# Adopting machine learning to predict breast cancer patients adherence with lifestyle recommendations and quality of life outcomes

**Authors:** Anna Crispo, Maria Elisabetta Pagnano, Agnese Bonfigli, Leandro Pecchia, Assunta Luongo, Giuseppe Porciello, Sergio Coluccia, Melania Prete, Luca Bacco, Sara Vitale, Elvira Palumbo, Paolo Giaccone, Rosa Pica, Maria Grimaldi, Marco Cascella, Ernesta Cavalcanti, Anita Minopoli, Michelino De Laurentiis, Massimo Libra, Jerry Polesel, Samuele Massarut, Egidio Celentano, Livia S. A. Augustin

PMC · DOI: 10.3389/fdgth.2025.1645233 · 2025-11-06

## TL;DR

This study uses machine learning to predict lifestyle adherence and quality of life in breast cancer survivors, aiming to improve personalized care and long-term outcomes.

## Contribution

The novel use of machine learning models to predict adherence and quality of life outcomes in breast cancer survivors.

## Key findings

- Random forest classifiers achieved up to 81% accuracy in predicting adherence to lifestyle interventions.
- XGBoost outperformed linear regression in predicting quality of life with an R-squared of 0.62.

## Abstract

Healthy lifestyle behaviors and improved quality of life have been associated with better prognoses in breast cancer survivors. However, sustaining behavioral changes remains challenging; therefore, identifying effective components of lifestyle education programs is essential to enhance adherence, improve quality of life, and facilitate their integration into clinical practice. This study aimed to predict patient adherence to a lifestyle intervention of diet, physical activity, and vitamin D supplementation and to forecast the most frequent Health-Related Quality of Life over the subsequent three measurements.

A total of 316 breast cancer survivors were included in the analysis. Adherence was modeled as a multi-label time series classification task, with compliance recorded on a three-point scale for each treatment component at quarterly intervals over one year. Health-Related Quality of Life was predicted by evaluating first-year adherence data to estimate the mean score over the subsequent three measurements.

The dataset was split into 70% for training and 30% for evaluation. Random forest classifiers were employed for adherence prediction, achieving accuracy of up to 81%. An XGBoost regressor was used for Health-Related quality of life prediction, and it was compared to a baseline linear regression model. XGBoost demonstrated superior predictive performance, achieving an R-squared value of 0.62.

Our findings highlight the promise of machine learning techniques in supporting personalized medicine. Advanced predictive models may aid in identifying patients at risk of non-adherence, enabling early interventions, and improving long-term outcomes through tailored lifestyle strategies for breast cancer survivors.

## Linked entities

- **Diseases:** breast cancer (MONDO:0004989)

## Full-text entities

- **Diseases:** breast cancer (MESH:D001943)
- **Chemicals:** vitamin D (MESH:D014807)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Figures

3 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12631627/full.md

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Source: https://tomesphere.com/paper/PMC12631627