Breast Cancer

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Overview

The field studies how to detect breast cancer, estimate future risk, classify tumors, and predict treatment response or recurrence. Common approaches include deep learning on mammograms, MRI, and pathology slides; longitudinal alignment of screening images; and models that combine imaging with clinical records or molecular data. Methods are tested on settings such as EMBED and CSAW-CC mammograms, TCGA-BRCA pathology data, and multi-cohort MRI studies, with external validation used to assess transfer across hospitals and populations. Strong results remain difficult to translate reliably: performance can shift across datasets and subgroups, and safety, calibration, interpretability, and prospective clinical benefit remain important tests.

Latest papers

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47 papers5 papers in the last four weeks, down 29% on the four weeks before. 0.0% of all new papers.

Jun 12, 2026

A Lightweight Fiducial-Based Pipeline for 3D Hyperspectral Mapping of ex-vivo Lumpectomy Specimens

Hyperspectral Imaging (HSI) is a promising modality for intraoperative assessment of resection margins in Breast-Conserving Surgery (BCS), but its clinical translation requires aligning the inherently 2D spectral information onto the 3D shape of the excised tissue so that suspicious regions can be precisely localized for targeted follow-up. We present a fully automated, calibration-free pipeline that produces a 3D hyperspectral point cloud of an ex-vivo lumpectomy specimen from a set of consumer-camera RGB images and a single top-down HSI acquisition. The 3D geometry is reconstructed with a deep-learning Structure-from-Motion backbone, stabilized in a metric reference frame by a custom bundle adjustment that enforces consistency on the corners of four ArUco markers placed around the specimen. The HSI cube is then registered to the reconstruction without recovering the HSI camera pose: the markers, visible in both modalities, define 16 corner correspondences that drive a planar homography, and 3D coordinates are recovered by lookup on an orthographically rendered depth map. Evaluated on two ex-vivo lumpectomy specimens, the pipeline achieves a median 3D registration error below 1~mm and a 2D reprojection error below 0.02 mm, with a total per-specimen processing time under 4 minutes on accelerated hardware. These results support the feasibility of integrating HSI-guided spatial localization into intraoperative margin assessment workflows for breast-conserving surgery.

Anna Bicchi, Alberto Rota, Leonardo Passoni +5

Department of Electronics, Information and Bioengineering (DEIB), Politecnico di Milano, Milan, Italy · Department of Physics, Politecnico di Milano, Milan, Italy

Breast CancerMedical Image RegistrationHyperspectral Imaging
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Jun 10, 2026

Seeing Below the Limit of Detection: A Censored-Poisson Bayesian Latent-Growth Change-Point Detector (the Span Detector) for Serial ctDNA in HR+/HER2- Metastatic Breast Cancer

Circulating-tumour DNA (ctDNA) carries evidence of drug resistance months before imaging shows it, but the earliest evidence lives below the assay's limit of detection (LoD): a nascent subclone is detected only intermittently, producing a flickering sequence of faint detects and non-detects. Commercial liquid biopsies treat each draw as an independent snapshot and a non-detect as nothing. We argue a non-detect is a left-censored observation, and the pattern of non-detects and faint detects over time carries actionable evidence of growth before any single value is trustworthy. We introduce Span, a censored-Poisson Bayesian latent-growth change-point detector that models the binary detection process, accumulates a sequential generalised-likelihood-ratio statistic for an upward change-point in the per-variant detection rate, and raises a competing-risks alarm with calibrated false-alarm control. Span has no learned weights, so there is nothing to overfit. On a synthetic cohort of HR+/HER2- metastatic breast cancer on first-line CDK4/6-inhibitor plus endocrine therapy, at a matched 10% false-alarm rate, Span roughly doubles the fraction of impending progressions caught three months ahead (indolent regime: 25% vs 11% for the snapshot), with a falsifiable dose-response: large for indolent emergence, vanishing for fast emergence. A value-trajectory baseline performs identically to the snapshot, isolating the gain to the censored detection model. The survival backbone matches a Cox baseline on real breast-cancer data (GBSG-2, n=686; C-index 0.67 vs 0.68), and on a real longitudinal cohort with clean biomarkers (PBC2, n=312) the same pipeline correctly declines to win, a falsifiable boundary test confirming the mechanism is regime-specific. All ctDNA trajectories are synthetic.

