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Women who have had early stage breast cancer may develop the disease again, within 15 years after an initial diagnosis, if their white blood cell ratio is high, international research has found.
Yasmin Noone

9 Mar 2016 - 10:53 AM  UPDATED 9 Mar 2016 - 10:53 AM

Early-stage breast cancer survivors may face a greater risk of having to battle the disease a second time within 15 years after their diagnosis, if they have a high white blood cell ratio.

A new study, published in the online journal ESMO Open, has discovered a link between an increased risk of breast cancer recurrence and blood with a higher ratio of two types of immune system cells.

The international findings suggest that a woman’s “neutrophils to lymphocytes ratio (NLR)” plays a strong role in the development and progression of breast cancer.

What are neutrophils and lymphocytes? White blood cells that are despatched as part of the body’s immune system response to fight harmful invaders, like cancer cells.

Italian scientists found that a high NLR is associated with a greater risk of recurrence of breast cancer, within 15 years after a diagnosis.

It’s estimated that nearly 20 per cent of patients with breast cancer still suffer from recurrence of disease.

“Our study suggests that pre-surgery NLR is strongly associated with distant metastasis-free survival in a series of 300 Italian patients with early breast cancer.

“In simple terms, a high NLR may [enhance] the formation of new blood vessels, tumour growth, and development of metastasis [spread].”

According to the Cancer Council Australia, breast cancer is the most common cancer in women in Australiaand the second most common cancer to cause death in women, after lung cancer.

It’s estimated that nearly 20 per cent of patients with breast cancer still suffer from recurrence of disease.

Australia’s National Breast Cancer Foundation welcomes the research findings, which further investigates why and how breast cancer returns and spreads elsewhere in the body.

“The findings from this study are exciting, and could potentially lead to identifying which women have a higher risk of recurrence,” says director research investment at National Breast Cancer Foundation, Alessandra Muntoni.

“Knowing more about breast cancer recurrence risk markers would enable health professionals to tailor each person’s after-care, and ensure they are monitored appropriately for their risk level.

“This could help with earlier diagnosis and therefore increase chances of survival.”

Breast cancer physician and Cancer Council Australia medical advisor, Dr Susan Fraser, agrees. She says these findings hold great potential for future discoveries into breast cancer treatment and prevention.

“If further research shows that this initial finding is accurate, there could be fascinating implications for how women with early breast cancer are monitored and treated,” says Dr Fraser, chair of the Breast Cancer Group within the Clinical Oncology Society of Australia.

“A greater understanding of the link between white blood cell ratios, inflammation and risk of reoccurrence could also lead to the development of more targeted treatments.”

After 15 years, cancer had returned in another part of the body in around 12 per cent of the women.

However, she explains, “it's too early yet to say what the implications of the research in terms of treatment - there is a lot more work to be done”.

This study tracked the health of 300 Caucasian women, aged over 35 years old, for 15 years after they were diagnosed with early stage breast cancer.

After 15 years, cancer had returned in another part of the body in around 12 per cent of the women.

The study showed that when cancer returned, women with a low NLR fared better at each of the subsequent check-ups years after diagnosis.

The researchers also found that being pre-menopausal, having nodes with cancerous cells in the armpit, and a high NLR were independently associated with the risk of recurrence.

Previous studies examining white blood cell ratios in groups of women of Asian ethnicity also suggest that a high NLR is associated with recurrence.

The scientists say more research is needed to confirm the association found in this study. 

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