Objective To investigate the value of multimodal ultrasound combined with immune-inflammatory indicators in predicting axillary lymph node (ALN) metastasis in patients with breast cancer.

Methods The clinical data of 106 breast cancer patients treated in the Ultrasound Department of Nantong Cancer Hospital from January 2023 to June 2024 were analyzed, and the patients were divided into ALN metastasis group and non-metastasis group based on postoperative pathological results. Univariate and multivariate Logistic regression models were used to analyze the immune-inflammatory indicators and ultrasound parameters in both groups. The receiver operating characteristic (ROC) curve was plotted to evaluate the predictive value of each indicator.

Results Univariate analysis showed significant differences between the ALN metastasis group and the non-metastasis group in terms of the neutrophil-to-lymphocyte ratio (NLR), platelet-to-lymphocyte ratio (PLR), aspect ratio, maximum tumor diameter, and Adler blood flow grade (P < 0.05). NLR, PLR, maximum tumor diameter, and Adler blood flow grade were independent influencing factors for predicting ALN metastasis in breast cancer (P < 0.05). The area under the curve (AUC) for predicting ALN metastasis using multimodal ultrasound combined with immune-inflammatory indicators was 0.877, with a diagnostic sensitivity of 84.7% and a specificity of 76.6%. The predictive efficacy of the combined multi-indicators was significantly higher than that of individual indicators (P < 0.05).

Conclusion Multimodal ultrasound combined with immune-inflammatory indicators is associated with ALN metastasis in breast cancer patients and can provide a reference basis for clinical diagnosis, subsequent treatment, and prognosis evaluation.