Landmark Prediction of Survival for Breast Cancer Patients: A Case Study in Tehran, Iran (original) (raw)
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Cancers, 2021
Simple Summary Prognostication of breast cancer patients is essential for risk communication and clinical decision-making. Many clinical tools for the survival prediction of breast cancer patients have been developed over the years. However, most of them were developed from Western countries. Studies have shown that these tools did not perform well in other ethnicities, such as Asian populations, including Thai. This study developed a new prediction model for survival predictions using modern statistical methods that allow a more accurate estimation of the baseline survival. The model was entitled the Individualized Prediction of Breast cancer Survival or the IPBS model. It contains twelve routinely available predictors that oncologists usually evaluate in daily practice. The survival information provided by the model was proven to be acceptably accurate and might be useful for physicians and patients, especially in Thailand or other Asian countries, to arrive at the most appropriat...
Development of Predictive Models for Survival among Women with Breast Cancer in Malaysia
International Journal of Environmental Research and Public Health
Prediction of survival probabilities based on models developed by other countries has shown inconsistent findings among Malaysian patients. This study aimed to develop predictive models for survival among women with breast cancer in Malaysia. A retrospective cohort study was conducted involving patients who were diagnosed between 2012 and 2016 in seven breast cancer centres, where their survival status was followed until 31 December 2021. A total of 13 predictors were selected to model five-year survival probabilities by applying Cox proportional hazards (PH), artificial neural networks (ANN), and decision tree (DT) classification analysis. The random-split dataset strategy was used to develop and measure the models’ performance. Among 1006 patients, the majority were Malay, with ductal carcinoma, hormone-sensitive, HER2-negative, at T2-, N1-stage, without metastasis, received surgery and chemotherapy. The estimated five-year survival rate was 60.5% (95% CI: 57.6, 63.6). For Cox PH,...
Development of a prediction model for breast cancer based on the national cancer registry in Taiwan
Breast Cancer Research
Background: This study aimed to develop a prognostic model to predict the breast cancer-specific survival and overall survival for breast cancer patients in Asia and to demonstrate a significant difference in clinical outcomes between Asian and non-Asian patients. Methods: We developed our prognostic models by applying a multivariate Cox proportional hazards model to Taiwan Cancer Registry (TCR) data. A data-splitting strategy was used for internal validation, and a multivariable fractional polynomial approach was adopted for prognostic continuous variables. Subjects who were Asian, black, or white in the US-based Surveillance, Epidemiology, and End Results (SEER) database were analyzed for external validation. Model discrimination and calibration were evaluated in both internal and external datasets. Results: In the internal validation, both training data and testing data calibrated well and generated good area under the ROC curves (AUC; 0.865 in training data and 0.846 in testing data). In the external validation, although the AUC values were larger than 0.85 in all populations, a lack of model calibration in non-Asian groups revealed that racial differences had a significant impact on the prediction of breast cancer mortality. For the calibration of breast cancerspecific mortality, P values < 0.001 at 1 year and 0.018 at 4 years in whites, and P values ≤ 0.001 at 1 and 2 years and 0.032 at 3 years in blacks, indicated that there were significant differences (P value < 0.05) between the predicted mortality and the observed mortality. Our model generally underestimated the mortality of the black population. In the white population, our model underestimated mortality at 1 year and overestimated it at 4 years. And in the Asian population, all P values > 0.05, indicating predicted mortality and actual mortality at 1 to 4 years were consistent. Conclusions: We developed and validated a pioneering prognostic model that especially benefits breast cancer patients in Asia. This study can serve as an important reference for breast cancer prediction in the future.
