Clinical Report: Low Prognostic Nutritional Index and Lymph Node Metastasis in Breast Cancer

Overview

This study identifies a significant association between low prognostic nutritional index (PNI) scores and lymph node metastasis (LNM) in breast cancer patients, while the hemoglobin-albumin-lymphocyte-platelet (HALP) score did not show a similar correlation. The findings suggest that PNI could serve as a valuable prognostic tool in assessing LNM risk.

Background

Breast cancer remains a leading cause of cancer-related morbidity and mortality among women globally. Lymph node metastasis is a critical prognostic factor that influences treatment decisions and patient outcomes. Understanding the role of nutritional and immune status in cancer progression is essential for optimizing treatment strategies and improving patient prognosis.

Data Highlights

Key Findings

• Low PNI levels are significantly associated with LNM in breast cancer patients (OR: 1.481, p = 0.041).
• HALP scores were lower in LNM-positive patients compared to LNM-negative patients (p < 0.001).
• The optimal cutoff for PNI to predict LNM was determined to be 52.45.
• PNI can be utilized as a convenient warning tool for assessing LNM risk.
• Attention to nutritional and immune interventions is recommended before and after surgery.

Clinical Implications

Clinicians should consider incorporating PNI assessments into preoperative evaluations for breast cancer patients to better stratify the risk of lymph node metastasis. Nutritional support and immune interventions may enhance patient outcomes and should be prioritized in treatment planning.

Conclusion

The study underscores the importance of nutritional status in breast cancer prognosis, highlighting low PNI as a potential risk factor for lymph node metastasis. Further research is warranted to explore the implications of nutritional interventions in this patient population.

References

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4. Springer, The Role of the Advanced Lung Cancer Inflammation Index as a Prognostic Tool for Patients Undergoing Radical Nephroureterectomy for Upper Tract Urothelial Carcinoma, 2025
5. PubMed, Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update, 2025
6. ScienceDirect, Prognostic nutritional index and cancer prognostic outcomes: an umbrella review of systematic reviews and meta-analyses of observational studies, 2026
7. Sentinel Lymph Node Biopsy in Early-Stage Breast Cancer: ASCO Guideline Update - PubMed
8. Prognostic nutritional index and cancer prognostic outcomes: an umbrella review of systematic reviews and meta-analyses of observational studies - ScienceDirect