Exploration of a noninvasive radiomics classifier for breast cancer tumor microenvironment categorization and prognostic outcome prediction

Rationale and Objectives: Breast cancer progression and treatment response are significantly influenced by the tumor microenvironment (TME). Traditional methods for assessing TME are invasive, posing a challenge for patient care. This study introduces a non-invasive approach to TME classification by integrating radiomics and machine learning, aiming to predict the TME status using imaging data, thereby aiding in prognostic outcome prediction. Utilizing multi-omics data from The Cancer Genome Atlas (TCGA) and The Cancer Imaging Archive (TCIA), this study employed CIBERSORT and MCP-counter algorithms analyze immune infiltration in breast cancer. A radiomics classifier was developed using a random forest algorithm, leveraging quantitative features extracted from intratumoral and peritumoral regions of Dynamic Contrast-Enhanced Magnetic Resonance Imaging (DCE-MRI) scans. The classifer’s ability to predict diverse TME states were and their prognostic implications were evaluated using Kaplan-Meier survival curves. Three distinct TME states were identified using RNA-Seq data, each displaying unique prognostic and biological characteristics. Notably, patients with increased immune cell infiltration showed significantly improved prognoses (P