Development of Web tools to predict axillary lymph node metastasis and pathological response to neoadjuvant chemotherapy in breast cancer patients

Masahiro Sugimoto, Masahiro Takada, Masakazu Toi

Research output: Contribution to journalArticlepeer-review

6 Citations (Scopus)

Abstract

Nomograms are a standard computational tool to predict the likelihood of an outcome using multiple available patient features. We have developed a more powerful data mining methodology, to predict axillary lymph node (AxLN) metastasis and response to neoadjuvant chemotherapy (NAC) in primary breast cancer patients. We developed websites to use these tools. The tools calculate the probability of AxLN metastasis (AxLN model) and pathological complete response to NAC (NAC model). As a calculation algorithm, we employed a decision tree–based prediction model known as the alternative decision tree (ADTree), which is an analog development of if-then type decision trees. An ensemble technique was used to combine multiple ADTree predictions, resulting in higher generalization abilities and robustness against missing values. The AxLN model was developed with training datasets (n=148) and test datasets (n=143), and validated using an independent cohort (n=174), yielding an area under the receiver operating characteristic curve (AUC) of 0.768. The NAC model was developed and validated with n=150 and n=173 datasets from a randomized controlled trial, yielding an AUC of 0.787. AxLN and NAC models require users to input up to 17 and 16 variables, respectively. These include pathological features, including human epidermal growth factor receptor 2 (HER2) status and imaging findings. Each input variable has an option of “unknown,” to facilitate prediction for cases with missing values. The websites developed facilitate the use of these tools, and serve as a database for accumulating new datasets.

Original languageEnglish
Pages (from-to)e372-e379
JournalInternational Journal of Biological Markers
Volume29
Issue number4
DOIs
Publication statusPublished - 2014 Oct 1

Keywords

  • Alternative decision tree
  • Breast cancer
  • Data mining
  • Lymph node metastasis
  • Neoadjuvant therapy
  • Nomogram

ASJC Scopus subject areas

  • Pathology and Forensic Medicine
  • Oncology
  • Clinical Biochemistry
  • Cancer Research

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