Preoperative lymphocyte‑albumin‑monocyte index as an inflammation‑ and nutrition‑based predictor of overall survival in triple‑negative breast cancer: A retrospective cohort study

Serum albumin (ALB) and the lymphocyte‑to‑monocyte ratio (LMR) are established inflammation‑ and nutrition‑related biomarkers associated with tumor progression. Their combined prognostic value in triple‑negative breast cancer (TNBC) has not been fully defined. Therefore, the present study aimed to develop and demonstrate a lymphocyte‑albumin‑monocyte index (LANI) that integrates ALB and LMR for prognostic assessment in TNBC. A retrospective cohort of 166 surgically treated patients with TNBC was analyzed and divided into training (n=116) and validation (n=50) cohorts. Receiver operating characteristic analysis yielded optimal thresholds of 39.35 g/l for ALB and 2.526 for LMR, which were rounded to clinical cutoffs of 40 g/l and 2.97. Patients were categorized into three LANI groups, namely LANI=0 (ALB <40 g/l and LMR <2.97), LANI=1 (either indicator above the cutoff) and LANI=2 (both indicators above the cutoff). Multivariate Cox analysis demonstrated that tumor stage, histologic grade and LANI were independent predictors of overall survival, with a LANI value of 2 indicating markedly reduced mortality risk (hazard ratio=0.03; 95% CI: 0.002‑0.46; P=0.012). A nomogram incorporating these factors showed strong discrimination, good calibration and a meaningful clinical net benefit across both cohorts. Overall, the LANI provides a simple, reproducible and cost‑effective biomarker that enhances prognostic stratification and supports individualized management in TNBC.