In the PSM cohort, detailed subgroup analyses indicated the high-HALP group was associated with improved OS within specific subgroups, including patients under 60 years, those with invasive ductal carcinoma, those with no hypertension and diabetes, ER-negative, PR-negative, HER-2 negative, Ki-67 ≥ 14%, those not receiving targeted therapy, CEA negative, and those with high PLR, when adjustments were made for other covariates (Fig. 6). This evidence concerns the gene MKI67 and invasive ductal breast carcinoma.