Aarchi Singh Thakur, Abhijoy Sarkar

Span AI

Breast CancerOncologyChange-Point Detection
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Jun 3, 2026

BreastGPT: A Multimodal Large Language Model for the Full Spectrum of Breast Cancer Clinical Routine

Breast cancer remains a leading cause of cancer-related mortality among women. Its clinical management requires multimodal reasoning across a clinical workflow that spans screening, diagnosis and treatment planning, where each stage involves distinct imaging modalities, task objectives, and reasoning patterns. However, constrained by data scarcity and model versatility, existing medical MLLMs are typically evaluated on isolated modalities or narrow task families, limiting their ability to support workflow-level clinical reasoning. In this work, we first introduce BreastStage, a workflow-aligned breast imaging instruction corpus comprising 1.86M instruction-following pairs curated from 17 sub-datasets across 5 imaging modalities and 136 task templates. Its held-out split, BreastStage-Bench, provides a comprehensive benchmark for evaluating multimodal reasoning across the breast cancer care continuum. Building on this corpus, we propose BreastGPT, a unified MLLM equipped with a dual-branch visual encoder and concept-preserving token compression to bridge the scale gap between standard radiology and gigapixel pathology. On BreastStage-Bench, BreastGPT achieves 75.66% closed-ended accuracy and 89.92% open-ended score, outperforming both general-purpose and medical-specific MLLMs across clinical stages and task formats. These results suggest that workflow-aligned data and cross-scale visual modeling are critical for clinically grounded medical MLLMs. All data, code, and model checkpoints are released at https://yangyy-liu.github.io/BreastGPT.io.

Yang Liu, Jiajin Zhang, Danyang Tu +8

DAMO Academy, Alibaba Group · Zhejiang University · West China Hospital +1

Breast CancerMedical ImagingMultimodal ReasoningMedical VLMsMammographyOncology+1
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Jun 1, 2026

Multi-Modal Machine Learning for Breast Cancer Recurrence Prediction

Breast cancer recurrence, a leading cause of long-term mortality among survivors, requires timely and accurate risk assessment to guide follow-up care and treatment planning. Traditional predictive models, often limited to either structured or unstructured data alone, struggle to capture the full clinical context. This study examines the impact of integrating multi-modal clinical data, including treatment records, pathology reports, and clinician notes, on recurrence prediction. By integrating a rule-based regular expression extraction mechanism with a rigorous precedence-based conflict reconciliation strategy, our approach effectively recovers definitive tumor characteristics from free-text pathology narratives to augment structured records. We also benchmark performance against commonly used feature sets from prior breast cancer studies to assess the added value of multi-modal integration. Single-source and multi-modal inputs are evaluated across a range of machine learning models. Results show that multi-modal integration consistently improves predictive accuracy compared to single-modal methods.

Jiahao Shao, Xudong Wang, Anam Nawaz Khan +3

Department of Industrial & Systems Engineering, The University of Tennessee, Knoxville, TN 37996, USA · The University of Tennessee Medical Center, Knoxville, TN 37920, USA

Breast CancerClinical Outcome PredictionMultimodal Learning
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May 8, 2026

Can Language Models Identify Side Effects of Breast Cancer Radiation Treatments?

Accurately communicating the side effects of cancer treatments to cancer survivors is critical, particularly in settings such as informed consent, where clinicians must clearly and comprehensively convey potential treatment toxicities. However, this task remains challenging due to clinical knowledge deficits about adverse treatment effects and fragmentation across electronic health record (EHR) systems. Large language models (LLMs) have the potential to assist in this task, though their reliability in oncology survivorship contexts remains poorly understood. We present a deployment-oriented stress-testing framework for evaluating LLM-generated radiation side effect lists in breast cancer treatment and survivorship care. Using 21 breast cancer patient profiles, we construct paired patient clinical scenarios that differ only in radiotherapy regimens to evaluate seven instruction-tuned LLMs under multiple prompting regimes. We then compare LLM outputs to a clinician-curated reference derived from informed consent documents at two major academic medical centers and developed by a team including more than seven breast radiation oncologists. The reference maps radiation dose-fractionation, fields, and locations to associated toxicities, broken down by frequency and temporal onset. Across models, we reveal sensitivity to minor documentation changes, trade-offs between precision and recall, and systematic under-recall of rare and long-term side effects. When used alone, constraints on the number of side effects generated reduce precision, and grounding outputs in clinician-curated side effect lists substantially improves reliability and robustness. These findings highlight important limitations of LLM use in oncology and suggest practical design choices for safer and more informative survivorship-focused applications.

