Deep learning for survival prediction in triple-negative breast cancer: development and validation in real-world cohorts

Triple-negative breast cancer (TNBC) is an aggressive and heterogeneous disease, highlighting the need for better patient stratification to guide treatment. We developed a deep learning-based survival model and an individualized prognosis system using data from 37,818 TNBC patients in the SEER database (split into training 65%, validation 17.5%, and test 17.5% sets). The survival model, built using the pysurvival algorithm, achieved strong performance (C-index: 0.824 in validation set, 0.816 in test set), outperforming traditional methods (CPH: 0.781 and 0.785; RSH: 0.779 and 0.766). External validation on a real-world cohort confirmed its robustness (C-index: 0.758). Our individualized prognosis system also showed higher predictive accuracy than traditional AJCC-TNM staging (AUC 0.821 vs. 0.771). These tools improve TNBC prognosis assessment, enable better patient stratification, and provide clinicians with significant treatment recommendations.