Explainable machine learning versus known nomogram for predicting non-sentinel lymph node metastases in breast cancer patients: A comparative study.

Journal: Computers in biology and medicine
PMID:

Abstract

INTRODUCTION: Axillary lymph node dissection (ALND) is the standard of care for breast cancer patients with positive sentinel lymph nodes (SLN), which are the first lymph nodes that drain the breast. However, many patients with positive SLNs may not have additional positive nodes, making the prediction of non-sentinel lymph node (NSLN) metastasis challenging. Reliable prognostic tools are essential for accurately assessing NSLN metastasis. The Memorial Sloan Kettering Cancer Center (MSKCC) nomogram has demonstrated effectiveness in this context, but it requires further evaluation within the Iranian breast cancer population. While ALND remains the gold standard, its unnecessary application in patients without evidence of additional positive nodes raises concerns due to potential complications such as lymphedema, nerve injury, and shoulder joint dysfunction. Furthermore, integrating Artificial Intelligence (AI) and Machine Learning (ML) techniques presents an opportunity to enhance the precision of NSLN metastasis predictions.

Authors

  • Asieh Sadat Fattahi
    Department of Surgery, Faculty of Medicine, Endoscopic and Minimally Invasive Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: fattahima@mums.ac.ir.
  • Maryam Hoseini
    General Surgeon, Department of Surgery, Endoscopic and Minimally Invasive Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: emis@mums.ac.ir.
  • Toktam Dehghani
    Department of Computer Engineering, Ferdowsi University of Mashhad, Mashhad, Iran.
  • Raheleh Ghouchan Nezhad Noor Nia
    Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: ghouchannezhadr4012@mums.ac.ir.
  • Zeinab Naseri
    Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.
  • Amirali Ebrahimzadeh
    Computer Engineering, Sharif University of Technology, Tehran, Iran. Electronic address: ebrahimzadeh.amirali@gmail.com.
  • Ali Mehri
    Endoscopic and Minimally Invasive Research Center, Mashhad University of Medical Sciences, Mashhad, Iran. Electronic address: mehri.ali1996@gmail.com.
  • Saeid Eslami
    Department of Medical Informatics, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran.