title: Effect of patient history data on the prediction of breast cancer from mammographic findings with artificial neural networks.
abstract: OBJECTIVE
  The authors evaluated the contribution of medical history data to the prediction of breast cancer with artificial neural network (ANN) models based on mammographic findings.
  
  
  METHODS
  Three ANNs were developed: The first used 10 Breast Imaging Reporting and Data System (BI-RADS) variables; the second, the BI-RADS variables plus patient age; the third, the BI-RADS variables, patient age, and seven other history variables, for a total of 18 inputs. Performance of the ANNs and the original radiologist's impression were evaluated with five metrics: receiver operating characteristic area index (Az); specificity at given sensitivities of 100%, 98%, and 95%; and positive predictive value.
  
  
  RESULTS
  All three ANNs consistently outperformed the radiologist's impression over all five performance metrics. The patient-age variable was particularly valuable. Adding the age variable to the basic ANN model, which used only the BI-RADS findings, significantly improved Az (P = .028). In fact, replacing all history data with just the age variable resulted in virtually no changes for Az or specificity at 98% sensitivity (P = .324 and P = .410, respectively).
  
  
  CONCLUSIONS
  Patient age was an important variable for the prediction of breast cancer from mammographic findings with the ANNs. For this data set, all history data could be replaced with age alone.
authors.affiliation: Department of Radiology, Duke University Medical Center, Durham, NC 27710, USA.
authors.forename: J Y
authors.initials: JY
authors.lastname: Lo
authors.forename: J A
authors.initials: JA
authors.lastname: Baker
authors.forename: P J
authors.initials: PJ
authors.lastname: Kornguth
authors.forename: C E
authors.initials: CE
authors.lastname: Floyd
mesh_terms: D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D019540:Area Under Curve; D001706:Biopsy; D001943:Breast Neoplasms / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000235:genetics / Q000473:pathology; D003936:Diagnosis, Computer-Assisted; D005260:Female; D005544:Forecasting; D006801:Humans; D008327:Mammography; D008487:Medical History Taking; D008875:Middle Aged; D016571:Neural Networks, Computer; D011237:Predictive Value of Tests; D012372:ROC Curve; D017584:Reproductive History; D012680:Sensitivity and Specificity