Performance of Machine Learning Classification in Sonomammogram Images using BI-RADS

Deep learning methods have demonstrated promising results in predicting BI-RADS scores from mammography images. However, the interpretation of these images can vary, leading to discrepancies even among radiologists. Given the inherent complexity of mammograms, training classification models solely on image labels often yields limited performance. To address this challenge, we curated 2313 mammogram images and their corresponding captions from two mammography atlases. Our proposed approach employs a multi-modal model that uses a pretrained PubMedBERT as the language component. By training this model on image-text pairs with contrastive learning, we enable the vision encoder to absorb the rich information contained in the captions, thereby improving its understanding of mammography findings. We then fine-tune the vision encoder on two datasets for BI-RADS prediction, achieving superior performance compared with models trained without this pretraining, particularly when labeled samples are scarce. The improvement in the 3-class average F1 score ranges from +1% to +14%: a +1% increase with 40K training samples, and a +14% increase with 1K samples. Furthermore, our experiments reveal that 2K image-text pairs from mammography atlases can be more informative than 2K labeled samples for label prediction, with an average margin of +1.1% when more than 10K training samples are available. Overall, our work provides a vision-language model for mammography and highlights the value of textual information from mammography atlases. In addition, we publicly release preprocessed mammography images of the TEKNOFEST dataset. The training code, pre-trained model weights, data extraction scripts, and the released dataset are publicly available at: https://github.com/igulluk/MAM-CLIP

Breast ultrasound imaging is an important noninvasive method for early breast cancer diagnosis, but automatic benign/malignant classification remains challenging due to tumor heterogeneity, blurred boundaries, and data imbalance. To improve feature representation and classification accuracy, this paper proposes the Cross-Stage Attention Mixture-of-Experts Network (CSA-MoE-Net). It adopts a Cross-Stage Attention-enhanced ResNet-18 as the backbone, in which the Cross-Stage Attention module adaptively recalibrates multi-level features, thereby enhancing key tumor features and suppressing redundancy. A three-branch Mixture of Experts (MoE) Block learns complementary features from the Whole Tumor Image, Tumor Core, and Boundary, and an Adaptive Gating Network fuses them to capture morphological, textural, and contextual information. The fused features are denoted as Fused Expert Feature (FEF) in the architecture. Experiments on a balanced dataset of 2,129 breast ultrasound images show that, averaged over 20 independent runs, the model achieves an accuracy of 96.33%, precision of 94.09%, recall of 98.53%, F1-score of 96.25%, and AUC of 99.50%. Compared to the baseline ResNet-18, these metrics improve by 3.01, 0.70, 5.37, 2.98, and 5.42 percentage points, respectively. The proposed mechanism requires no invasive modification and can be seamlessly embedded into VGG-16, DenseNet-121, etc., yielding stable performance gains, thus providing reliable support for computer-aided diagnosis.

Mammography is an essential tool for breast cancer detection, with millions of examinations conducted annually. However, publicly available high-quality mammography datasets for AI development remain limited in both scale and annotation richness, particularly regarding pathological subtype coverage and structured diagnostic reasoning annotations. In this paper, we present MammoExpert, the first mammography dataset with Chain-of-Thought reasoning annotations across three diagnostic phases: (i) primal observation, (ii) factual assessment, and (iii) diagnostic synthesis. Comprising 2,379 mammography images covering 67 WHO-classified histopathology subtypes, each exam provides 42 radiographic features annotated by nine senior radiologists. We evaluate its performance on the breast lesion classification task, demonstrating superior accuracy and reasonability compared to existing classification models. Combining public dataset CBIS-DDSM with MammoExpert yields 7.1% classification accuracy improvement, while the training model to learn CoT reasoning achieves another 4% gain on the MammoExpert test set. Similar improvements are observed on INBreast and Vindr datasets, where the full approach yields accuracy gains of 6.9% and 6.7%, respectively. MammoExpert can serve as a benchmark for interpretable breast lesion diagnosis through explicit CoT reasoning.