Sarcopenia and inflammatory markers in early-stage breast cancer: a retrospective case-control study of NLR, MLR, RDW-CV, and HRR in middle-aged and elderly women.

OBJECTIVE: To investigate the association between sarcopenia and inflammatory markers in middle-aged and elderly women with early-stage breast cancer. METHODS: Data collection was performed between April 18 and April 30, 2026. We retrospectively collected data from 263 middle-aged and elderly female patients with early-stage breast cancer who were newly diagnosed and treatment-naïve in the Department of Breast Surgery at Hebei Medical University Affiliated Hengshui People's Hospital (Harrison International Peace Hospital) between 01/09/2024 and 31/01/2026. Patients were classified into the sarcopenia and non-sarcopenia groups based on the presence of concurrent sarcopenia. Baseline patient characteristics, clinical indicators, and inflammatory markers were collected. Multivariate logistic regression was used to analyze the relationship between sarcopenia and inflammatory markers. The predictive value of NLR for sarcopenia in early-stage breast cancer was evaluated using ROC curve analysis. RESULTS: Compared with the non-sarcopenia group, the sarcopenia group were significantly older, neutrophils, RDW-CV, PLR, NLR, MLR, and were more likely to be postmenopausal (P < 0.05). Conversely, body weight, BMI, alanine aminotransferase, prealbumin, cholinesterase, lymphocytes, hemoglobin, red blood cell count, and HRR were significantly lower in the sarcopenia group (P < 0.05). Multivariate logistic regression revealed that increased age, elevated hemoglobin, and elevated NLR were independent risk factors for sarcopenia (P < 0.05), while higher BMI, RDW-CV, MLR, red blood cell count, and HRR were independent protective factors. ROC curve analysis indicated that the area under the curve of NLR for predicting sarcopenia was 0.772. CONCLUSION: An elevated NLR was independently associated with sarcopenia in middle-aged and elderly patients with early-stage breast cancer and has reference value for predicting sarcopenia in this population, which may serve as an inexpensive preliminary screening marker.