This study evaluated the diagnostic performance of SPIO-enhanced MRI in differentiating metastatic from reactive hyperplastic lymph nodes and explored the association between MRI signal characteristics and Vascular Endothelial Growth Factor C (VEGF-C) expression.<h4>Methods</h4>Sixty female breast cancer patients (January-May 2024) underwent preoperative plain and SPIO-enhanced MRI (Resovist, 0.2 mL/kg, 12-h delay). Here, VEGFC is linked to breast carcinoma.