Predicting Characteristics Associated with Breast Cancer Survival Using Multiple Machine Learning Approaches

Breast cancer is one of the most commonly diagnosed female disorders globally. Numerous studies have been conducted to predict survival markers, although the majority of these analyses were conducted using simple statistical techniques. In lieu of that, this research employed machine learning approaches to develop models for identifying and visualizing relevant prognostic indications of breast cancer survival rates. A comprehensive hospital-based breast cancer dataset was collected from the National Cancer Institute's SEER Program's November 2017 update, which offers population-based cancer statistics. The dataset included female patients diagnosed between 2006 and 2010 with infiltrating duct and lobular carcinoma breast cancer (SEER primary cites recode NOS histology codes 8522/3). The dataset included nine predictor factors and one predictor variable that were linked to the patients' survival status (alive or dead). To identify important prognostic markers associated with breast cancer survival rates, prediction models were constructed using K-nearest neighbor (K-NN), decision tree (DT), gradient boosting (GB), random forest (RF), AdaBoost, logistic regression (LR), voting classifier, and support vector machine (SVM). All methods yielded close results in terms of model accuracy and calibration measures, with the lowest achieved from logistic regression (accuracy = 80.57 percent) and the greatest acquired from the random forest (accuracy = 94.64 percent). Notably, the multiple machine learning algorithms utilized in this research achieved high accuracy, suggesting that these approaches might be used as alternative prognostic tools in breast cancer survival studies, especially in the Asian area.

Machine Learning Based Comparative Analysis for Breast Cancer Prediction

One of the most prevalent and leading causes of cancer in women is breast cancer. It has now become a frequent health problem, and its prevalence has recently increased. The easiest approach to dealing with breast cancer findings is to recognize them early on. Early detection of breast cancer is facilitated by computer-aided detection and diagnosis (CAD) technologies, which can help people live longer lives. The major goal of this work is to take advantage of recent developments in CAD systems and related methodologies. In 2011, the United States reported that one out of every eight women was diagnosed with cancer. Breast cancer originates as a result of aberrant cell division in the breast, which leads to either benign or malignant cancer formation. As a result, early detection of breast cancer is critical, and with effective treatment, many lives can be saved. This research covers the findings and analyses of multiple machine learning models for identifying breast cancer. The Wisconsin Breast Cancer Diagnostic (WBCD) dataset was used to develop the method. Despite its small size, the dataset provides some interesting data. The information was analyzed and put to use in a number of machine learning models. For prediction, random forest, logistic regression, decision tree, and K-nearest neighbor were utilized. When the results are compared, the logistic regression model is found to offer the best results. Logistic regression achieves 98% accuracy, which is better than the previous method reported.

A review on breast cancer in Iraq and future therapies insights

Cancer is one of the most common diseases around the world and the second leading cause of death after cardiovascular disease. Breast cancer is the most prevalent cancer type among Iraqi women, as it represents the highest percentage of malignant tumors in women until 2018. Therefore, women should be aware of the aggravation of this disease, the importance of the periodic examination for early detection for breast cancer, and following the most appropriate means for the treatment to get recovered and, thus, to reduce mortality. To fight cancer, there is an urgent need to search for new effective anticancer therapies that alter the molecular biology of tumor cells, stimulate the immune system, or specifically deliver chemotherapy factors directly to cancer cells without affecting normal cells and reducing the side effects of treatments. In this context, this paper aimed to highlight the therapeutic approaches used in the current researches of breast cancer treatment. Accumulated evidence showed that medicinal plant extracts, and can serve as anticancer agents. The proposed mechanisms were discussed and presented in this review.

