Prediction of axillary lymph node metastasis in primary breast cancer patients using a decision tree-based model.
BACKGROUND
The aim of this study was to develop a new data-mining model to predict axillary lymph node (AxLN) metastasis in primary breast cancer. To achieve this, we used a decision tree-based prediction method-the alternating decision tree (ADTree).


METHODS
Clinical datasets for primary breast cancer patients who underwent sentinel lymph node biopsy or AxLN dissection without prior treatment were collected from three institutes (institute A, n = 148; institute B, n = 143; institute C, n = 174) and were used for variable selection, model training and external validation, respectively. The models were evaluated using area under the receiver operating characteristics (ROC) curve analysis to discriminate node-positive patients from node-negative patients.


RESULTS
The ADTree model selected 15 of 24 clinicopathological variables in the variable selection dataset. The resulting area under the ROC curve values were 0.770 [95% confidence interval (CI), 0.689-0.850] for the model training dataset and 0.772 (95% CI: 0.689-0.856) for the validation dataset, demonstrating high accuracy and generalization ability of the model. The bootstrap value of the validation dataset was 0.768 (95% CI: 0.763-0.774).


CONCLUSIONS
Our prediction model showed high accuracy for predicting nodal metastasis in patients with breast cancer using commonly recorded clinical variables. Therefore, our model might help oncologists in the decision-making process for primary breast cancer patients before starting treatment.
Department of Breast Surgery, Graduate School of Medicine, Kyoto University, Kyoto, Japan.
Masahiro
M
Takada
Masahiro
M
Sugimoto
Yasuhiro
Y
Naito
Hyeong-Gon
HG
Moon
Wonshik
W
Han
Dong-Young
DY
Noh
Masahide
M
Kondo
Katsumasa
K
Kuroi
Hironobu
H
Sasano
Takashi
T
Inamoto
Masaru
M
Tomita
Masakazu
M
Toi
D001943:Breast Neoplasms / Q000473:pathology*; D057225:Data Mining; D003663:Decision Trees; D005260:Female; D006801:Humans; D008198:Lymph Nodes / Q000473:pathology / Q000601:surgery; D008207:Lymphatic Metastasis; D008954:Models, Biological; D012372:ROC Curve; D021701:Sentinel Lymph Node Biopsy