Cross Validation Evaluation for Breast Cancer Prediction Using Multilayer Perceptron Neural Networks

Problem statement: The presence of metastasis in the regional lymph nodes is the most important factor in predicting prognosis in breast cancer. Many biomarkers have been identified that appear to relate to the aggressive behaviour of cancer. However, the nonlinear relation of these markers to nodal status and also the existence of complex interaction between markers have prohibited an accurate prognosis. Approach: The aim of this study is to investigate the effectiveness of a Multilayer Perceptron (MLP) for predicting breast cancer progression using a set of four biomarkers of breast tumors. The biomarkers include DNA ploidy, cell cycle distribution (G0G1/G2M), steroid receptors (ER/PR) and S-Phase Fraction (SPF). A further objective of the study is to explore the predictive potential of these markers in defining the state of nodal involvement in breast cancer. Two methods of outcome evaluation viz. stratified and simple k-fold Cross Validation (CV) are studied in order to assess their accuracy and reliability for neural network validation. Criteria such as output accuracy, sensitivity and specificity are used for selecting the best validation technique besides evaluating the network outcome for different combinations of markers. Results: The results show that stratified 2-fold CV is more accurate and reliable compared to simple k-fold CV as it obtains a higher accuracy and specificity and also provides a more stable network validation in terms of sensitivity. Best prediction results are obtained by using an individual marker-SPF which obtains an accuracy of 65%. Conclusion/Recommendations: Our findings suggest that MLP-based analysis provides an accurate and reliable platform for breast cancer prediction given that an appropriate design and validation method is employed.