Assessment of uranium concentration in blood of Iraqi females diagnosed with breast cancer

Cancer is a widespread significant health problem in Iraq and contributes 11% to total deaths. Throughout the Gulf Wars of 1991 and 2003, about 1200 tons of ammunition were dropped around Iraq. After the wars, cancer incidence in Iraq is about 7,000 to 8,000 cancers cases per year, and the overall incidence of lymphoma, leukemia, breast cancer, and lung cancer has increased twofold and even tripled, as compared to the time before the wars. This increase could result from environmental pollution with radioactive materials including uranium, as cancer can be caused by ionizing radiation. To investigate this hypothesis, uranium concentration in the blood of 64 Iraqi females has been measured by means of CR-39 track etch detectors (42 blood samples collected from females diagnosed with breast cancer and 22 blood samples from females without breast cancer). The results show that the uranium concentrations ranged from 19.1 ± 0.3 to 238.4 ± 0.4 with an average value of 94.9 ± 5.0 ng L^-1 in the blood of women with breast cancer and from 5.2 ± 0.2 to 18.7 ± 0.04 with an average value of 10.5 ± 0.1 ng L^-1 in the blood of women without breast cancer. In comparison with the literature data, elevated levels of uranium concentration were recorded in both groups, and significantly higher average uranium concentrations were found in the blood of women with breast cancer as compared to those in the blood samples of women without breast cancer. It is concluded that there is a correlation between the incidence of breast cancer in Iraqi women and elevated levels of uranium concentrations in their blood. Whether this is a casual relationship is unclear, because cancer can be caused by various carcinogens, including environmental pollution in the region.

Determinants of screening methods utilization among Iraq/Sulaimani women

PURPOSE

This study aims to find out the participation rate of women in the utilization of screening methods to determine the relationship of sociodemographic health characteristics and breast cancer (BC) awareness with the utilization of screening methods. The authors' study aims to examine the relationship between women's belief and the utilization of screening methods.

DESIGN/METHODOLOGY/APPROACH

A cross-sectional study was conducted in three health centers from December 13, 2016 to June 12, 2017. A questionnaire was constructed for data collection about sociodemographic characteristics, screening awareness and medical and health background variables. Additionally, BC awareness measure and champion health belief model scales were used to measure women's perceptiveness about BC.

FINDINGS

Despite the awareness among 78.9% of women regarding clinical breast examination (CBE) as a screening method, only 9.5% women utilized it for screening. Due to prescription by physicians for diagnosis of BC, 23.6% women had done mammography at least once in their life. Having jobs and a good education significantly influenced the utilization of CBE as a screening method. The logistic regression analysis found that old age, family history of BC, good knowledge about BC, perceived susceptibility, low rate of perceived barriers to mammography and CBE predicted participation in screening.

ORIGINALITY/VALUE

Enhancing knowledge about BC and screening, emphasizing the susceptibility to BC and the benefits of screening will help in better participation. Importance should be given to illiterate and unemployed women.

Incidence trend of breast Cancer in women of eastern Mediterranean region countries from 1998 to 2019: A systematic review and meta-analysis

BACKGROUND

This study was conducted to provide evidence on the current status of breast cancer and its incidence trend in Eastern Mediterranean Region during 1998-2019. Also, this study aimed to investigate the association between the incidence of breast cancer and Human Development Index and some factors related to this index, including total fertility rate, and obesity, using a meta-analysis.

METHOD

Data on incidence of breast cancer were collected from various sources, including PubMed, Embase, Web of Science, and WHO, from 1998 to 2019 using systematic review and meta-analysis. Pooled age standardized rate was calculated based on study duration and quality of data using a subgroup analysis and random effect meta-analysis.

RESULTS

A total of 80 studies (545 data points) were analyzed. Pooled age standardized rate of breast cancer for Eastern Mediterranean Region was 37.1 per 100,000 person-year (95% confidence interval [CI], 34.5, 39.8) during 2011-2019. age standardized rate of breast cancer had an upward trend in Eastern Mediterranean Region from 2005 to 2019. However, the increasing trend was found to be slightly different in various regions based on quality of data. Moreover, pooled age standardized rate had a significant association with Human Development Index [- 89.2 (95% CI, - 119.8, - 58.7)] and obesity [1.2 (95% CI, 0.9, 1.5)].

