Predictive model for 5.year mortality after breast cancer surgery in Taiwan residents

Background:Few studies of breast cancer surgery outcomes have used longitudinal data for more than 2 years.This study aimed to validate the use of the artificial neural network(ANN)model to predict the 5?year mortality of breast cancer patients after surgery and compare predictive accuracy between the ANN model,multiple logistic regression(MLR)model,and Cox regression model.Methods:This study compared the MLR,Cox,and ANN models based on clinical data of 3632 breast cancer patients who underwent surgery between 1996 and 2010.An estimation dataset was used to train the model,and a validation dataset was used to evaluate model performance.The sensitivity analysis was also used to assess the relative signifi?cance of input variables in the prediction model.Results:The ANN model significantly outperformed the MLR and Cox models in predicting 5?year mortality,with higher overall performance indices.The results indicated that the 5?year postoperative mortality of breast cancer patients was significantly associated with age,Charlson comorbidity index(CCI),chemotherapy,radiotherapy,hormone therapy,and breast cancer surgery volumes of hospital and surgeon(all P<0.05).Breast cancer surgery volume of surgeon was the most influential(sensitive)variable affecting 5?year mortality,followed by breast cancer surgery volume of hospital,age,and CCI.Conclusions:Compared with the conventional MLR and Cox models,the ANN model was more accurate in predict?ing 5?year mortality of breast cancer patients who underwent surgery.The mortality predictors identified in this study can also be used to educate candidates for breast cancer surgery with respect to the course of recovery and health outcomes.

Traditional Chinese combined with western therapy in treatment of upper extremity edema after breast cancer surgery: A meta-analysis

Objective:To evaluate clinical efficacy by traditional Chinese combined with western therapy to treat upper extremity edema after breast cancer surgery.The clinical efficacy was described by the effective rate and the change of peripheral diameter of the affected limb.Methods:National Knowledge Internet(CNKI),Wan Fang Digital Journals(Wan Fang),VIP Chinese periodical service platform(VIP),Chinese biomedical literature service system(CBM),PubMed and EMBASE were searched on computer.And clinical randomized controlled trials(RCT)of the treatment of upper extremity edema after breast cancer surgery with integration of Chinese and western treatment were selected.The time was from January 2011 to May 2020.Upper extremity edema after breast cancer surgery was the first key word and the second was traditional Chinese combined with western therapy.Note Express was used to screen and extract literature.Bias risks of all the literature included in the study were evaluated and analyzed by RevMan5.3 software.Results:10 randomized controlled clinical tests,644 patients in conformity to the inclusion criteria,9 for the observation of curative effectiveness,5 of changes in limb circumference.322 cases were included in the observation group and the same number of cases in the control group,all of which were in Chinese.The results expressed that the curative effect in the observation group was 91.1%,and it was higher than the curative effect in the control group treated by single western treatment obviously,and it was only 68.9%[95%CI(1.22,1.44),Z=6.55,P<0.00001].The peripheral diameter shrinking degree of the affected limb in the observation group was also clearly higher than that in the control group which was healed by simple western treatment[95%CI(-0.98,-0.64),Z=9.40,P<0.00001].Conclusion:Traditional Chinese combined with western therapy treating upper extremity edema after the surgery of breast cancer had a notable clinical effect,which treated the disease and effectively lessened the peripheral diameter of the affected limb.The method was worthy of clinical application.However,owing to the low quality of the included documents,further discussion and learning were still needed.

Benefit Discovery Level and Influencing Factors of Postoperative Breast Cancer Patients

Objective:To investigate the level and influencing factors of benefit discovery in patients with breast cancer after operation.Methods:Convenient sampling method was used to evaluate the change of benefit discovery level of 60 patients with breast cancer after operation in a cancer ward of a hospital by using Chinese version of benefit discovery rating scale and general information questionnaire.Results:The level of benefit discovery of breast cancer patients at different stages was statistically different(P<0.05).Age and education level entered the multiple linear stepwise regression equation of influencing factors of benefit discovery level of breast cancer patients(P<0.05).Conclusion:Targeted nursing measures should be taken to improve the quality of life of patients with breast cancer.