JOURNAL OF ASSOCIATED MEDICAL SCIENCES (Online), 2024
Background: Many studies employed machine learning (ML) to forecast the prognosis of breast cancer (BC) patients and discovered that the ML model showed high individualized forecasting ability. Breast cancer is the most frequent kind of carcinoma in women globally and ranks as the leading cause of death in women. Objectives: This study intends to use the Surveillance, Epidemiology, and End Results dataset to categorize breast carcinoma cases' alive and dead conditions. Deep learning and machine learning have been extensively utilized in clinical studies to address various categorization problems due to their ability to manage massive data sets in an organized manner. Pre-processing the data allows it to be visualized and analyzed for making critical choices. This study describes a realistic machine learning-based strategy for categorizing the SEER breast cancer dataset. Materials and methods: We employed classification and machine learning algorithms to classify breast cancer mortality. Four well-known classification ML algorithms were employed in this study. To identify risk factors, we employed multivariate analysis using the data set. Results: The decision tree performed the best accuracy (0.914) among all the models. T4 stage (β=1.4, p<0.001, OR=4.22, 95% CI (2.06-8.64), N2 stage (β=0.39, p=0.008, OR= 1.49, 95% CI (1.111-1.997) found to be major risk factors for breast cancer mortality using multivariate analysis. Conclusion: The significant prognostic variables affecting the breast carcinoma survival rates reported in the current research are relevant and might be turned into decision support systems in the medical realm.
Stage – Specific Predictive Models for Main Prognosis Measures of Breast Cancer
Future Computing and Informatics Journal, 2018
Breast cancer is a malignant tumor that starts in the cells of the breast. A malignant tumor is a group of cancer cells that can grow into near tissues or invading the distant areas of the body. The disease occurs almost entirely in women, but men can get it, too. Survival rate, recurrence detection and disease-free survival rate (DFS) are the main patient's outcome and prognosis measures. Breast cancer outcomes are vary among different stages of the disease. There are five stages of breast cancer named as 0, 1, 2, 3, and 4. Prognosis helps doctors to save patients' lives by estimating how patient will progress in the therapy plan by comparing the patient's results with another patient's has the same disease characteristics and completed his therapy plan. In Egypt breast cancer represented 21.6% of 33,000 women cancer deaths Ibrahim et al.,2014, with incidence rate (48.8/100,000) and mortality rate (19.2/100,000). We selected a sample about 1692 cases were diagnosed as breast cancer patients at the period from 2010 to 2012 taken from the cases recorded in the Tumors Hospital and Institute of First Settlement one of the National Cancer Institute "NCI" cancer hospitals in Egypt. NCI is the central cancer institute in Egypt. We select the main sufficient attributes to building a prognosis predictive model 0.1471 records have been selected form the whole sample. The data set we select is used to compute and predict the three main outcome of prognosis measure at two level, data level for the complete data set, stage level for every stage of breast cancer separately. The study uses efficient five prediction models with highest accuracy. Results shows that the 5-years survival rate and local recurrence was in continuous decreasing since 2010 to 2012. Metastatic as a type of breast cancer recurrence was 20.74% in 2010, 17.59% in 2011 and 22.35% in 2012.The DFS (Disease-Free Survival) have the worst rate ever in 2012 as 7.13% after it was 30.37% in 2010.Prognosis predictive models results shows that the SVM classifiers is the most accurate model to predict the three prognosis measures at the two data level.
Open Access Library Journal, 2024
Breast cancer remains a significant global health challenge, with prognosis and treatment decisions largely dependent on clinical characteristics. Accurate prediction of patient outcomes is crucial for personalized treatment strategies. This study employs survival analysis techniques, including Cox proportional hazards and parametric survival models, to enhance the prediction of the log odds of survival in breast cancer patients. Clinical variables such as tumor size, hormone receptor status, HER2 status, age, and treatment history were analyzed to assess their impact on survival outcomes. Data from 1557 breast cancer patients were obtained from a publicly available dataset provided by the University College Hospital, Ibadan, Nigeria. This dataset was preprocessed and analyzed using both univariate and multivariate approaches to evaluate survival outcomes. Kaplan-Meier survival curves were generated to visualize survival probabilities, while the Cox proportional hazards model identified key risk factors influencing mortality. The results showed that older age, larger tumor size, and HER2-positive status were significantly associated with an increased risk of mortality. In contrast, estrogen receptor positivity and breastconserving surgery were linked to better survival outcomes. The findings suggest that integrating these clinical variables into predictive models improves How to cite this paper:
Model-based survival estimates of female breast cancer data
Asian Pacific journal of cancer prevention : APJCP, 2014
Statistical methods are very important to precisely measure breast cancer patient survival times for healthcare management. Previous studies considered basic statistics to measure survival times without incorporating statistical modeling strategies. The objective of this study was to develop a data-based statistical probability model from the female breast cancer patients' survival times by using the Bayesian approach to predict future inferences of survival times. A random sample of 500 female patients was selected from the Surveillance Epidemiology and End Results cancer registry database. For goodness of fit, the standard model building criteria were used. The Bayesian approach is used to obtain the predictive survival times from the data-based Exponentiated Exponential Model. Markov Chain Monte Carlo method was used to obtain the summary results for predictive inference. The highest number of female breast cancer patients was found in California and the lowest in New Mexico....