Natalie Seah, Danielle S. Bitterman, Daphna Spiegel +1

University of Virginia · Mass General Brigham, Dana-Farber Cancer Institute, Harvard Medical School

Breast CancerHealthcareOncologyClinical Language Model EvaluationLanguage Model RobustnessMedical LLMs
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May 8, 2026

Multimodal Stepwise Clinically-Guided Attention Learning for Pathological Complete Response Prediction in Breast Cancer

Pathological complete response (pCR) is a key prognostic factor in breast cancer patients undergoing neoadjuvant therapy, strongly associated with long-term survival and treatment personalization. However, accurate pre-treatment pCR prediction remains challenging due to severe class imbalance and limited generalizability across diverse clinical settings. In this work, we propose a multimodal stepwise clinically-guided attention learning framework for pCR prediction from breast magnetic resonance imaging (MRI), designed to address these limitations through medically grounded spatial guidance and multimodal integration. The approach follows a stepwise training strategy inspired by physician reasoning: the model first learns global discriminative imaging patterns, then attention mechanisms are introduced to constrain the network toward tumor regions, and finally clinical variables are integrated to refine decision-making. This guidance strategy encourages prioritization of task-relevant features, improving identification of responders despite their limited representation in the dataset. Moreover, grounding attention in anatomically consistent tumor regions reduces reliance on dataset-specific patterns, thereby enhancing cross-institutional generalization. The framework is evaluated through external validation across heterogeneous MRI cohorts. Compared to non-guided single-stage baselines, the proposed approach improves sensitivity while maintaining competitive specificity, and produces anatomically coherent attention maps that support interpretation of the model's predictions. These findings highlight the potential of clinically-guided multimodal attention learning for robust and generalizable pCR prediction in breast cancer.

Alice Natalina Caragliano, Valerio Guarrasi, Michela Gravina +2

Unit of Artificial Intelligence and Computer Systems, Department of Engineering, Università Campus Bio-Medico di Roma, Rome, Italy · Department of Electrical Engineering and Information Technology, University of Naples Federico II, Naples, Italy · Department of Diagnostics and Intervention, Radiation Physics, Biomedical Engineering, Umeå University, Umeå, Sweden

Breast CancerClinical Outcome PredictionMultimodal ClassificationOncologyExplainable Medical Image Analysis
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May 7, 2026

Feature Dimensionality Outweighs Model Complexity in Breast Cancer Subtype Classification Using TCGA-BRCA Gene Expression Data

Accurate classification of breast cancer subtypes from gene expression data is critical for diagnosis and treatment selection. However, such datasets are characterized by high dimensionality and limited sample size, posing challenges for machine learning models. In this study, we evaluate the impact of model complexity and feature selection on subtype classification performance using TCGA-BRCA gene expression data. Logistic regression, random forest, and support vector machine (SVM) models were trained using varying numbers of highly variable genes (50 to 20,518). Performance was evaluated using stratified 5-fold cross-validation and assessed with accuracy and macro F1 score. While all models achieved high accuracy, macro F1 analysis revealed substantial differences in subtype-level performance. Logistic regression demonstrated the most stable and balanced performance across subtypes, including improved detection of rare classes. Random forest underperformed on minority subtypes despite strong overall accuracy, while SVM showed sensitivity to feature dimensionality. These findings highlight the importance of model simplicity, evaluation metrics, and feature selection in high-dimensional biological classification tasks.

