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Machine Learning Method Can Help Women Avoid Unnecessary Breast Surgery

By MedImaging International staff writers
Posted on 19 Mar 2019

A team of researchers from the Geisel School of Medicine at Dartmouth (Hanover, NH, USA) has developed a machine learning method to predict atypical ductal hyperplasia (ADH) upgrade to cancer.

ADH, a breast lesion associated with a four- to five-fold increase in the risk of breast cancer, is mainly found using mammography and identified on core needle biopsy. Despite multiple passes of the lesion during biopsy, only portions of the lesions are sampled. Other variable factors influence sampling and accuracy such that the presence of cancer may be underestimated by 10-45%. Currently, surgical removal is recommended for all ADH cases found on core needle biopsies to determine if the lesion is cancerous. About 20-30% of ADH cases are upgraded to cancer after surgical excision. However, this means that 70-80% of women undergo a costly and invasive surgical procedure for a benign (but high-risk) lesion.

The new machine learning method to predict ADH upgrade to cancer can potentially help clinicians and low-risk patients decide whether active surveillance and hormonal therapy is a reasonable alternative to surgical excision. An evaluation of the model by the researchers showed that the machine learning approach can identify 98% of all malignant cases prior to surgery while sparing from surgery 16% of women who otherwise would have undergone an unnecessary operation for a benign lesion. The researchers now plan to expand the scope of their model by including other high-risk breast lesions such as lobular neoplasia, papillomas, and radial scars. They also plan on further validating their approach on large external datasets using state and national breast cancer registries, and collaborating with other medical centers.

"Our results suggest there are robust clinical differences between women at low versus high risk for ADH upgrade to cancer based on core needle biopsy data that allowed our machine learning model to reliably predict malignancy upgrades in our dataset," said Saeed Hassanpour, PhD, who led the Dartmouth research team. "This study also identified important clinical variables involved in ADH upgrade risk."

"Our model can potentially help patients and clinicians choose an alternative management approach in low-risk cases," added Hassanpour. "In the era of personalized medicine, such models can be desirable for patients who value a shared decision-making approach with the ability to choose between surgical excision for certainty versus surveillance to avoid cost, stress, and potential side effects in women at low risk for upgrade of ADH to cancer."

Related Links:
Geisel School of Medicine at Dartmouth

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71 (132.08389282227): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (41.961669921875): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (46.968460083008): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (800.84800720215): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (66.041946411133): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (44.822692871094): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (34.809112548828): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.954879760742): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (56.028366088867): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (28.133392333984): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (30.994415283203): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (25.033950805664): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (25.98762512207): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (122.0703125): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (729.08401489258): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

105 (!!!!! 3068.9239501953): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

106 (55.074691772461): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (131.84547424316): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (305.8910369873): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

109 (560.04524230957): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

110 (747.2038269043): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (621.08039855957): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (529.05082702637): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (330.92498779297): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

115 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

116 (43.869018554688): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

117 (38.14697265625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

118 (41.961669921875): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

119 (36.001205444336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

120 (186.92016601562): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 37605.047225952): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (101.08947753906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

123 (48.160552978516): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

124 (463.96255493164): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777297 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777297 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 584250.2117157): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (!!!!! 557497.02453613): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (105.14259338379): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (46.968460083008): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (60.081481933594): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (41.961669921875): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (32.901763916016): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (37.908554077148): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (622.98774719238): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (463.96255493164): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (48.160552978516): SELECT name FROM jos_deeppockets WHERE id=217

136 (36.954879760742): SELECT name FROM jos_deeppockets WHERE id=217

137 (582.93342590332): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (503.0632019043): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))217((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (76.055526733398): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

140 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

141 (!!!!! 9361.0286712646): TRUNCATE TABLE jos_trademed_module

142 (109.91096496582): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (69.141387939453): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294777297 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (!!!!! 1043.7965393066): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

147 (61.03515625): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

148 (!!!!! 1523.0178833008): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (97.036361694336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

150 (72.956085205078): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

151 (46.014785766602): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294777297 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294777297 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (41.961669921875): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

153 (39.100646972656): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=217 or channel_id is null)

154 (40.054321289062): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (89.883804321289): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

156 (66.995620727539): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294777297 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294777297 AND published='1' LIMIT 1

157 (41.961669921875): select jos_twitters.link from jos_twitters where cat=10

158 (35.04753112793): select jos_facebook.link from jos_facebook where cat=10

159 (33.855438232422): select jos_google_plus.link from jos_google_plus where cat=10

160 (34.093856811523): select jos_linkedin.link from jos_linkedin where cat=10

161 (328.77922058105): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 1338.9587402344): insert into jos_banners_delta values (14615,'2025-05-01 21:50:13','3.133.157.86','view'),(14202,'2025-05-01 21:50:13','3.133.157.86','view'),(14203,'2025-05-01 21:50:13','3.133.157.86','view')

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