Novel radiomic models based on DCE MRI for predicting axillary pathologic response in node-positive breast cancer after neoadjuvant therapy

Motivation: It's essential for breast and axillary conservation surgery decisions by accurately predicting axillary lymph node (ALN) status after neoadjuvant chemotherapy (NAC) in node-positive breast cancer. Goal(s): We aimed to evaluate the performance of intratumor and peritumor radiomics signature from pretreatment DCE-MRI for predicting ALN pathologic complete response (pCR) after NAC in breast cancer patients. Approach: We retrospectively collected 175 patients and integrated the clinicopathological features and DCE-MRI radiomics signature for prediction. Results: The radiomics score was identified as one of independent predictor for ALN pCR. The factors in the optimal model include initial clinical N stage, ER status, HER2 status, and radiomics score. Impact: The independent risk factors can provide valuable insights into the patients’ conditions before NAC. The nomogram model may help to identify the candidates who do not necessarily require ALN dissection, thereby facilitating personalized treatment strategies for node-positive breast cancer.