Meena Al Hasani

Independent Researcher

Breast CancerMulticlass ClassificationFeature Selection
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Apr 26, 2026

Mammographic Lesion Segmentation with Lightweight Models: A Comparative Study

Breast cancer is a leading cause of cancer-related mortality among women worldwide, with mammography as the primary screening tool. While deep learning models have shown strong performance in lesion segmentation, most rely on computationally intensive architectures that limit their use in resource-constrained environments. This study evaluates the performance and efficiency of lightweight models for mammographic lesion segmentation. Architectures including MobileNetV2, EfficientNet Lite, FPN, and Fast-SCNN were compared against a U-Net baseline using the INbreast dataset with 5-fold cross-validation. Performance was assessed using Dice score, Intersection over Union (IoU), and Recall, alongside model complexity. MobileNetV2 with Squeeze-and-Excitation (SCSE) achieved the best performance, with a Dice score of 0.5766 while using approximately 75% fewer parameters than U-Net. Cross-dataset evaluation on the DMID dataset showed reduced accuracy due to domain shift but preserved recall. These results demonstrate that lightweight architectures offer a practical balance between performance and efficiency for deployable CAD systems.

Helder Oliveira

aIndependent Researcher, GnosisX, Calgary, AB, Canada

Breast CancerEfficient Neural Network InferenceMedical Image SegmentationLightweight Neural Networks
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Apr 18, 2026

Multimodal Fusion of Histopathology Images and Electronic Health Records for Early Breast Cancer Diagnosis

Breast cancer is a leading cause of cancer-related mortality worldwide, and timely accurate diagnosis is critical to improving survival outcomes. While convolutional neural networks (CNNs) have demonstrated strong performance on histopathology image classification, and machine learning models on structured electronic health records (EHR) have shown utility for clinical risk stratification, most existing work treats these modalities in isolation. This paper presents a systematic multimodal framework that integrates patch-level histopathology features from the BreCaHAD dataset with structured clinical data from MIMIC-IV. We train and evaluate unimodal image models (a simple CNN baseline and ResNet-18 with transfer learning), unimodal tabular models (XGBoost and a multilayer perceptron), and an intermediate-fusion model that concatenates latent representations from both modalities. ResNet-18 achieves near-perfect accuracy (1.000) and AUC (1.000) on three-class patch-level classification, while XGBoost achieves 98% accuracy on the EHR prediction task. The intermediate fusion model yields a macro-average AUC of 0.997, outperforming all unimodal baselines and delivering the largest improvements on the diagnostically critical but class-imbalanced mitosis category (AUC 0.994). Grad-CAM and SHAP interpretability analyses validate that model decisions align with established pathological and clinical criteria. Our results demonstrate that multimodal integration delivers meaningful improvements in both predictive performance and clinical transparency.

Aditya Shribhagwan Khandelwal, Mohammad Samar Ansari, Asra Aslam

University of Sheffield, UK · University of Chester, UK

Breast CancerComputational PathologyMultimodal ClassificationOncologyHistopathology Image ClassificationMultimodal Fusion
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Apr 13, 2026

LoGo-MR: Screening Breast MRI for Cancer Risk Prediction by Efficient Omni-Slice Modeling

Efficient and explainable breast cancer (BC) risk prediction is critical for large-scale population-based screening. Breast MRI provides functional information for personalized risk assessment. Yet effective modeling remains challenging as fully 3D CNNs capture volumetric context at high computational cost, whereas lightweight 2D CNNs fail to model inter-slice continuity. Importantly, breast MRI modeling for shor- and long-term BC risk stratification remains underexplored. In this study, we propose LoGo-MR, a 2.5D local-global structural modeling framework for five-year BC risk prediction. Aligned with clinical interpretation, our framework first employs neighbor-slice encoding to capture subtle local cues linked to short-term risk. It then integrates transformer-enhanced multiple-instance learning (MIL) to model distributed global patterns related to long-term risk and provide interpretable slice importance. We further apply this framework across axial, sagittal, and coronal planes as LoGo3-MR to capture complementary volumetric information. This multi-plane formulation enables voxel-level risk saliency mapping, which may assist radiologists in localizing risk-relevant regions during breast MRI interpretation. Evaluated on a large breast MRI screening cohort (~7.5K), our method outperforms 2D/3D baselines and existing SOTA MIL methods, achieving AUCs of 0.77-0.69 for 1- to 5-year prediction and improving C-index by ~6% over 3D CNNs. LoGo3-MR further improves overall performance with interpretable localization across three planes, and validation across seven backbones shows consistent gains. These results highlight the clinical potential of efficient MRI-based BC risk stratification for large-scale screening. Code will be released publicly.

