ArticleAmerican journal of cancer research2026
A multimodal imaging-based decision tree for preoperative axillary risk stratification in breast cancer: a retrospective clinical utility analysis.
Article in American journal of cancer research, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
To evaluate the clinical utility of a preoperative multimodal imaging-based decision tree for axillary risk stratification in breast cancer and to explore its associations, in a retrospective manner with axillary management patterns and short-term postoperative outcomes. This retrospective single-center study included 204 women with primary breast cancer who underwent surgery between January 2023 and December 2024. Preoperative breast MRI and axillary ultrasound performed within 2 weeks before surgery were reviewed in a blinded manner. Postoperative paraffin pathology served as the reference standard for axillary lymph node metastasis (ALNM). Imaging variables associated with ALNM were identified by multivariable logistic regression, and a CART decision tree was constructed for preoperative risk stratification. Model discrimination was evaluated in the overall cohort and in randomly split training and validation sets. Retrospective analyses were further performed to examine the associations of model-defined risk strata with actual axillary surgical management, postoperative morbidity, and 1-year disease-free survival (DFS). Five imaging variables were associated with ALNM: lesion margin morphology, RI, lymph node hilum integrity, lymph node microcalcification, and Adler blood flow grade. The decision tree showed moderate discriminative ability, with an AUC of 0.829 in the overall cohort and AUCs of 0.835 and 0.803 in the training and validation sets, respectively. Model-defined risk strata showed a stepwise increase in the observed rate of ALNM and were retrospectively associated with different patterns of axillary surgery and postoperative morbidity. Exploratory survival analyses based on 1-year follow-up did not support definitive conclusions regarding benefit from postoperative adjuvant therapy. In conclusion, a decision tree derived from routine preoperative breast MRI and axillary ultrasound features may serve as an interpretable tool for preoperative axillary risk stratification in breast cancer. Its potential relevance to axillary management should be interpreted as exploratory and hypothesis-generating, and prospective multicenter validation is required before clinical decision support can be considered.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.