Predicting the recurrence of breast cancer using machine learning algorithms

AI in Breast Cancer Imaging: An Update and Future Trends

Breast cancer is one of the most common types of cancer affecting women worldwide. Artificial intelligence (AI) is transforming breast cancer imaging by enhancing diagnostic capabilities across multiple imaging modalities including mammography, digital breast tomosynthesis, ultrasound, magnetic resonance imaging, and nuclear medicines techniques. AI is being applied to diverse tasks such as breast lesion detection and classification, risk stratification, molecular subtyping, gene mutation status prediction, and treatment response assessment, with emerging research demonstrating performance levels comparable to or potentially exceeding those of radiologists. The large foundation models are showing remarkable potential in different breast cancer imaging tasks. Self-supervised learning gives an insight into data inherent correlation, and federated learning is an alternative way to maintain data privacy. While promising results have been obtained so far, data standardization from source, large-scale annotated multimodal datasets, and extensive prospective clinical trials are still needed to fully explore and validate deep learning's clinical utility and address the legal and ethical considerations, which will ultimately determine its widespread adoption in breast cancer care. We hereby provide a review of the most up-to-date knowledge on AI in breast cancer imaging.

Harnessing artificial intelligence for predicting breast cancer recurrence: a systematic review of clinical and imaging data

Breast cancer is a leading cause of mortality among women, with recurrence prediction remaining a significant challenge. In this context, artificial intelligence application and its resources can serve as a powerful tool in analyzing large amounts of data and predicting cancer recurrence, potentially enabling personalized medical treatment and improving the patient's quality of life. Thus, the systematic review examines the role of AI in predicting breast cancer recurrence using clinical data, imaging data, and combined datasets. Support Vector Machine (SVM) and Neural Networks, especially when applied to combined data, demonstrate strong potential in improving prediction accuracy. SVMs are effective with high-dimensional clinical data, while Neural Networks in genetic and molecular analysis. Despite these advancements, limitations such as dataset diversity, sample size, and evaluation standardization persist, emphasizing the need for further research. AI integration in recurrence prediction offers promising prospects for personalized care but requires rigorous validation for safe clinical application.

The Challenge of Deep Learning for the Prevention and Automatic Diagnosis of Breast Cancer: A Systematic Review

OBJECTIVES

This review aims to evaluate several convolutional neural network (CNN) models applied to breast cancer detection, to identify and categorize CNN variants in recent studies, and to analyze their specific strengths, limitations, and challenges.

METHODS

Using PRISMA methodology, this review examines studies that focus on deep learning techniques, specifically CNN, for breast cancer detection. Inclusion criteria encompassed studies from the past five years, with duplicates and those unrelated to breast cancer excluded. A total of 62 articles from the IEEE, SCOPUS, and PubMed databases were analyzed, exploring CNN architectures and their applicability in detecting this pathology.

RESULTS

The review found that CNN models with advanced architecture and greater depth exhibit high accuracy and sensitivity in image processing and feature extraction for breast cancer detection. CNN variants that integrate transfer learning proved particularly effective, allowing the use of pre-trained models with less training data required. However, challenges include the need for large, labeled datasets and significant computational resources.

CONCLUSIONS

CNNs represent a promising tool in breast cancer detection, although future research should aim to create models that are more resource-efficient and maintain accuracy while reducing data requirements, thus improving clinical applicability.

Performance assessment of hybrid machine learning approaches for breast cancer and recurrence prediction