CONCLUSION

Pooled age standardized rate of breast cancer in Eastern Mediterranean Region was lower than the global average. Also, the age standardized rate value and its incremental trend have been higher in countries with high-quality data than in other countries of this region in recent years. Data quality or physiological factors, such as increase in obesity rates, could be the reasons for this incremental trend.

The prediction incidence of the three most common cancers among Iranian military community during 2007-2019: a time series analysis

OBJECTIVE

Cancers are one of the most important public health problems in Iran. Because of the importance of cancers, the purpose of the current study was to the prediction of the future incidence of the most common cancers among Iranian military community (MC) by using the time series analysis during 2007 to 2019.

METHODS

In the current cross-sectional study, all registered cancers among Iranian MC entered the study. To select the best model of prediction, various methods including autocorrelation function (ACF), partial autocorrelation function (PACF), and Akaike information criterion (AIC) statistics were used. All analysis was performed by using ITSM, stata14, and Excel2010 software.

RESULTS

The most prevalent cancers among Iranian MC were breast, prostate, and colon cancers respectively. The time series analysis was shown that the trend of all mentioned cancers in Iranian MC will increase in the coming years.

CONCLUSIONS

The trend of most prevalent cancers among Iranian MC was increasing but the different factors like the growth of population size and improving the registration system should be regarded.

The cardiotoxicity effect of different chemotherapeutic regimens in Iraqi patients with breast cancer: A follow up study

Introduction

Breast cancer is the first in ranking among cancers in Iraq. Anthracyclines, cyclophosphamide and taxane are the most active chemotherapeutic regimens used. Anthracyclines induced cardiotoxicity through free radical formation while there is no full understanding about that of cyclophosphamide, but it thought that it may cause direct cardiac muscle damage. While, taxane induced cardiotoxicity through coronary vasoconstriction and oxidative stress. Thus; it is very important to study changes in the cardiac biomarkers as they were the most reliable and sensitive markers associated with cardiotoxicity.

Aim

This research was designed to carry out investigations on the cardiotoxicity effects of these chemotherapeutic drugs in Iraqi patients with breast cancer.

Materials and methods

This research was performed at the Department of Biochemistry, Medicine College, Baghdad University and at the Oncology Department of the Teaching Hospital, Baghdad - Iraq, during the period from May 2018 to October 2018. It was carried out on 56 women with undisturbed menstrual cycle (25–45 years), These women were divided into 3 groups: GI was of 29 women with primary breast cancer without starting any kind of chemotherapy, GII: the same 29 women of GI after finishing 4 cycles of anthracyclines (course 1) and GIII: which involved another 27 women after finishing both course 1 and course 2 (4 cycles of taxanes). Investigations included serum measurements of high sensitive cardiac troponin (hs-cTn), NT-pro-brain natriuretic peptide (NT-ProBNP), and high sensitive- C reactive protein (hs-CRP) by using ELISA technique. The statistical analysis was performed using the Statistical Package for Social Sciences (SPSS) version 23, when the P-values were less than 0.05, it was considered as significant.

Results

The mean (±SEM) value of the serum hs-CRP levels was decreased significantly in GIII in comparison to both GI (p = 0.004) and GII (p = 0.049) while there was no significant difference between GI and GII. Also, there was no significant difference in the mean (±SEM) value of the serum hs-cTn and the serum NT-PROBNP levels between all groups. The results also showed that there was a significant negative correlation between BMI values and serum NT-proBNP levels in GI (r = −0.435, p = 0.018), GII (r = −0.438, p = 0.018), and GIII (r = −0.384, p = 0.048). In GI, there was also a significant positive correlation between BMI and serum hs-CRP levels (r = 0.395, p = 0.034). Also, there was a significant positive correlation between serum hs-cTn levels and NT-proBNP levels in GI (r = 0.416, p = 0.025) and GII (r = 0.467, p = 0.011). Moreover, there was a significant negative correlation between the serum hs-cTn levels and serum hs- CRP concentrations (r = −0.397, p = 0.040) in GIII.

