Article first published online: 17 AUG 2012
Copyright © 2012 John Wiley & Sons, Ltd.
Statistics in Medicine
Volume 32, Issue 9, pages 1536–1546, 30 April 2013
How to Cite
Cobre, J., Castro Perdoná, G. S., Peria, F. M. and Louzada, F. (2013), A mechanistic breast cancer survival modelling through the axillary lymph node chain. Statist. Med., 32: 1536–1546. doi: 10.1002/sim.5576
- Issue published online: 10 APR 2013
- Article first published online: 17 AUG 2012
- Manuscript Accepted: 28 JUL 2012
- Manuscript Received: 25 MAY 2011
- axillary lymph node chain;
- breast cancer;
- cure rate;
- competing causes;
- survival modelling
In this paper, we proposed a mechanistic breast cancer survival model based on the axillary lymph node chain structure, considering lymph nodes as a potential dissemination arrangement. We assume a naive breast cancer treatment protocol consisting of exposing patients first to a chemotherapy treatment on r intervals at k-cycles separated by equal time intervals, and then they proceed to surgery. Our model, different from former ones, accommodates a quantity of contaminated lymph nodes, which is observed during surgery. We assume a generalised negative binomial survival distribution for the unknown number of contaminated lymph nodes after surgery, which, during an unknown period, may potentially propagate the disease. Estimation is based on a maximum likelihood approach. A simulation study assesses the coverage probability of asymptotic confidence intervals when small or moderate samples are considered. A Brazilian breast cancer data illustrate the applicability of our modelling. Copyright © 2012 John Wiley & Sons, Ltd.