Breast cancer is a major health concern for women everywhere and a major killer of women. Malignant tumors may be distinguished from benign ones, allowing for early diagnosis of this disease. Therefore, doctors need an accurate method of diagnosing tumors as either malignant or benign. Even if therapy begins immediately after diagnosis, some cancer cells may persist in the body, increasing the risk of a recurrence. Metastasis and recurrence are the leading causes of death from breast cancer. Therefore, detecting a return of breast cancer early has become a pressing medical issue. Evaluating and contrasting various Machine Learning (ML) techniques for breast cancer and recurrence prediction is crucial to choosing the best successful method. Inaccurate forecasts are common when using datasets with a large number of attributes. This study addresses the need for effective feature selection and optimization methods by introducing Recursive Feature Elimination (RFE) and Grey Wolf Optimizer (GWO), in response to the limitations observed in existing approaches. In this research, the performance evaluation of methods is enhanced by employing the RFE and GWO, considering the Wisconsin Diagnostic Breast Cancer (WDBC) and Wisconsin Prognostic Breast Cancer (WPBC) datasets taken from the UCI-ML repository. Various preprocessing techniques are applied to raw data, including imputation, scaling, and others. In the second step, relevant feature correlations are used with RFE to narrow down candidate discriminative features. The GWO chooses the best possible combination of attributes for the most accurate result in the next step. We use seven ML classifiers in both datasets to make a binary decision. On the WDBC and WPBC datasets, several experiments have shown accuracies of 98.25% and 93.27%, precisions of 98.13% and 95.56%, sensitivities of 99.06% and 96.63%, specificities of 96.92% and 73.33%, F1-scores of 98.59% and 96.09% and AUCs of 0.982 and 0.936, respectively. The hybrid approach's superior feature selection improved the accuracy of breast cancer performance indicators and recurrence classification.

Impact of Hyperparameter Optimization to Enhance Machine Learning Performance: A Case Study on Breast Cancer Recurrence Prediction

Accurate and early prediction of breast cancer recurrence is crucial to guide medical decisions and treatment success. Machine learning (ML) has shown promise in this domain. However, its effectiveness critically depends on proper hyperparameter setting, a step that is not always performed systematically in the development of ML models. In this study, we aimed to highlight the impact that this process has on the final performance of ML models through a real-world case study by predicting the five-year recurrence of breast cancer patients. We compared the performance of five ML algorithms (Logistic Regression, Decision Tree, Gradient Boosting, eXtreme Gradient Boost, and Deep Neural Network) before and after optimizing their hyperparameters. Simpler algorithms showed better performance using the default hyperparameters. However, after the optimization process, the more complex algorithms demonstrated superior performance. The AUCs obtained before and after adjustment were 0.7 vs. 0.84 for XGB, 0.64 vs. 0.75 for DNN, 0.7 vs. 0.8 for GB, 0.62 vs. 0.7 for DT, and 0.77 vs. 0.72 for LR. The results underscore the critical importance of hyperparameter selection in the development of ML algorithms for the prediction of cancer recurrence. Neglecting this step can undermine the potential of more powerful algorithms and lead to the choice of suboptimal models.

Predicting disease recurrence in breast cancer patients using machine learning models with clinical and radiomic characteristics: a retrospective study

BACKGROUND

The goal is to use three different machine learning models to predict the recurrence of breast cancer across a very heterogeneous sample of patients with varying disease kinds and stages.

METHODS

A heterogeneous group of patients with varying cancer kinds and stages, including both triple-negative breast cancer (TNBC) and non-triple-negative breast cancer (non-TNBC), was examined. Three distinct models were created using the following five machine learning techniques: Adaptive Boosting (AdaBoost), Random Under-sampling Boosting (RUSBoost), Extreme Gradient Boosting (XGBoost), support vector machines (SVM), and Logistic Regression. The clinical model used both clinical and pathology data in conjunction with the machine learning algorithms. The machine learning algorithms were combined with dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) imaging characteristics in the radiomic model, and the merged model combined the two types of data. Each technique was evaluated using several criteria, including the receiver operating characteristic (ROC) curve, precision, recall, and F1 score.

RESULTS

The results suggest that the integration of clinical and radiomic data improves the predictive accuracy in identifying instances of breast cancer recurrence. The XGBoost algorithm is widely recognized as the most effective algorithm in terms of performance.

CONCLUSION

The findings presented in this study offer significant contributions to the field of breast cancer research, particularly in relation to the prediction of cancer recurrence. These insights hold great potential for informing future investigations and clinical interventions that seek to enhance the accuracy and effectiveness of recurrence prediction in breast cancer patients.

