Breast cancer predictions by neural networks analysis: a comparison with logistic regression

This paper presents an exploratory fixed time study to identify the most significant covariates as a precursor to a longitudinal study of specific mortality, disease free survival and disease recurrences. The data comprise consecutive patients diagnosed with primary breast cancer and entered into the study from 1996 at a single French clinical center, Centre Léon Bérard, based in Lyon, where they received standard treatment. The methodology was to compare and contrast multi-layer perceptron neural networks (NN) with logistic regression (LR), to identify key covariates and their interactions and to compare the selected variables with those routinely used in clinical severity of illness indices for breast cancer. The Logistic regression in this work was chosen as an accepted standard for prediction by biostatisticians in order to evaluate the neural network. Only covariates available at the time of diagnosis and immediately following surgery were used. We used for comparison classification performance indices: AUROC (AREA Under Receiver-Operating Characteristics) curves, sensitivity, specificity, accuracy and positive predictive value for the two following events of interest: Specific Mortality and Disease Free Survival.