Meixin Zhen,1,* Haibing Chen,1,* Qing Lu,1 Hui Li,2 Huang Yan,2 Ling Wang2 

1Xiangya College of Nursing, Central South University, Changsha, Hunan, 410013, People’s Republic of China; 2Nursing Department, The Third Xiangya Hospital, Central South University, Changsha, Hunan, 410013, People’s Republic of China

*These authors contributed equally to this work

Correspondence: Ling Wang, Nursing department, Department of Thyroid Breast Surgery, The third Xiangya hospital of Central South University, 138 Tong Zi Po Road, Changsha, Hunan, 410013, People’s Republic of China, Tel +86-15274940253, Email 1322788113@qq.com

Purpose: To construct a free and accurate breast cancer mortality prediction tool by incorporating lifestyle factors, aiming to assist healthcare professionals in making informed decisions.
Patients and Methods: In this retrospective study, we utilized a ten-year follow-up dataset of female breast cancer patients from a major Chinese hospital and included 1,390 female breast cancer patients with a 7% (96) mortality rate. We employed six machine learning algorithms (ridge regression, k-nearest neighbors, neural network, random forest, support vector machine, and extreme gradient boosting) to construct a mortality prediction model for breast cancer.
Results: This model incorporated significant lifestyle factors, such as postsurgery sexual activity, use of totally implantable venous access ports, and prosthetic breast wear, which were identified as independent protective factors. Meanwhile, ten-fold cross-validation demonstrated the superiority of the random forest model (average AUC = 0.918; 1-year AUC = 0.914, 2-year AUC = 0.867, 3-year AUC = 0.883). External validation further supported the model’s robustness (average AUC = 0.782; 1-year AUC = 0.809, 2-year AUC = 0.785, 3-year AUC = 0.893). Additionally, a free and user-friendly web tool was developed using the Shiny framework to facilitate easy access to the model.
Conclusion: Our breast cancer mortality prediction model is free and accurate, providing healthcare professionals with valuable information to support their clinical decisions and potentially promoting healthier lifestyles for breast cancer patients.

Keywords: breast cancer, machine learning, predict model, mortality, lifestyle, SHAP