Haematological and systemic inflammatory markers associated with chemotherapy exposure and hormone receptor status in Ghanaian patients with breast cancer

Abstract Background and aim Systemic inflammation and haematological alterations play important roles in breast cancer progression and treatment response. This study evaluated haematological and inflammatory biomarkers across treatment groups and hormone receptor subtypes among breast cancer patients. Methods This comparative cross-sectional study included 120 participants comprising chemotherapy-naïve patients (n = 35), chemotherapy-experienced patients (n = 43), and healthy controls (n = 42) using purposive sampling. Haematological parameters and complete blood count–derived inflammatory indices were assessed. Group comparisons were performed using the Kruskal–Wallis test with Bonferroni post hoc analysis. Associations between inflammatory markers and hormone receptor status were evaluated using multivariable logistic regression, with model performance assessed using area under the curve (AUC). P < 0.05 was statistically significant. Results The median age of participants was 44 years (IQR: 35–55). Chemotherapy-experienced patients exhibited significantly lower red blood cell count (p = 0.008), haemoglobin (p = 0.004), haematocrit (p = 0.002), and lymphocyte counts (p < 0.001), alongside higher red cell distribution width (p = 0.004) and monocyte-to-lymphocyte ratio (p = 0.001), compared to other groups. Platelet indices, were also significantly reduced (p ≤ 0.004). Across receptor subtypes, platelet counts were higher in ER-positive (p = 0.032) and PR-positive (p = 0.013) patients, while PR-positive patients additionally demonstrated elevated plateletcrit (p = 0.014), AISI (p = 0.017), and SII (p = 0.028). HER2-positive patients had higher haemoglobin levels (p = 0.048). The combined model (clinical variables plus biomarkers) showed the best discriminatory performance for ER-negative (AUC = 0.679) and HER2-positive (AUC = 0.644) disease, while achieving comparable performance to the biomarker-only model for PR-negative disease (AUC = 0.646). Adding biomarkers significantly improved discrimination for ER-negative (IDI = 0.089, p = 0.025) and PR-negative (IDI = 0.066, p = 0.040) disease. Conclusion Chemotherapy exposure was associated with significant haematological alterations among Ghanaian breast cancer patients. Although CBC-derived inflammatory markers showed limited associations with hormone receptor status, their inclusion modestly improved predictive performance for some receptor outcomes; however, individual markers were not independent predictors. These findings suggest potential complementary value of inflammatory indices alongside standard receptor testing, warranting external validation in larger prospective studies.