Xin Wang, Yuan Gao, George Yiasemis +13

Netherlands Cancer Institute · Radboud University Medical Center · University Medical Center Utrecht +1

Medical Image AnalysisClinical Risk PredictionBreast CancerExplainable Medical Image AnalysisMagnetic Resonance Imaging
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Mar 16, 2026

Longitudinal Risk Prediction in Mammography with Privileged History Distillation

Longitudinal mammography screening has become an important source of information for improving future breast cancer risk prediction. However, the performance of current longitudinal mammography models degrades when prior examinations are unavailable at inference, creating a structured privileged-information setting in which temporal context is available during training but absent at deployment. We propose Single-Exam Mammography risk prediction with privileged History Distillation (SEM-HD), a framework that uses longitudinal history as privileged information available only during training to preserve the predictive benefits of longitudinal modeling while requiring only the current screening examination at deployment. During training, the student relies on the current examination to predict latent representations of prior visits, while horizon-specific teachers provide additional supervision from the observed longitudinal history. Together, latent history prediction and teacher distillation preserve the temporal modeling structure of longitudinal predictors under current-exam-only inference. We validate SEM-HD on three longitudinal mammography cohorts, the CSAW-CC, EMBED, and OMI-DB, using the transformer-based Longitudinal Mammography Risk (LoMaR) and recurrent Visual Memory Recurrent Attention (VMRA) backbones. Under current-exam-only inference, SEM-HD consistently improves long-horizon AUC and pAUC over longitudinal models evaluated without history, particularly in the clinically relevant low false-positive-rate region. It also recovers much of the performance gap with respect to full-history inference across datasets and backbones. Ablations further show that these gains are not reproduced by masking or heuristic history imputation. The strongest performance is achieved by combining patient-specific latent history prediction with distilled temporal risk supervision.

Banafsheh Karimian, Soufiane Belharbi, Alexis Guichemerre +3

LIVIA, Dept. of Systems Engineering, ETS Montreal, Canada · Goodman Cancer Institute, Dept. of Oncology, McGill University, Canada

Breast CancerMedical ImagingLongitudinal Medical Image AnalysisMammographyLearning Using Privileged InformationKnowledge Distillation
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Mar 16, 2026

Extracting Breast Cancer Phenotypes from Clinical Notes: Comparing LLMs with Classical Ontology Methods

A significant amount of data held in Oncology Electronic Medical Records (EMRs) is contained in unstructured provider notes -- including but not limited to the chemotherapy (or cancer treatment) outcome, different biomarkers, the tumor's location, sizes, and growth patterns of a patient. The clinical studies show that the majority of oncologists are comfortable providing these valuable insights in their notes in a natural language rather than the relevant structured fields of an EMR. The major contribution of this research is to report an LLM-based framework to process provider notes and extract valuable medical knowledge and phenotype mentioned above, with a focus on the domain of oncology. In this paper, we focus on extracting phenotypes related to breast cancer using our LLM framework, and then compare its performance with earlier works that used knowledge-driven annotation system, paired with the NCIt Ontology Annotator. The results of the study show that an LLM-based information extraction framework can be easily adapted to extract phenotypes with an accuracy that is comparable to the classical ontology-based methods. However, once trained, they could be easily fine-tuned to cater for other cancer types and diseases.

Abdullah Bin Faiz, Arbaz Khan Shehzad, Asad Afzal +5

CureMD Research, 80 Pine Street, New York, 10005, USA · Oncology Department, Shifa International Hospital, 4 Pitras Bukhari Rd, H-8/4 H 8/4 H-8, Islamabad, Pakistan

Clinical Information ExtractionLLM Information ExtractionBreast Cancer
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Mar 12, 2026

Leveraging Large Language Models and Survival Analysis for Early Prediction of Chemotherapy Outcomes

