Pretreatment Axillary Nodal Volume as a Prognostic Factor for Breast Cancer

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Neoadjuvant systemic therapy is a standard treatment for breast cancer.
• Accurate prognostic markers are crucial for tailoring treatment strategies.
• The prognostic role of axillary nodal volume in this setting requires further elucidation.

Purpose of the Study:

• To evaluate the prognostic significance of pretreatment axillary nodal volume.
• To assess the association between nodal volume and survival outcomes in breast cancer patients.
• To compare the prognostic value of nodal volume with the N stage.

Main Methods:

• Retrospective review of 302 breast cancer patients with biopsy-proven axillary lymph node involvement.
• Measurement of axillary nodal volumes using pretreatment magnetic resonance imaging.
• Univariate and multivariate analyses to determine prognostic factors for disease-free survival (DFS) and overall survival (OS).

Main Results:

• Median follow-up was 57.0 months; 5-year DFS and OS rates were 81.6% and 91.9%.
• Pretreatment axillary nodal volume was a significant prognostic factor for DFS and OS (p<0.001).
• Larger nodal volumes (≥12.0 mL) were associated with significantly worse DFS and OS compared to smaller volumes (<2.6 mL).

Conclusions:

• Pretreatment axillary nodal volume is a valuable prognostic indicator in breast cancer patients undergoing neoadjuvant therapy.
• Nodal volume provides prognostic information independent of, and potentially superior to, the N stage.
• Incorporating nodal volume assessment may refine risk stratification and treatment decisions.