Construction of a comprehensive predictive model for axillary lymph node metastasis in breast cancer: A retrospective study

Purpose: The accurate assessment of axillary lymph node metastasis (LNM) in early stage breast cancer (BC) is of great importance. This study aimed to construct an integrated model based on clinicopathology, ultrasound, PET/CT, and PET radiomics for predicting axillary LNM in early stage BC. Materials and Methods 124 BC patients who underwent 18 F-fluorodeoxyglucose ( 18 F-FDG) PET/CT and whose diagnosis were confirmed by surgical pathology were retrospectively analyzed and included in this study. Ultrasound, PET and clinicopathological features of all patients were analyzed, and PET radiomics features were extracted to establish an ultrasound model (clinicopathology and ultrasound; model 1), a PET model (clinicopathology, ultrasound, and PET; model 2), and a comprehensive model (clinicopathology, ultrasound, PET, and radiomics; model 3), and the diagnostic efficacy of each model was evaluated and compared. Results The sensitivity was 48.57%, 88.57%, and 82.86%, the specificity was 88.76%, 68.54%, and 82.02%, and the AUC was 0.686, 0.823, and 0.874 for models 1, 2, and 3, respectively. Conclusion The use of an comprehensive model based on clinicopathology, ultrasound, PET/CT, and PET radiomics can effectively improve the diagnostic efficacy of axillary LNM in BC.