MammoMix: Leveraging Mixture of Experts for Robust Mammogram Breast Detection
Authors: Dinh Tan Nguyen, Hoang Quan Dang, Chen Zhang, Sai Ho Ling
Organizations: School of Biomedical Engineering, University of Technology Sydney · School of Computer Science, University of Technology Sydney · School of Electrical and Data Engineering, University of Technology Sydney
Abstract
Breast lesion detection in mammography remains a challenging task due to variations in image quality, lesion appearance, and population demographics across datasets. While current object detectors such as YOLO and DETR achieve strong results on individual datasets, their performance often degrades when trained on or applied across heterogeneous sources. To address this, we propose MammoMix, a novel framework based on Mixture-of-Experts (MoE) paradigm for robust and generalizable lesion detection. In MammoMix, each expert model is trained on a specific domain, allowing it to specialize in distinct characteristics of its source data. A gating mechanism adaptively weighs contributions from each expert based on input image, combining their outputs to enable domain-adaptive inference. To improve reliability, we further incorporate a calibration module, MoCAE, which adjusts confidence scores to reflect true predictive uncertainty. We evaluate MammoMix on 3 public mammography datasets: CSAW, DDSM, and DMID, covering diverse clinical settings. Results show that MammoMix outperforms baseline detectors in both average precision and reliability, particularly on datasets with greater variability. Our findings demonstrate that expert specialization and calibrated ensemble fusion significantly enhance model generalization and robustness. MammoMix offers a promising step toward dependable AI-assisted breast cancer screening across real-world clinical domains.
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.
Breast density classification is a critical component of breast cancer risk assessment, yet AI models often struggle to generalize across clinical sites due to vendor-specific acquisition styles. In this work, we introduce two new datasets, BreastMammo and DenseMammo, to facilitate robust multi-view mammography research. We propose a domain generalization framework that utilizes a foreground-only histogram matching protocol to resolve the domain shift issue arising from disparate clinical sources. Internal evaluation using a 5-fold cross-validation protocol demonstrates the efficacy of our approach, with the Swin Transformer backbone achieving a peak AUC of 98.32% for density classification. External evaluation on the TNMammo and LUMINA datasets demonstrates that the proposed approach consistently reduces domain shift, significantly outperforming prominent domain generalization paradigms, including MixStyle and Discrete-Fourier-Transform-based frameworks.
Hongyi Pan, Gorkem Durak, Halil Ertugrul Aktas +18
Breast cancer remains one of the leading causes of cancer-related mortality among women worldwide, making early detection essential for effective treatment. Mammography is the primary screening modality; however, accurate delineation of suspicious lesions remains challenging and subject to inter-observer variability. Automated segmentation methods can assist radiologists by providing consistent and efficient lesion localization. This study presents DSU-Net, an attention-enhanced Dense Skip U-Net architecture for automated breast lesion segmentation in mammographic images. The proposed framework integrates dense skip connections and attention mechanisms to improve feature propagation, preserve spatial information, and enhance lesion boundary delineation. Experiments were conducted using the Curated Breast Imaging Subset of the Digital Database for Screening Mammography (CBIS-DDSM). To address severe foreground-background imbalance, a composite loss function combining Dice loss, focal loss, and binary cross-entropy loss was employed during training. The proposed model achieved a Dice Similarity Coefficient of 0.9421, an Intersection over Union of 0.8905, an accuracy of 0.9711, and an AUC-ROC of 0.9878 on the validation dataset. Qualitative evaluation demonstrated accurate delineation of lesions with varying sizes and morphologies, while quantitative results confirmed robust discrimination between lesion and background regions. These findings demonstrate that DSU-Net provides accurate and reliable breast lesion segmentation in mammographic images and highlights the potential of attention-guided deep learning for computer-aided breast cancer screening and diagnosis.