A mechanistic breast cancer survival modelling through the axillary lymph node chain.
In this paper, we proposed a mechanistic breast cancer survival model based on the axillary lymph node chain structure, considering lymph nodes as a potential dissemination arrangement. We assume a naive breast cancer treatment protocol consisting of exposing patients first to a chemotherapy treatment on r intervals at k-cycles separated by equal time intervals, and then they proceed to surgery. Our model, different from former ones, accommodates a quantity of contaminated lymph nodes, which is observed during surgery. We assume a generalised negative binomial survival distribution for the unknown number of contaminated lymph nodes after surgery, which, during an unknown period, may potentially propagate the disease. Estimation is based on a maximum likelihood approach. A simulation study assesses the coverage probability of asymptotic confidence intervals when small or moderate samples are considered. A Brazilian breast cancer data illustrate the applicability of our modelling.
Department of Applied Mathematics and Statistics, University of São Paulo, Brazil.
Juliana
J
Cobre
Gleici S
GS
Castro Perdoná
Fernanda M
FM
Peria
Francisco
F
Louzada
D001365:Axilla / Q000601:surgery; D001938:Brazil; D001943:Breast Neoplasms / Q000628:therapy*; D003198:Computer Simulation; D005260:Female; D006801:Humans; D016013:Likelihood Functions; D008198:Lymph Nodes / Q000601:surgery*; D008875:Middle Aged; D008954:Models, Biological; D015233:Models, Statistical; D016019:Survival Analysis