A contemporary review of breast cancer risk factors and the role of artificial intelligence

Background

Breast cancer continues to be a significant global health issue, necessitating advancements in prevention and early detection strategies. This review aims to assess and synthesize research conducted from 2020 to the present, focusing on breast cancer risk factors, including genetic, lifestyle, and environmental aspects, as well as the innovative role of artificial intelligence (AI) in prediction and diagnostics.

Methods

A comprehensive literature search, covering studies from 2020 to the present, was conducted to evaluate the diversity of breast cancer risk factors and the latest advances in Artificial Intelligence (AI) in this field. The review prioritized high-quality peer-reviewed research articles and meta-analyses.

Results

Our analysis reveals a complex interplay of genetic, lifestyle, and environmental risk factors for breast cancer, with significant variability across different populations. Furthermore, AI has emerged as a promising tool in enhancing the accuracy of breast cancer risk prediction and the personalization of prevention strategies.

Conclusion

The review highlights the necessity for personalized breast cancer prevention and detection approaches that account for individual risk factor profiles. It underscores the potential of AI to revolutionize these strategies, offering clear recommendations for future research directions and clinical practice improvements.

An enhanced and efficient approach for feature selection for chronic human disease prediction: A breast cancer study

Computer-aided diagnosis (CAD) systems play a vital role in modern research by effectively minimizing both time and costs. These systems support healthcare professionals like radiologists in their decision-making process by efficiently detecting abnormalities as well as offering accurate and dependable information. These systems heavily depend on the efficient selection of features to accurately categorize high-dimensional biological data. These features can subsequently assist in the diagnosis of related medical conditions. The task of identifying patterns in biomedical data can be quite challenging due to the presence of numerous irrelevant or redundant features. Therefore, it is crucial to propose and then utilize a feature selection (FS) process in order to eliminate these features. The primary goal of FS approaches is to improve the accuracy of classification by eliminating features that are irrelevant or less informative. The FS phase plays a critical role in attaining optimal results in machine learning (ML)-driven CAD systems. The effectiveness of ML models can be significantly enhanced by incorporating efficient features during the training phase. This empirical study presents a methodology for the classification of biomedical data using the FS technique. The proposed approach incorporates three soft computing-based optimization algorithms, namely Teaching Learning-Based Optimization (TLBO), Elephant Herding Optimization (EHO), and a proposed hybrid algorithm of these two. These algorithms were previously employed; however, their effectiveness in addressing FS issues in predicting human diseases has not been investigated. The following evaluation focuses on the categorization of benign and malignant tumours using the publicly available Wisconsin Diagnostic Breast Cancer (WDBC) benchmark dataset. The five-fold cross-validation technique is employed to mitigate the risk of over-fitting. The evaluation of the proposed approach's proficiency is determined based on several metrics, including sensitivity, specificity, precision, accuracy, area under the receiver-operating characteristic curve (AUC), and F1-score. The best value of accuracy computed through the suggested approach is 97.96%. The proposed clinical decision support system demonstrates a highly favourable classification performance outcome, making it a valuable tool for medical practitioners to utilize as a secondary opinion and reducing the overburden of expert medical practitioners.

An Explainable AI Approach for Breast Cancer Metastasis Prediction Based on Clinicopathological Data

OBJECTIVE

Breast Cancer is the most prevalent cancer and the first cause of cancer deaths among women worldwide. In 90% of the cases, mortality is related to distant metastasis. Computer-aided prognosis systems using machine learning models have been widely used to predict breast cancer metastasis. Despite that, these systems still face several challenges. First, the models are generally biased toward the majority class due to datasets unbalance. Second, their increased complexity is associated with decreased interpretability which causes clinicians to distrust their prognosis.

METHODS

To tackle these issues, we have proposed an explainable approach for predicting breast cancer metastasis using clinicopathological data. Our approach is based on cost-sensitive CatBoost classifier and utilises LIME explainer to provide patient-level explanations.

