Interpretable machine learning for survival prediction and risk stratification in elderly patients with breast cancer after breast-conserving surgery

We successfully established a prognostic risk stratification system identifying three distinct survival groups (low-risk, intermediate-risk, and high-risk). The low-risk group's 5-year survival matched radiotherapy-treated patients in a previous study (Yang <i>et al.</i>, 88.6%). Our system provides prognostic information that, integrated with existing radiotherapy evidence, can inform individualised treatment discussions. Prospective studies comparing radiotherapy outcomes within risk strata are needed to validate clinical utility for treatment decision-making.