Aims: To develop a model based on breast MRI to stratify axillary lymph node metastasis (ALNM) in breast cancer. Patients & methods: A total of 134 eligible patients were used to build a predicting model, which was validated with an independent group of 57 patients and evaluated for accuracy and sensitivity. Results: A model based on breast MRI was developed and yielded total accuracy of 82.5% and sensitivities of 94.3, 64.3 and 62.5% to predict patients with no, low and heavy ALNM burden, respectively, in the validation group. Conclusion: A noninvasive model based on breast MRI was developed to preoperatively stratify ALNM in breast cancer; its performance needs to be validated and improved in future research.
Keywords: MRI; axillary lymph node dissection; axillary lymph node metastasis; axillary management; axillary metastasis burden; breast cancer; model; prediction; sentinel lymph node biopsy; stratification.
Plain language summary Assessment of axillary lymph node metastasis burden before surgery in breast cancer patients is warranted for axillary management. This study tried to develop a simple model based on breast MRI to differentiate patients with no, low or heavy axillary metastasis burden. By providing the probability of different axillary metastasis burdens, this model would help patients and clinicians to make more rational decisions when choosing to omit intervention, undergo sentinel lymph node biopsy or axillary lymph node dissection for axilla management.