Leveraging survival analysis and machine learning for accurate prediction of breast cancer recurrence and metastasis

Breast cancer, with its high incidence and mortality globally, necessitates early prediction of local and distant recurrence to improve treatment outcomes. This study develops and validates predictive models for breast cancer recurrence and metastasis using Recurrence-Free Survival Analysis and machine learning techniques. We merged datasets from the Molecular Taxonomy of Breast Cancer International Consortium, Memorial Sloan Kettering Cancer Center, Duke University, and the SEER program, creating a comprehensive dataset of 272, 252 rows and 23 columns. Our methodology utilized three predictive strategies: assessing recurrence risk, differentiating local from distant recurrences, and identifying potential metastatic sites. Key prognostic factors were identified through survival analysis. LightGBM, XGBoost, and Random Forest models were employed and validated against data from the Baheya Foundation. The models demonstrated strong performance; the survival analysis achieved a C-index of 0.837. The LightGBM model reached an AUC of 92% in predicting recurrences, while XGBoost and Random Forest models distinguished recurrence types with up to 86% accuracy, and they effectively differentiated between bone metastasis and all other locations combined (brain, liver, and lungs). This study highlights the significant potential of machine learning in advancing breast cancer management and sets a new benchmark for predictive analytics. Future research will integrate genetic data to further enhance these models.