Fuzzy method for pre-diagnosis of breast cancer from the Fine Needle Aspirate analysis

Background: Across the globe, breast cancer is one of the leading causes of death among women and, currently, Fine Needle Aspirate (FNA) with visual interpretation is the easiest and fastest biopsy technique for the diagnosis of this deadly disease. Unfortunately, the ability of this method to diagnose cancer correctly when the disease is present varies greatly, from 65% to 98%. This article introduces a method to assist in the diagnosis and second opinion of breast cancer from the analysis of descriptors extracted from smears of breast mass obtained by FNA, with the use of computational intelligence resources - in this case, fuzzy logic. Methods: For data acquisition of FNA, the Wisconsin Diagnostic Breast Cancer Data (WDBC), from the University of California at Irvine (UCI) Machine Learning Repository, available on the internet through the UCI domain was used. The knowledge acquisition process was carried out by the extraction and analysis of numerical data of the WDBC and by interviews and discussions with medical experts. The PDM-FNA-Fuzzy was developed in four steps: 1) Fuzzification Stage; 2) Rules Base; 3) Inference Stage; and 4) Defuzzification Stage. Performance cross-validation was used in the tests, with three databases with gold pattern clinical cases randomly extracted from the WDBC. The final validation was held by medical specialists in pathology, mastology and general practice, and with gold pattern clinical cases, i.e. with known and clinically confirmed diagnosis. Results: The Fuzzy Method developed provides breast cancer pre-diagnosis with 98.59% sensitivity (correct pre-diagnosis of malignancies); and 85.43% specificity (correct pre-diagnosis of benign cases). Due to the high sensitivity presented, these results are considered satisfactory, both by the opinion of medical specialists in the aforementioned areas and by comparison with other studies involving breast cancer diagnosis using FNA. Conclusions: This paper presents an intelligent method to assist in the diagnosis and second opinion of breast cancer, using a fuzzy method capable of processing and sorting data extracted from smears of breast mass obtained by FNA, with satisfactory levels of sensitivity and specificity. The main contribution of the proposed method is the reduction of the variation hit of malignant cases when compared to visual interpretation currently applied in the diagnosis by FNA. While the MPD-FNA-Fuzzy features stable sensitivity at 98.59%, visual interpretation diagnosis provides a sensitivity variation from 65% to 98% (this track showing sensitivity levels below those considered satisfactory by medical specialists). Note that this method will be used in an Intelligent Virtual Environment to assist the decision-making (IVEMI), which amplifies its contribution.