https://doi.org/10.46889/JCMR.2024.5316 https://athenaeumpub.com/journal-of-clinical-medical-research/ Research Article Assessing the Prognostic Utility of the HALP Score in Breast Cancer and Its Association with Axillary Lymph Node Involvement Rufina Soomro 1* , Sabiha Rizwan 1 , Nikhat Fatima 1 , Maria Zia 1 1 Liaquat National Hospital. Karachi. Pakistan *Correspondence author: Rufina Soomro, Liaquat National Hospital. Karachi. Pakistan; Email: Rufina.soomro@hotmail.com Abstract Background: The Hemoglobin, Albumin, Lymphocyte, and Platelet (HALP) score has recently gained fame as a novel prognostic marker for predicting clinical outcomes in different cancers. Data regarding its applicability in breast cancer is rare. This study aimed to evaluate the prognostic utility of the HALP score in breast cancer, specifically its correlation with clinicopathological features and its effectiveness in predicting axillary lymph node involvement. Methods: This cross-sectional study was performed in the Breast Surgery Unit, Liaquat National Hospital, Pakistan during Jan-Sep 2023. HALP score was calculated in patients who planned to undergo surgery for breast cancer. Included in the study were 180 patients who underwent surgical treatment for breast cancer. HALP values were obtained by taking the product of hemoglobin, albumin, and lymphocytes and dividing it by the platelet count. The Area Under the Curve (AUC) was calculated to determine the predictive ability of the HALP score. The young index was computed. Two groups were formed using the threshold value and compared using the Chi-square of the Fisher exact test. Results: 180 patients were studied with a median age of 53.5 (IQR=22-85) years. Lymph node involvement was seen in 32.2% of patients. Median HALP score was 5.7 (IQR=4-7.2). The receiver operative characteristic curve showed an AUC of 0.544 (p=0.338). Youden index showed 5.95 to be the cut-off value. 53.3% of patients had a HALP score of <5.95. None of the patients’ features were found to be significantly different between those with HALP scores of <5.95 and ≥5.95. Conclusion: The study did not find a link between the HALP score and the clinicopathological characteristics of breast cancer. However, younger patients and those with positive lymph nodes tend to have higher HALP scores. Keywords: HALP: Hemoglobin, Albumin, Lymphocytes, Platelets; Axillary Lymph Node Involvement; Predictive Tool Introduction Breast cancer is the most common cancer in women worldwide. It has now overtaken lung cancer as the leading cause of cancer- related deaths in women [1]. Developing countries, particularly those in Asia, are experiencing a significant increase in breast cancer incidence and mortality, often attributed to lifestyle changes [2,3]. In Pakistan, the situation is alarming, with one in nine women at risk of developing breast cancer. Alarmingly, 178,388 new cases were reported in 2020 alone [4]. Prognostic factors in breast cancer are crucial for individualized treatment planning and predicting outcomes. Factors such as molecular subtypes, hormone receptor status, tumor size, and histological grade play a significant role in guiding therapy. Axillary Lymph Node (ALN) status is a critical determinant, with metastasis significantly reducing five-year survival rates. Although several imaging modalities (ultrasound, MRI, and PET scan and biopsy techniques (image-guided and sentinel node biopsy) are used for ALN assessment, several studies have been conducted to determine the presence of metastasis in the axilla using preoperative data in breast cancer [7-11]. But, they often lack sensitivity or are prohibitively expensive. Citation: Soomro R, et al. Assessing the Prognostic Utility of the HALP Score in Breast Cancer and Its Association with Axillary Lymph Node Involvement. Jour Clin Med Res. 2024;5(3):1-7. https://doi.org/10.46889/JCMR.2024. 5316 Received Date: 02-12-2024 Accepted Date: 23-12-2024 Published Date: 30-12-2024 Copyright: © 2024 by the authors. Submitted for possible open access publication under the terms and conditions of the Creative Commons Attribution (CCBY) license (https://creativecommons.org/li censes/by/4.0/).