Comparing the prediction accuracy of artificial neural networks and other statistical models for breast cancer survival

The TNM staging system has been used since the early 1960's to predict breast cancer patient outcome. In an attempt to increase prognostic accuracy, many putative prognostic factors have been identified. Because the TNM stage model can not accommodate these new factors, the proliferation of factors in breast cancer has lead to clinical confusion. What is required is a new computerized prognostic system that can test putative prognostic factors and integrate the predictive factors with the TNM variables in order to increase prognostic accuracy. Using the area under the curve of the receiver operating characteristic, we compare the accuracy of the following predictive models in terms of five year breast cancer-specific survival: pTNM staging system, principal component analysis, classification and regression trees, logistic regression, cascade correlation neural network, conjugate gradient descent neural, probabilistic neural network, and backpropagation neural network. Several statistical models are significantly more accurate than the TNM staging system. Logistic regression and the backpropagation neural network are the most accurate prediction models for predicting five year breast cancer-specific survival.