RESULTS

We used a public dataset of 716 breast cancer patients to assess our approach. The results demonstrate the superiority of cost-sensitive CatBoost in precision (76.5%), recall (79.5%), and f1-score (77%) over classical and boosting models. The LIME explainer was used to quantify the impact of patient and treatment characteristics on breast cancer metastasis, revealing that they have different impacts ranging from high impact like the non-use of adjuvant chemotherapy, and moderate impact including carcinoma with medullary features histological type, to low impact like oral contraception use. The code is available at https://github.com/IkramMaouche/CS-CatBoost Conclusion: Our approach serves as a first step toward introducing more efficient and explainable computer-aided prognosis systems for breast cancer metastasis prediction.

SIGNIFICANCE

This approach could help clinicians understand the factors behind metastasis and assist them in proposing more patient-specific therapeutic decisions.

Application of Artificial Intelligence in Assessing the Self-Management Practices of Patients with Type 2 Diabetes

The use of Artificial intelligence in healthcare has evolved substantially in recent years. In medical diagnosis, Artificial intelligence algorithms are used to forecast or diagnose a variety of life-threatening illnesses, including breast cancer, diabetes, heart disease, etc. The main objective of this study is to assess self-management practices among patients with type 2 diabetes in rural areas of Pakistan using Artificial intelligence and machine learning algorithms. Of particular note is the assessment of the factors associated with poor self-management activities, such as non-adhering to medications, poor eating habits, lack of physical activities, and poor glycemic control (HbA1c %). The sample of 200 participants was purposefully recruited from the medical clinics in rural areas of Pakistan. The artificial neural network algorithm and logistic regression classification algorithms were used to assess diabetes self-management activities. The diabetes dataset was split 80:20 between training and testing; 80% (160) instances were used for training purposes and 20% (40) instances were used for testing purposes, while the algorithms' overall performance was measured using a confusion matrix. The current study found that self-management efforts and glycemic control were poor among diabetes patients in rural areas of Pakistan. The logistic regression model performance was evaluated based on the confusion matrix. The accuracy of the training set was 98%, while the test set's accuracy was 97.5%; each set had a recall rate of 79% and 75%, respectively. The output of the confusion matrix showed that only 11 out of 200 patients were correctly assessed/classified as meeting diabetes self-management targets based on the values of HbA1c < 7%. We added a wide range of neurons (32 to 128) in the hidden layers to train the artificial neural network models. The results showed that the model with three hidden layers and Adam's optimisation function achieved 98% accuracy on the validation set. This study has assessed the factors associated with poor self-management activities among patients with type 2 diabetes in rural areas of Pakistan. The use of a wide range of neurons in the hidden layers to train the artificial neural network models improved outcomes, confirming the model's effectiveness and efficiency in assessing diabetes self-management activities from the required data attributes.

Natural Language Processing Applications for Computer-Aided Diagnosis in Oncology

In the era of big data, text-based medical data, such as electronic health records (EHR) and electronic medical records (EMR), are growing rapidly. EHR and EMR are collected from patients to record their basic information, lab tests, vital signs, clinical notes, and reports. EHR and EMR contain the helpful information to assist oncologists in computer-aided diagnosis and decision making. However, it is time consuming for doctors to extract the valuable information they need and analyze the information from the EHR and EMR data. Recently, more and more research works have applied natural language processing (NLP) techniques, i.e., rule-based, machine learning-based, and deep learning-based techniques, on the EHR and EMR data for computer-aided diagnosis in oncology. The objective of this review is to narratively review the recent progress in the area of NLP applications for computer-aided diagnosis in oncology. Moreover, we intend to reduce the research gap between artificial intelligence (AI) experts and clinical specialists to design better NLP applications. We originally identified 295 articles from the three electronic databases: PubMed, Google Scholar, and ACL Anthology; then, we removed the duplicated papers and manually screened the irrelevant papers based on the content of the abstract; finally, we included a total of 23 articles after the screening process of the literature review. Furthermore, we provided an in-depth analysis and categorized these studies into seven cancer types: breast cancer, lung cancer, liver cancer, prostate cancer, pancreatic cancer, colorectal cancer, and brain tumors. Additionally, we identified the current limitations of NLP applications on supporting the clinical practices and we suggest some promising future research directions in this paper.