Conclusion

This study had concluded insignificant changes of cardiac biochemical markers during the chemotherapeutic treatment and that chemotherapy-induced cardiotoxicity is negligible.

The Effect of Group Counseling Using Ellis’s A-B-C Technique on Irrational Beliefs and Self-Efficacy About Breast Self-Awareness of Women Health Volunteers

Purpose: This preliminary pilot effort assessed the effect of group counseling using A-B-C technique on irrational beliefs and self-efficacy for women health volunteers (WHVs) in breast self-awareness. Design: In this randomized controlled trial, 40 WHVs from three health centers (Abhar, Iran) were randomly allocated into two groups. Method: Seven weekly group counseling sessions were held for the intervention group. Data about cancer fatalism belief, dissatisfaction of body, anxiety, and self-efficacy were collected through validated questionnaires 1 month before and 2 weeks after the intervention. Results: Mean scores of anxiety ( p = .036), body dissatisfaction ( p = .002), cancer fatalism belief ( p ≤ .0001), and self-efficacy ( p ≤ .0001) were improved in the intervention group compared with control group. Discussion/Conclusion: Group counseling using A-B-C technique was effective in improving irrational beliefs and self-efficacy of the WHVs about breast self-awareness. Implications for Practice: The findings may help in further development of strategies and cultural programs to improve health-related irrational beliefs.

Breast Cancer Epidemiology in Gulf Cooperation Council Countries: A Regional and International Comparison

Breast cancer is the most frequently diagnosed noncutaneous malignancy in women living in Gulf Cooperation Council countries. The present report aimed to highlight the similarities and variations in breast cancer incidence, age at diagnosis, clinicopathologic features, molecular characteristics, and lifestyle factors that contribute to an increasing incidence of breast cancer compared with neighboring Arab and westernized countries. The data presented, although having important implications for policy makers, also highlights the need for further research. Such research would ensure that effective prevention and detection strategies are tailored to the specific needs of the Gulf women such that the management of breast cancer is optimized.

Breast cancer in Iraq is associated with a unimodally distributed predominance of luminal type B over luminal type A surrogates from young to old age

BACKGROUND

Breast cancer has recently increased in post-menopausal Iraqi women. In Western countries at high-risk for breast cancer, there is a bimodal increase in estrogen receptor (ER) positive tumors with a peak of low proliferation rate luminal A over higher proliferation rate luminal B tumors after 60 years of age. The aim of this study was to analyze in Iraqi women whether shifts are occurring in immunohistochemical (IHC) surrogates of molecular breast cancer subtypes toward a high-risk profile.

METHODS

Age specific and age standardized womens breast cancer incidence was estimated for the years 2006 through 2012. IHC results of ER, PR, HER2, and Ki67 testing were analyzed on the breast cancers of 125 Arabic and 725 Kurdish women by frequency of distribution and by age.

RESULTS

Between 2006 and 2012, age standardized incidence of breast cancer in Iraq increased from 30 to 40/100,000 women with the increase specifically occurring in women ≥ 60 years old (P < 0.001). Breast cancers in Kurdish women ≥ 60 years old may also have increased (P = 0.047) with urban exceeding rural rates by 2:1. For both Kurdish and Arabic women, there was a marked predominance of luminal B tumors at all ages in which luminal B and luminal A tumors were asymmetric skewed toward older age but with no late luminal A age peak.

CONCLUSIONS

Older Iraqi women do not show the bimodal shift toward higher rates of luminal A breast cancers seen in the West. The modest increase in age standardized incidence of breast cancer in Iraqi is being seen specifically in older women and may be better attributed to a trend for care in urban cancer centers rather than changing tumor characteristics.

