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Objective: This study aimed to determine the prognostic role of baseline maximum standardized uptake value (SUVmax) obtained by pretreatment PET/CT and the change in SUVmax (ΔSUVmax [%]) in patients with axillary lymph node-positive breast cancer receiving neoadjuvant chemotherapy (NAC)., Methods: One hundred and eighty patients with baseline SUVmax and 121 patients with SUVmax measurement after treatment were evaluated in the study. The baseline SUVmax value of the breast (SUVmax B I) and axilla (SUVmax A I) and the change in the SUVmax of the breast (ΔSUVmax B ) and axilla (ΔSUVmaxA) were measured. The optimal cut-off value of SUVmax and ΔSUVmax were determined by ROC curve analysis. Disease-free survival (DFS) and overall survival (OS) were calculated using Kaplan-Meier curves., Results: ΔSUVmax B , pCR B , pCR A , and pCR parameters were found to be associated with relapse (p < 0.001, p = 0.033, p = 0.016, and p = 0.013, respectively). ΔSUVmax B and SUVmax A I were associated with mortality (p = 0.001 and p = 0.006, respectively). Multiple Cox regression analyses revealed that ΔSUVmax B value was an independent prognostic factor for relapse and mortality (p = 0.013 and p = 0.010, respectively)., Conclusion: The results showed that ΔSUVmax B was an independent prognostic factor for relapse and mortality in patients with axillary lymph node-positive breast cancer who received NAC., (Copyright © 2021 Sociedad Española de Medicina Nuclear e Imagen Molecular. Publicado por Elsevier España, S.L.U. All rights reserved.)