were older. Compared to older patients, younger participants had more commonly tumor size larger than 5 cm (P = 0.034), higher chance of lymph node metastasis (P = 0.036), and overexpression of HER-2 (P = 0.004). No significant differences were observed between the two groups regarding ER, PR, and LNR (lymph node ratio). Age was the only factor affecting patients' disease-free survival and younger patients had higher chance of local or distant metastases compared to older subjects (HR: 1.49, 95%CI: 1.02-2.17, P = 0.038). Conclusions: Based on the results of current study, it can be suggested that younger patients who are diagnosed with breast cancer tend to have larger tumor size, higher chance of lymph node metastasis and overexpression of HER-2 compared to patients older than 40 years. Age was the only significant factor that was associated with shorter disease-free survival