Artigo Acesso aberto Produção Nacional Revisado por pares

Unlocking the complete blood count as a risk stratification tool for breast cancer using machine learning: a large scale retrospective study

2024; Nature Portfolio; Volume: 14; Issue: 1 Linguagem: Inglês

10.1038/s41598-024-61215-y

ISSN

2045-2322

Autores

Daniella Castro Araújo, Bruno Aragão Rocha, Karina Braga Gomes, Daniel Noce da Silva, Vinicius Moura Ribeiro, Marco Aurelio Kohara, Fernanda Tostes Marana, Renata Andrade Bitar, Adriano Veloso, Maria Carolina Tostes Pintão, Flávia Helena da Silva, Celso Ferraz Viana, Pedro Henrique Araújo de Souza, Ismael Dale Cotrim Guerreiro da Silva,

Tópico(s)

AI in cancer detection

Resumo

Abstract Optimizing early breast cancer (BC) detection requires effective risk assessment tools. This retrospective study from Brazil showcases the efficacy of machine learning in discerning complex patterns within routine blood tests, presenting a globally accessible and cost-effective approach for risk evaluation. We analyzed complete blood count (CBC) tests from 396,848 women aged 40–70, who underwent breast imaging or biopsies within six months after their CBC test. Of these, 2861 (0.72%) were identified as cases: 1882 with BC confirmed by anatomopathological tests, and 979 with highly suspicious imaging (BI-RADS 5). The remaining 393,987 participants (99.28%), with BI-RADS 1 or 2 results, were classified as controls. The database was divided into modeling (including training and validation) and testing sets based on diagnostic certainty. The testing set comprised cases confirmed by anatomopathology and controls cancer-free for 4.5–6.5 years post-CBC. Our ridge regression model, incorporating neutrophil–lymphocyte ratio, red blood cells, and age, achieved an AUC of 0.64 (95% CI 0.64–0.65). We also demonstrate that these results are slightly better than those from a boosting machine learning model, LightGBM, plus having the benefit of being fully interpretable. Using the probabilistic output from this model, we divided the study population into four risk groups: high, moderate, average, and low risk, which obtained relative ratios of BC of 1.99, 1.32, 1.02, and 0.42, respectively. The aim of this stratification was to streamline prioritization, potentially improving the early detection of breast cancer, particularly in resource-limited environments. As a risk stratification tool, this model offers the potential for personalized breast cancer screening by prioritizing women based on their individual risk, thereby indicating a shift from a broad population strategy.

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