While, the independent associations of NLR and PLR with clinical outcomes were lost after adjusting for clinical confounders.<h4>Conclusion</h4>SAA appears to be independently associated with both ORR to neoadjuvant therapy and long-term survival outcomes in breast cancer patients, particularly those with HER2+ status, when compared to NLR, PLR, and SII. This evidence concerns the gene ERBB2 and breast cancer.