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Objective To evaluate the diagnostic efficacy of modified DIXON magnetic resonance angiography (mDIXON-MRA) in the possibility of axillary lymph node dissection for patients with breast cancer. Methods A retrospective case-control trial was conducted on 77 patients with breast cancer who underwent MRI examination in the Affiliated Tumor Hospital of Chongqing University from December 2018 to January 2020. All the patients preoperatively received mDIXON-MRA, T1 weighted imaging (T1WI), T2 weighted imaging (T2WI), fat-suppressed T2-weighted imaging (T2WI-FS), and contrast-enhanced T1 weighted imaging (T1WI-CE) on the axillary region. After image post-processing and reconstruction, the obtained images were analyzed and scored by 2 radiologists respectively according to the film reviewing criteria. The resectability of lymph nodes was evaluated by judging the relationship between lymph nodes and peripheral blood vessels, and the difference of scoring the images from different sequences was compared and analyzed. Receiver operating characteristic (ROC) curve was plotted based on the intraoperative judgment of the surgeon, and then the effectiveness of different sequences was analyzed in diagnosis of the resectability of enlarged lymph nodes in breast cancer patients. Results Mean score of the images from mDIXON-MRA, T1WI, T2WI, T2WI-FS and T1WI-CE were 2.01±0.97, 2.22±1.05, 2.22±1.07, 2.42±1.06, and 2.53±1.02, respectively. And significant differences were observed in the diagnostic effectiveness of axillary lymph nodes resectability based on the 5 sequences (P < 0.05). The area under the curve (AUC) of mDIXON-MRA sequence took the highest (0.854) among the 5 sequences, which was equivalent to the area after the combination of multiple sequences, showing the best evaluation efficiency. Conclusion mDIXON-MRA presents the highest clinical diagnostic value among various MRI sequences in the evaluation of the resectability of axillary lymph nodes in breast cancer patients, with its diagnostic efficiency similar to that of combined application of multiple sequences.