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. 2025 Apr 23:2025:1823771.
doi: 10.1155/tbj/1823771. eCollection 2025.

Pretreatment Axillary Nodal Volume as a Prognostic Factor for Breast Cancer

Yuri Jeong  1 , Jung Hoon Kim  2 , Su Ssan Kim  3 , Jinhong Jung  3 , Ji Hyeon Joo  4 , Hwa Jung Kim  5 , Hak Hee Kim  6 , Joo Hee Cha  6 , Hee Jung Shin  6 , Seung Do Ahn  3
Affiliations

Pretreatment Axillary Nodal Volume as a Prognostic Factor for Breast Cancer

Yuri Jeong et al. Breast J. .

Abstract

Background and Objectives: We evaluated the prognostic value of pretreatment axillary nodal volume in breast cancer patients treated with neoadjuvant systemic therapy. Methods: We retrospectively reviewed 302 breast cancer patients with biopsy-proven axillary LN involvement who received neoadjuvant systemic therapy. Axillary nodal volumes were obtained from pretreatment magnetic resonance imaging. Univariate and multivariate analyses for disease-free survival (DFS) and overall survival (OS) rates were conducted. Results: The median follow-up period was 57.0 months, and 5-year DFS and OS rates were 81.6% and 91.9%, respectively. Pretreatment axillary nodal volume ranged from 0.2 mL to 134.2 mL, and the first tertile (2.6 mL) and fifth quintile (12.0 mL) were chosen as the optimal cutoff points for survival outcomes. In the multivariate analysis, nodal volume (< 2.6 mL vs. 2.6-12.0 mL vs. ≥ 12.0 mL) was a significant prognostic factor for DFS (5-year DFS, 90.1% vs. 79.6% vs. 72.2%) and OS (5-year OS, 97.9% vs. 90.9% vs. 84.2%), whereas the N stage was not. Conclusions: In breast cancer patients treated with neoadjuvant systemic therapy, larger pretreatment axillary nodal volume was associated with poor survival outcomes.

Keywords: axilla; breast neoplasm; lymph nodes; prognosis; survival.

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Conflict of interest statement

The authors declare no conflicts of interest.

Figures

Figure 1
Figure 1
Disease-free survival rate by clinical N stage (a) and the level of involved axillary LNs (b).
Figure 2
Figure 2
Disease-free survival (a) and overall survival (b) rates depending on the cutoffs for the first tertile and fifth quintile of pretreatment axillary nodal volume.
Figure 3
Figure 3
Disease-free survival (DFS) rate by axillary nodal volume in subgroups of hormone receptor status. (a) DFS rate by the cutoffs for the first tertile and fifth quintile of axillary nodal volume in patients with ER (+) and/or PR (+). (b) DFS rate by the cutoffs for the first tertile and fifth quintile of axillary nodal volume in patients with ER (−) and PR (−). (c) DFS rate by the cutoff for the first tertile of axillary nodal volume in patients with ER (+) and/or PR (+). (d) DFS rate by the cutoff for the fifth quintile of axillary nodal volume in patients with ER (−) and PR (−).
See this image and copyright information in PMC

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