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Prediction of survival in individual patients with breast carcinoma.

9680 Background: Currently, the most important prognostic markers for breast carcinoma are the components of the staging system . The usefulness of these conventional indicators is limited and more than 100 prognostic variables have been described to attempt to improve the prognostic accuracy. A neural network model was developed to predict prognosis in breast cancer patients using multiple conventional and novel prognostic biomarkers.


METHODS
Formalin fixed paraffin embedded tissue was collected from 144 patients. Putative predictive antigens including ER, PR, HER-2, p53, MIB1, microvessel density, Rb1, nm23, KAI1, CD9 and p27 were evaluated using immunohistochemistry. Patients were partitioned into training and testing sets using time as an input variable and overall survival as the single output node. 20% of the data was used for a validation set. Twenty-two patients died from disease. Individual survival curves were then evaluated for each patient. Treatment options were utilised in the final model. A further 14 patients who were not included in the initial database were used to validate the model.


RESULTS
The correlation between the actual survival and predicted survival for the 144 patients is indicated in the Table. Of the 14 test patients, one was alive at 28 months (survival probability 1), one was alive at 30 months (survival probability 0.87), one was deceased at 60 months (survival probability 0.02) and 11 patients were alive at 60 months (survival probability for 8 patients 1 and 0.94, 0.77 and 0.1 for the remaining 3 patients). Altering the treatment options results in a modified probability for the patient increasing the probability of survival for Patient 3 from 0.77 to 1 at 60 months with the addition of CMF chemotherapy.


CONCLUSIONS
Artificial neural networks can be used to predict probability survival curves for individual breast cancer patients and the effect of treatment options can be evaluated using these models. [Figure: see text] No significant financial relationships to disclose.