Objective:

To evaluate the association between nine axillary nodal variables and post-neoadjuvant chemotherapy breast cancer survival, and to identify the nodal metric with the strongest prognostic value, highlighting its clinical significance.

Key Findings:

• The study identified nine axillary nodal variables that may influence survival post-NAC, with implications for clinical decision-making.
• Pathological node (pN) staging and lymph node ratio (LNR) systems were compared for their prognostic performance, revealing differences in stratification.

Interpretation:

The findings suggest that certain axillary metrics may provide valuable prognostic information for breast cancer patients post-NAC, potentially enhancing survival predictions and informing treatment strategies.

Limitations:

• The study was retrospective and based on a single-center database, which may introduce selection bias.
• No formal sample size calculation was performed, which may affect the generalizability of the results.
• Incomplete data on treatment regimens limited the analysis, potentially impacting the findings.

Conclusion:

The study underscores the importance of evaluating various axillary metrics to improve prognostic assessments in breast cancer patients after neoadjuvant chemotherapy, with potential implications for clinical practice.