# Mortality Prediction in Patients With Breast Cancer by Artificial Neural Network Model and Elastic Net Regression

## TL;DR

This study compares two models for predicting breast cancer mortality, finding that each has strengths in different metrics.

## Contribution

The novel contribution is the comparison of elastic net regression and artificial neural networks for breast cancer mortality prediction.

## Key findings

- The ANN model had higher sensitivity and AUC than elastic net regression for predicting mortality.
- Elastic net regression outperformed ANN in specificity, accuracy, precision, and F1-score.
- Morphology, tumor differentiation, and age were identified as major factors affecting mortality.

## Abstract

Background: Breast cancer (BC) is the most common cancer in women, and it is important to identify models that can accurately predict mortality in patients with this cancer. The aim of the present study was to use the elastic net regression and artificial neural network (ANN) models in diagnosing and predicting factors affecting BC mortality.

Study Design: A cross-sectional study.

Methods: The data of 2,836 people with BC during 2014-2018 were analyzed in this study. Information was registered in the cancer registration system of Kerman University of Medical Sciences. Death status was considered the dependent variable, while age, morphology, tumor differentiation, residence status, and residence place were regarded as independent variables. Sensitivity, specificity, accuracy, area under the receiver operating characteristic curve (AUC), precision, and F1-score were used to compare the models.

Results: Based on the test set, the elastic net regression determined factors affecting BC mortality (with sensitivity of 0.631, specificity of 0.814, AUC of 0.629, accuracy of 0.792, precision of 0.318, and F1-score of 0.42) and ANN did so (with sensitivity of 0.66, specificity of 0.748, AUC of 0.704, accuracy of 0.738, precision of 0.265, and F1-score of 0.37).

Conclusion: The sensitivity and AUC of the ANN model were higher than those of the elastic net regression, but the specificity, accuracy, precision, and F1-score of the elastic net were higher than those of the ANN. According to the purpose of the study, two models can be used simultaneously. Based on the results of models, morphology, tumor differentiation, and age had a greater effect on death.