Abstract
<title>Abstract</title> <p> Background Systemic inflammatory markers may predict prognosis after curative breast cancer surgery. This study evaluated the prognostic value of the preoperative neutrophil-to-lymphocyte ratio (NLR) and platelet-to-lymphocyte ratio (PLR) for postoperative recurrence according to age. Methods In this retrospective cohort study, 200 women who underwent curative breast cancer surgery between 2022 and 2024 were followed for a mean of 24.3 ± 1.5 months. Clinical, pathological, and inflammatory parameters were extracted from medical records. Outcomes included disease recurrence and all-cause mortality. Results Disease recurrence occurred in 10 patients (4.5%), with a higher incidence in patients > 65 years than in those ≤ 65 years (11.4% vs. 2.8%, <italic>p</italic> = 0.015). Mortality was low (1.4%) and did not differ between age groups ( <italic>p</italic> = 0.561). Among patients ≤ 65 years, those with recurrence had significantly higher preoperative NLR than those without recurrence (5.39 ± 3.30 vs. 2.36 ± 1.31, <italic>p</italic> = 0.001). In patients > 65 years, recurrence was associated with significantly lower PLR (109.37 ± 17.42 vs. 143.65 ± 51.39, <italic>p</italic> = 0.042). The optimal NLR cutoff for predicting recurrence in younger patients was 2.4 (75.0% sensitivity, 65.6% specificity), whereas the optimal PLR cutoff in older patients was 97 (78.4% sensitivity, 62.7% specificity). Conclusion Age influences the prognostic significance of preoperative inflammatory markers in breast cancer. Elevated NLR in patients ≤ 65 years and reduced PLR in those > 65 years were associated with an increased risk of postoperative recurrence and may serve as simple, readily available prognostic biomarkers. </p>