DCA demonstrated superior net clinical benefit across a range of threshold probabilities compared with single-modality approaches.<h4>Conclusions</h4>The integration of habitat analysis with ultrasound-based radiomics enables the development of a nomogram that synergistically incorporates multimodal imaging features and clinicopathological parameters, offering a non-invasive predictive tool for Ki-67 expression in breast cancer. This evidence concerns the gene MKI67 and breast cancer.