Application of Artificial Intelligence Techniques to Predict Risk of Recurrence of Breast Cancer: A Systematic Review

Breast cancer is the most common disease among women, with over 2.1 million new diagnoses each year worldwide. About 30% of patients initially presenting with early stage disease have a recurrence of cancer within 10 years. Predicting who will have a recurrence and who will not remains challenging, with consequent implications for associated treatment. Artificial intelligence strategies that can predict the risk of recurrence of breast cancer could help breast cancer clinicians avoid ineffective overtreatment. Despite its significance, most breast cancer recurrence datasets are insufficiently large, not publicly available, or imbalanced, making these studies more difficult. This systematic review investigates the role of artificial intelligence in the prediction of breast cancer recurrence. We summarise common techniques, features, training and testing methodologies, metrics, and discuss current challenges relating to implementation in clinical practice. We systematically reviewed works published between 1 January 2011 and 1 November 2021 using the methodology of Kitchenham and Charter. We leveraged Springer, Google Scholar, PubMed, and IEEE search engines. This review found three areas that require further work. First, there is no agreement on artificial intelligence methodologies, feature predictors, or assessment metrics. Second, issues such as sampling strategies, missing data, and class imbalance problems are rarely addressed or discussed. Third, representative datasets for breast cancer recurrence are scarce, which hinders model validation and deployment. We conclude that predicting breast cancer recurrence remains an open problem despite the use of artificial intelligence.

Predicting Breast Cancer Based on Optimized Deep Learning Approach

Breast cancer is a dangerous disease with a high morbidity and mortality rate. One of the most important aspects in breast cancer treatment is getting an accurate diagnosis. Machine-learning (ML) and deep learning techniques can help doctors in making diagnosis decisions. This paper proposed the optimized deep recurrent neural network (RNN) model based on RNN and the Keras–Tuner optimization technique for breast cancer diagnosis. The optimized deep RNN consists of the input layer, five hidden layers, five dropout layers, and the output layer. In each hidden layer, we optimized the number of neurons and rate values of the dropout layer. Three feature-selection methods have been used to select the most important features from the database. Five regular ML models, namely decision tree (DT), support vector machine (SVM), random forest (RF), naive Bayes (NB), and K-nearest neighbor algorithm (KNN) were compared with the optimized deep RNN. The regular ML models and the optimized deep RNN have been applied the selected features. The results showed that the optimized deep RNN with the selected features by univariate has achieved the highest performance for CV and the testing results compared to the other models.

Breast cancer recurrence prediction with ensemble methods and cost-sensitive learning

Breast cancer is one of the most common cancers in women all over the world. Due to the improvement of medical treatments, most of the breast cancer patients would be in remission. However, the patients have to face the next challenge, the recurrence of breast cancer which may cause more severe effects, and even death. The prediction of breast cancer recurrence is crucial for reducing mortality. This paper proposes a prediction model for the recurrence of breast cancer based on clinical nominal and numeric features. In this study, our data consist of 1,061 patients from Breast Cancer Registry from Shin Kong Wu Ho-Su Memorial Hospital between 2011 and 2016, in which 37 records are denoted as breast cancer recurrence. Each record has 85 features. Our approach consists of three stages. First, we perform data preprocessing and feature selection techniques to consolidate the dataset. Among all features, six features are identified for further processing in the following stages. Next, we apply resampling techniques to resolve the issue of class imbalance. Finally, we construct two classifiers, AdaBoost and cost-sensitive learning, to predict the risk of recurrence and carry out the performance evaluation in three-fold cross-validation. By applying the AdaBoost method, we achieve accuracy of 0.973 and sensitivity of 0.675. By combining the AdaBoost and cost-sensitive method of our model, we achieve a reasonable accuracy of 0.468 and substantially high sensitivity of 0.947 which guarantee almost no false dismissal. Our model can be used as a supporting tool in the setting and evaluation of the follow-up visit for early intervention and more advanced treatments to lower cancer mortality.