Nomogram Based on Breast MRI for Predicting Treatment Decisions in HR-Positive Breast Cancer

Motivation: Accurate recurrence risk stratification is crucial in HR+ breast cancer for guiding treatment. Multi-gene tests can be costly and have limitations, highlighting the need for a cost-effective, reliable alternative like MRI-based nomograms. Goal(s): To evaluate the effectiveness of MRI-based nomogram in predicting CTS5 for adjuvant therapy decisions in HR+ breast cancer. Approach: The study analyzed follow-up data of 106 patients and divided 303 patients into Training and validation cohorts. A nomogram was assessed using AUC and calibration metrics for CTS5 risk stratification. Results: The nomogram demonstrated high discrimination and calibration in CTS5 classification, aligning with actual recurrence outcomes and supporting precision treatment planning. Impact: This MRI-based nomogram enables personalized treatment for HR-positive breast cancer , thus offering a non-invasive, cost-effective approach for recurrence risk stratification and extended endocrine therapy decisions.