Comparison of Survival Estimation Methods in the Analysis of Breast Cancer Data
Asian Pacific Journal of Cancer Care
Objective: In many epidemiological studies or clinical trials, Cox Proportional Hazard model is the most commonly used technique for the analysis of effects of covariates on survival time when time are continuous and ties are present. It is important to handle the presence of ties in the data to prevent the inherent effect which may lead to unreliable result in the analysis. Therefore, this study was carried out handle the inadvertent inclusion of ties in survival time with three different estimation methods; Breslow, Efron and exact partial likelihood estimation methods of Cox regression model. Material and Methods: Analysis were carried out using data collected on 300 breast cancer patients from University of Ilorin Teaching Hospital to evaluate the factors affecting the survival of patients with breast cancer. The estimation methods used in handling ties in the breast cancer data are compared using Akaike Information Criterion. All analyses were performed using STATA version 14.0...
2021
Background: Accurate prediction of survival is crucial for both physicians and women with breast cancer to enable clinical decision making on appropriate treatments. The currently available survival prediction tools were developed based on demographic and clinical data obtained from specific populations and may underestimate or overestimate the survival of women with breast cancer in China. Objective: This study aims to develop and validate a prognostic app to predict the overall survival of women with breast cancer in China. Methods: Nine-year (January 2009-December 2017) clinical data of women with breast cancer who received surgery and adjuvant therapy from 2 hospitals in Xiamen were collected and matched against the death data from the Xiamen Center of Disease Control and Prevention. All samples were randomly divided (7:3 ratio) into a training set for model construction and a test set for model external validation. Multivariable Cox regression analysis was used to construct a survival prediction model. The model performance was evaluated by receiver operating characteristic (ROC) curve and Brier score. Finally, by running the survival prediction model in the app background thread, the prognostic app, called iCanPredict, was developed for women with breast cancer in China. Results: A total of 1592 samples were included for data analysis. The training set comprised 1114 individuals and the test set comprised 478 individuals. Age at diagnosis, clinical stage, molecular classification, operative type, axillary lymph node dissection, chemotherapy, and endocrine therapy were incorporated into the model, where age at diagnosis (hazard ratio [HR] 1.031, 95% CI 1.011-1.051; P=.002), clinical stage (HR 3.044, 95% CI 2.347-3.928; P<.001), and endocrine therapy (HR 0.592, 95% CI 0.384-0.914; P=.02) significantly influenced the survival of women with breast cancer. The operative type (P=.81) and the other 4 variables (molecular classification [P=.91], breast reconstruction [P=.36], axillary lymph node dissection [P=.32], and chemotherapy [P=.84]) were not significant. The ROC curve of the training set showed that the model exhibited good discrimination for predicting 1-(area under the curve [AUC] 0.802, 95% CI 0.713-0.892), 5-(AUC 0.813, 95% CI 0.760-0.865), and 10-year (AUC 0.740, 95% CI 0.672-0.808) overall survival. The Brier scores at 1, 5, and 10 years after diagnosis were 0.005, 0.055, and 0.103 in the training set, respectively, and were less than 0.25, indicating good predictive ability. The test set externally validated
Validation of death prediction after breast cancer relapses using joint models
BMC Medical Research Methodology, 2015
Cancer relapses may be useful to predict the risk of death. To take into account relapse information, the Landmark approach is popular. As an alternative, we propose the joint frailty model for a recurrent event and a terminal event to derive dynamic predictions of the risk of death.