Breast Cancer Trend in Iran from 2000 to 2009 and Prediction till 2020 using a Trend Analysis Method

BACKGROUND

Breast cancer is the most common cancer in women worldwide with a rising incidence rate in most countries. Considering the increase in life expectancy and change in lifestyle of Iranian women, this study investigated the age-adjusted trend of breast cancer incidence during 2000-2009 and predicted its incidence to 2020.

MATERIALS AND METHODS

The 1997 and 2006 census results were used for the projection of female population by age through the cohort-component method over the studied years. Data from the Iranian cancer registration system were used to calculate the annual incidence rate of breast cancer. The age-adjusted incidence rate was then calculated using the WHO standard population distribution. The five-year-age-specific incidence rates were also obtained for each year and future incidence was determined using the trend analysis method. Annual percentage change (APC) was calculated through the joinpoint regression method.

RESULTS

The bias adjusted incidence rate of breast cancer increased from 16.7 per 100,000 women in 2000 to 33.6 per 100,000 women in 2009. The incidence of breast cancer had a growing trend in almost all age groups above 30 years over the studied years. In this period, the age groups of 45-65 years had the highest incidence. Investigation into the joinpoint curve showed that the curve had a steep slope with an APC of 23.4% before the first joinpoint, but became milder after this. From 2005 to 2009, the APC was calculated as 2.7%, through which the incidence of breast cancer in 2020 was predicted as 63.0 per 100,000 women.

CONCLUSIONS

The age-adjusted incidence rate of breast cancer continues to increas in Iranian women. It is predicted that this trend will continue until 2020. Therefore, it seems necessary to prioritize the prevention, control and care for breast cancer in Iran.

Poor Knowledge and Practice Towards Breast Cancer among Women in Baghdad City, Iraq

BACKGROUND

Breast cancer is one of the most common cancers among females worldwide. The aim of this study was to assess the knowledge and practice about breast cancer and its related factors among women in Baghdad city, Iraq.

MATERIALS AND METHODS

A cross-sectional study was conducted among 508 women aged 18 to 55 years from four non-governmental organizations (NGO) in Baghdad city, Iraq. A self-administered questionnaire on breast cancer knowledge and practice was distributed to participants during weekly activity of the NGO.

RESULTS

A total of 61.2% of the respondents had poor knowledge, only 30.3% performed breast self-examination (BSE) and 41.8% said that they did not know the technique to perform BSE. Associations between knowledge and marital status and age were significant. For practice, working status, education, age and family income were significant. After controlling for cofounders, the most important contributing factors for poor knowledge among respondents were marital status and not performing BSE, with adjusted odds ratio of 1.6 and 1.8 respectively.

CONCLUSIONS

Breast cancer knowledge and practice of BSE are poor among women in Baghdad city, Iraq. More promotion regarding breast cancer signs and symptoms and also how to perform BSE should be conducted using media such as television and internet as these constituted the main sources of information for most women in our study.

Secular trend analysis of lung cancer incidence in Sihui city, China between 1987 and 2011

Background

With industrial and econom ic development in recent decades in South China, cancer incidence may have changed due to the changing lifestyle and environment. However, the trends of lung cancer and the roles of smoking and other environmental risk factors in the development of lung cancer in rural areas of South China remain unclear. The purpose of this study was to explore the lung cancer incidence trends and the possible causes of these trends.

Methods

Joinpoint regression analysis and the age–period–cohort (APC) model were used to analyze the lung cancer incidence trends in Sihui, Guangdong province, China between 1987 and 2011, and explore the possible causes of these trends.

Results

A total of 2,397 lung cancer patients were involved in this study. A 3-fold increase in the incidence of lung cancer in both sexes was observed over the 25-year period. Joinpoint regression analysis showed that while the incidence continued to increase steadily in females during the entire period, a sharp acceleration was observed in males starting in 2005. The full APC model was selected to describe age, period, and birth cohort effects on lung cancer incidence trends in Sihui. The age cohorts in both sexes showed a continuously significant increase in the relative risk (RR) of lung cancer, with a peak in the eldest age group (80–84 years). The RR of lung cancer showed a fluctuating curve in both sexes. The birth cohorts identified an increased trend in both males and females; however, males had a plateau in the youngest cohorts who were born during 1955–1969.

