A Lightweight CNN Integrated Compact Convolutional Transformer for Multi-Scale Feature Learning and reducing computational complexity for breast cancer mammography image detection and classification

Vision Transformers $(\texttt{ViT})$ have become the architecture of choice for many computer vision tasks, yet their performance in computer-aided diagnostics remains limited. Focusing on breast cancer detection from mammograms, we identify two main causes for this shortfall. First, medical images are high-resolution with small abnormalities, leading to an excessive number of tokens and making it difficult for the softmax-based attention to localize and attend to relevant regions. Second, medical image classification is inherently fine-grained, with low inter-class and high intra-class variability, where standard cross-entropy training is insufficient. To overcome these challenges, we propose a framework with three key components: (1) Region of interest $(\texttt{RoI})$ based token reduction using an object detection model to guide attention; (2) contrastive learning between selected $\texttt{RoI}$ to enhance fine-grained discrimination through hard-negative based training; and (3) a $\texttt{DINOv2}$ pretrained $\texttt{ViT}$ that captures localization-aware, fine-grained features instead of global $\texttt{CLIP}$ representations. Experiments on public mammography datasets demonstrate that our method achieves superior performance over existing baselines, establishing its effectiveness and potential clinical utility for large-scale breast cancer screening. Our code is available for reproducibility here: https://aih-iitd.github.io/publications/attend-what-matters

This study introduces a computationally efficient convolutional neural network (CNN) architecture enhanced with transfer learning for multi-cancer detection using biomedical images. The proposed lightweight CNN model is designed to reduce computational complexity while maintaining high classification performance, making it suitable for deployment in resource-constrained environments. We evaluate this approach on three distinct tumor datasets comprising brain magnetic resonance imaging (MRI) and lung and kidney computed tomography (CT) scans. The model achieves test accuracy of 90.85 +- 2.22%, 98.64 +- 2.43% and 99.92 +- 0.08% for brain, lung, and kidney cancer classification, respectively, using 5-fold stratified cross-validation (CV). Transfer learning is employed by pretraining the model on one cancer type and fine-tuning it on the others, requiring only 20 additional epochs to achieve performance comparable to models trained from scratch. The fine-tuning process involves updating the classification part of the CNN and requires approximately 0.014 seconds per image per epoch using an NVIDIA GeForce GTX 960. Comparative evaluations show that the proposed model outperforms several state-of-the-art pretrained architectures, such as Xception, VGG16, VGG19, MobileNetV2 and DenseNet121. Overall, the model's effectiveness is evaluated across three types of cancer with distinct morphological characteristics, assessing its performance on both MRI and CT imaging modalities and demonstrating robust performance across diverse tasks and data types. These findings underscore the potential of streamlined deep learning (DL) frameworks in accelerating cancer diagnosis without sacrificing accuracy, especially in settings with limited computational resources.

We present Aegis, a joint-embedding predictive architecture for breast cancer detection and density assessment in mammography. We train three Vision Transformer variants (Small/Base/Large) using self-supervised joint-embedding predictive architecture (JEPA) pre-training on 71,103 studies from 14 clinical sites, followed by supervised fine-tuning with progressive resolution scaling up to 2048x1536. On a curated 785-study test set, our largest model achieves area under the receiver operating characteristic curve (AUC) 0.949 for breast cancer triage with 93% sensitivity and 75% specificity at the optimal operating point. An ensemble combining our model with a U.S. Food and Drug Administration-cleared baseline further improves discrimination to 0.952 AUC. For breast density classification, the model achieves 0.953 AUC for binary (dense vs. non-dense) classification and 62.6% exact accuracy across four Breast Imaging Reporting and Data System (BI-RADS) categories, with 98.8% adjacent accuracy comparable to reported human inter-reader agreement. External validation on the public VinDr-Mammo dataset provides evidence of cross-population transfer under a different reference standard, with the largest model achieving 0.871 AUC for triage in a zero-shot setting.