Prognostic Biomarkers in Breast Cancer Management

Breast cancer encompasses a spectrum of molecular subtypes with distinct clinical behaviours and therapeutic sensitivities. Prognostic biomarkers inform clinicians about the likely course of disease, guiding decisions on the intensity and duration of systemic therapies. Traditional markers include hormone receptors (oestrogen and progesterone), HER2 status and tumour grade, while gene expression assays refine risk stratification in early-stage disease. More recently, attention has shifted to circulating biomarkers such as cell-free tumour DNA, tumour-infiltrating lymphocytes and routine haematological indices that reflect systemic inflammation and nutritional status. Integration of multi-omic data and artificial-intelligence-driven models promises more precise individual risk prediction. In practice, robust prognostic tools underpin global guidelines by identifying patients who may safely avoid chemotherapy, and those who require intensified regimens. Key challenges remain the standardisation of assay methodologies, validation of cut-off thresholds across diverse populations and prospective demonstration of clinical utility in randomised studies.

Research from Nature Portfolio

In a recent study analysing peripheral blood-derived indices in patients with locally advanced breast cancer receiving neoadjuvant chemotherapy, eight commonly used haematological markers were assessed two weeks before treatment. Among these, a low neutrophil-to-lymphocyte ratio (NLR) emerged as an independent predictor of pathological complete response, while the prognostic nutritional index (PNI) was significantly associated with both overall and progression-free survival. This work underscores the potential of simple, low-cost blood tests to refine treatment planning and calls for larger prospective trials to confirm optimal cut-off values and clinical implementation pathways.

Prognostic Biomarkers in Breast Cancer Management publication trend

The graph below shows the total number of articles in prognostic biomarkers in breast cancer management across all publications each year (not limited to Nature Index journals).

Technical terms

Prognostic biomarker: A measurable biological parameter used to estimate the likely outcome or course of a disease.

Neutrophil-to-lymphocyte ratio (NLR): The ratio of neutrophil count to lymphocyte count in peripheral blood, serving as a marker of systemic inflammation.

Pathological complete response (pCR): The absence of invasive cancer in the breast and axillary lymph nodes following neoadjuvant therapy.

Nomogram: A graphical statistical tool that integrates multiple prognostic variables to predict an individual patient’s clinical outcome.

References

1. The role of laboratory indices on treatment response and survival in breast cancer receiving neoadjuvant chemotherapy. Scientific Reports (2024).
2. Prognostic value of baseline neutrophil/lymphocyte ratio in HER2-positive metastatic breast cancer: exploratory analysis of data from the CLEOPATRA trial. Breast Cancer Research (2024).
3. A nomogram based on inflammation and nutritional biomarkers for predicting the survival of breast cancer patients. Frontiers in Endocrinology (2024).