Conclusions

Increasing trends of the incidence of lung cancer in Sihui were dominated by the effects of age and birth cohorts. Social aging, smoking, and environmental changes may play important roles in such trends.

Incidence and mortality of female breast cancer in Jiangsu, China

OBJECTIVES

The aim of this study was to describe and analyze the incidence and mortality of female breast cancer in Jiangsu Province of China.

METHODS

Incidence and mortality data for female breast cancer and corresponding population statistics from eligible cancer registries in Jiangsu from 2006 to 2010 were collected and analyzed. Crude rates, age-specific rates and age-standardized rates of incidence and mortality were calculated, and annual present changes (APCs) were estimated to describe the time trends.

RESULTS

From 2006 to 2010, 11,013 new cases and 3,068 deaths of female breast cancer were identified in selected cancer registry areas of Jiangsu. The annual average crude incidence and age-standardized incidence by world population (ASW) were 25.2/ and 17.9/100,000 respectively. The annual average crude and ASW for mortality rates were 7.03/ and 4.81/100,000. The incidence was higher in urban areas than that in rural areas, and this was consistent in all age groups. No significant difference was observed in mortality between urban and rural areas. Two peaks were observed when looking at age-specific rates, one at 50-59 years and another at over 85 years. During the 5 years, incidence and mortality increased with APCs of 4.47% and 6.89%, respectively. Compared to the national level, Jiangsu is an area with relatively low risk of female breast cancer.

CONCLUSION

Breast cancer has become a main public health problem among Chinese females. More prevention and control activities should be conducted to reduce the burden of this disease, even in relatively low risk areas like Jiangsu.

A clinical database of breast cancer patients reveals distinctive clinico-pathological characteristics: a study from central China

BACKGROUND

Breast cancer is the most common malignant tumor in females worldwide. Many differences exist in clinico-pathological characteristics of breast cancer patients between China and Western countries. This study aimed to analyze clinico-pathological characteristics of breast cancer from central China.

METHODS

Clinico- pathological information on breast cancer from three hospitals in central China was collected and analyzed.

RESULTS

From 1994 to 2012, 2,525 patients with a median age 50 years were included in this study. The 45-49-year age group and invasive ductal carcinoma not otherwise specified accounted for the highest proportions (19.1%, 480/2,525 and 81.0%, 1,982/2,446). Stages 0-I, II and III accounted for 28.0% (682/2,441), 48.4% (1,180/2,441), and 23.7% (578/2,441), respectively. Distribution of N stage showed that N0 accounted for 53.2% (1,344/2,525), and proportion of N0 rose from 51.1% (157/307) in 30-39-year age group to 64.3% (110/171) in ≥ 70-year age group, with an average increase of 2.1% in each age group. Modified radical mastectomy, radical mastectomy, breast-conserving surgery and simple mastectomy were performed for 71.8% (1,812/2,525), 18.0% (454/2,525), 5.2% (131/2,525) and 2.6% (66/2,525), respectively. Proportions of breast-conserving surgery in age ≤ 44-year group (68/132, 51.5%) and simple mastectomy in age ≥ 60-year group (57/89, 64.0%) were higher than in the other age groups. Breast cancers positive for estrogen receptor accounted for 53.0% (1,107/ 2,112). The comparisons among this study and other reports showed higher proportion of younger patients, lower proportion of breast- conserving surgery and positive estrogen receptor patients in China than western countries.

CONCLUSIONS

Clinico-pathological characteristics in this study demonstrated clear differences between the center of China than Western countries. Additional classification systems should be developed to guide grading of early breast cancer more accurately, especially for N0 patients. Invasive ductal carcinoma is a focus for intensive research.