Integrating clinical-pathological-MRI features to construct a prediction model for pathological complete remission of axillary lymph nodes after neoadjuvant therapy: a retrospective study.

Background: Accurate assessment of axillary lymph node (ALN) metastasis is essential for developing an effective treatment strategy for breast cancer (BC). Despite advancements in imaging and surgical techniques, a critical need remains for reliable, non-invasive methods to predict axillary response to neoadjuvant therapy (NAT). This study aimed to identify key factors influencing axillary lymph node pathological complete response (pCR) following NAT and to develop a predictive model for axillary pCR (apCR) to support clinical decision-making regarding the necessity of axillary lymph node dissection (ALND).