Transforming Breast Cancer Prediction: Advanced Machine Learning Models for Accurate Prediction and Personalized Care

Background: Breast cancer is the most common malignancy among women worldwide, underscoring the importance of early detection and accurate prognostication. Machine learning (ML) has emerged as a promising approach, offering powerful tools for analyzing complex datasets in breast cancer prediction and diagnosis. Objective: This study evaluates the predictive performance of diverse ML algorithms for breast cancer classification using publicly available datasets, focusing on accuracy, interpretability, and generalizability. Methods: The dataset included clinical and demographic variables such as age, menopausal status, tumor size, and lymph node involvement. Data preprocessing addressed missing values and class imbalance, with the Synthetic Minority Oversampling Technique (SMOTE) applied to improve sensitivity for the minority class. Feature engineering involved interaction terms and scaling of numerical variables. Multiple ML models—Logistic Regression, Decision Tree, Random Forest, Gradient Boosting, Support Vector Machine (SVM), Naive Bayes, K-Nearest Neighbors (KNN), and Neural Networks—were trained and evaluated. Performance was measured using sensitivity, F1-score, and AUC-ROC. Model interpretability was enhanced with SHapley Additive exPlanations (SHAP). Results: Random Forest achieved the best performance with an AUC-ROC of 0.9751, followed by Gradient Boosting (0.9242) and Neural Networks (0.9254). Logistic Regression and SVM yielded comparable results (0.9005 and 0.9344). Ensemble models showed higher accuracy and generalizability, particularly on external validation. Tumor size and lymph node involvement emerged as key predictors. SMOTE improved sensitivity across models. Conclusion: This study demonstrates the potential of ML in breast cancer prediction, emphasizing the effectiveness of ensemble methods and interpretability tools. Future work should focus on integrating ML into clinical practice for earlier detection and personalized treatment.