This study examined whether axillary lymph-node size accurately predicts or improves prediction of 10-year recurrence-free survival. We found that for single-variable analysis, the top predictor of recurrence-free survival was pre-neoadjuvant chemotherapy (NAC) nodal volume (AUC=0.67), followed by pre-NAC tumor volume (AUC=0.66). In 4-variable analysis, the top set of predictors was pre-NAC nodal volume, human epidermal growth factor receptor 2 (HER2) positivity, pre-NAC tumor volume, and tumor volume difference between pre- and early-NAC time points (AUC=0.79). This is the first study of investigating prediction performance of recurrence-free survival using longitudinal volume change of axillary lymph-node volume in breast cancer patients.
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