BackgroundAcross 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.MethodsFor 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.ResultsThe 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.ConclusionsThis 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.