LightGBM Model with Multimodal Imaging Predicts Sentinel Node Status After Neoadjuvant Chemotherapy in Early Breast Cancer

LightGBM model integrating MRI, mammography & ultrasound features predicted sentinel lymph node status after neoadjuvant chemotherapy in early breast cancer with AUCs of 0.95, 0.93 & 0.91 in internal, external test 1 & external 2 cohorts.

• The model achieved AUCs of 0.95, 0.93, and 0.91 in internal and two external test cohorts.
• Performance varied by molecular subtype, with highest AUC of 0.98 in Luminal B HER2-positive and lowest 0.79 in triple-negative.
• Limitations include retrospective design, small external cohorts, and molecular subtype imbalance; prospective validation is needed.

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