Importance of HALP Score in Breast Cancer and its Diagnostic Value in Predicting Axillary Lymph Node Status

Abstract

Objective: To determine the diagnostic value of the haemoglobin, albumin, lymphocyte, and platelet (HALP) score in predicting axillary lymph node (ALN) involvement. Study Design: Observational study. Place and Duration of Study: Department of General Surgery, Balikesir University and Mersin City Hospital, Turkey from January 2016-December 2021. Methodology: Included in the study were 307 patients who underwent surgical treatment for breast cancer. HALP values were calculated by multiplying the haemoglobin, albumin, and lymphocyte values and dividing the resulting value by the platelet number. The patients were divided in two groups, being those with low HALP (Group 1) and high HALP (Group 2) scores. We examined the potential of the HALP score for the prediction of ALN involvement. Result: Group 1 had 65 patients and the Group 2 had 242 patients. At the cut-off point, a HALP score of ≤29.01 predicted the presence of axillary involvement with a sensitivity of 84.33% and a specificity of 26.1%. The sentinel lymph node sampling rate was similar in both groups (12.3% vs. 16.9% p=0.365). The presence of positive lymph nodes in the axilla was higher in group 1 (67.7% vs. 53.3% p=0.038). There was no correlation between HALP score, and the metastatic lymph node and total lymph node count. Conclusion: The use of HALP score alone for the prediction of axillary lymph node positivity in patients with breast cancer is not advised. In the present study, a low HALP score was associated with aggressive tumour activity, such as advanced tumour and axillary lymph node positivity.