<h4>Purpose</h4>This study aimed to develop a noninvasive method for preoperatively predicting Ki-67 expression in breast cancer (BC) by integrating radiomics features derived from photoacoustic/ultrasound (PA/US) imaging with clinical factors.<h4>Materials and methods</h4>A total of 223 patients with pathologically confirmed BC underwent PA/US imaging before surgery. Here, MKI67 is linked to breast cancer.