Multivariate modeling and prediction of breast cancer prognostic factors using MR metabolomics.

Axillary lymph node status together with estrogen and progesterone receptor status are important prognostic factors in breast cancer. In this study, the potential of using MR metabolomics for prediction of these prognostic factors was evaluated. Biopsies from breast cancer patients (n = 160) were excised during surgery and analyzed by high resolution magic angle spinning MR spectroscopy (HR MAS MRS). The spectral data were preprocessed and variable stability (VAST) scaled, and training and test sets were generated using the Kennard-Stone and SPXY sample selection algorithms. The data were analyzed by partial least-squares discriminant analysis (PLS-DA), probabilistic neural networks (PNNs) and Bayesian belief networks (BBNs), and blind samples (n = 50) were predicted for verification. Estrogen and progesterone receptor status was successfully predicted from the MR spectra, and were best predicted by PLS-DA with a correct classification of 44 of 50 and 39 of 50 samples, respectively. Lymph node status was best predicted by BBN with 34 of 50 samples correctly classified, indicating a relationship between metabolic profile and lymph node status. Thus, MR profiles contain prognostic information that may be of benefit in treatment planning, and MR metabolomics may become an important tool for diagnosis of breast cancer patients.