Chemotherapy for cancer treatment is costly and accompanied by severe side effects, highlighting the critical need for early prediction of treatment outcomes to improve patient management and informed decision-making. Predictive models for chemotherapy outcomes using real-world data face challenges, including the absence of explicit phenotypes and treatment outcome labels such as cancer progression and toxicity. This study addresses these challenges by employing Large Language Models (LLMs) and ontology-based techniques for phenotypes and outcome label extraction from patient notes. We focused on one of the most frequently occurring cancers, breast cancer, due to its high prevalence and significant variability in patient response to treatment, making it a critical area for improving predictive modeling. The dataset included features such as vitals, demographics, staging, biomarkers, and performance scales. Drug regimens and their combinations were extracted from the chemotherapy plans in the EMR data and shortlisted based on NCCN guidelines, verified with NIH standards, and analyzed through survival modeling. The proposed approach significantly reduced phenotypes sparsity and improved predictive accuracy. Random Survival Forest was used to predict time-to-failure, achieving a C-index of 73%, and utilized as a classifier at a specific time point to predict treatment outcomes, with accuracy and F1 scores above 70%. The outcome probabilities were validated for reliability by calibration curves. We extended our approach to four other cancer types. This research highlights the potential of early prediction of treatment outcomes using LLM-based clinical data extraction enabling personalized treatment plans with better patient outcomes.

Muhammad Faisal Shahid, Asad Afzal, Abdullah Faiz +5

CureMD Research, 80 Pine St 21st Floor, New York, NY 10005, United States

Clinical Outcome PredictionCancer Survival PredictionBreast Cancer
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Mar 3, 2026

BRIGHT: A Collaborative Generalist-Specialist Foundation Model for Breast Pathology

Generalist pathology foundation models (PFMs), pretrained on large-scale multi-organ datasets, have demonstrated remarkable predictive capabilities across diverse clinical applications. However, their proficiency on the full spectrum of clinically essential tasks within a specific organ system remains an open question due to the lack of large-scale validation cohorts for a single organ as well as the absence of a tailored training paradigm that can effectively translate broad histomorphological knowledge into the organ-specific expertise required for specialist-level interpretation. In this study, we propose BRIGHT, the first PFM specifically designed for breast pathology, trained on over 51,000 breast whole-slide images derived from a cohort of over 40,000 patients across 19 hospitals. BRIGHT employs a collaborative generalist-specialist framework to capture both universal and organ-specific features. To comprehensively evaluate the performance of PFMs on breast oncology, we curate the largest multi-institutional cohorts to date for downstream task development and evaluation, comprising over 25,000 WSIs across 10 hospitals. The validation cohorts cover the full spectrum of breast pathology across 25 distinct clinical tasks spanning diagnosis, biomarker prediction, treatment response and survival prediction. Extensive experiments demonstrate that BRIGHT outperforms five leading generalist PFMs, achieving state-of-the-art (SOTA) performance in 25 of 25 internal validation tasks and in 4 of 11 external validation tasks with excellent heatmap interpretability. By evaluating on large-scale validation cohorts, this study not only demonstrates BRIGHT's clinical utility in breast oncology but also validates a collaborative generalist-specialist paradigm, providing a scalable template for developing PFMs on a specific organ system, accelerating the translation of foundation models into ...

Xiaojing Guo, Jiatai Lin, Yumian Jia +39

Breast CancerHealthcarePathology Foundation ModelsOncologyWhole-Slide Image Analysis
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Feb 25, 2026

Multimodal Survival Modeling and Fairness-Aware Clinical Machine Learning for 5-Year Breast Cancer Risk Prediction

Clinical risk prediction models often underperform in real-world settings due to poor calibration, limited transportability, and subgroup disparities. These challenges are amplified in high-dimensional multimodal cancer datasets characterized by complex feature interactions and a p >> n structure. We present a fully reproducible multimodal machine learning framework for 5-year overall survival prediction in breast cancer, integrating clinical variables with high-dimensional transcriptomic and copy-number alteration (CNA) features from the METABRIC cohort. After variance- and sparsity-based filtering and dimensionality reduction, models were trained using stratified train/validation/test splits with validation-based hyperparameter tuning. Two survival approaches were compared: an elastic-net regularized Cox model (CoxNet) and a gradient-boosted survival tree model implemented using XGBoost. CoxNet provides embedded feature selection and stable estimation, whereas XGBoost captures nonlinear effects and higher-order interactions. Performance was assessed using time-dependent area under the ROC curve (AUC), average precision (AP), calibration curves, Brier score, and bootstrapped 95 percent confidence intervals. CoxNet achieved validation and test AUCs of 98.3 and 96.6, with AP values of 90.1 and 80.4. XGBoost achieved validation and test AUCs of 98.6 and 92.5, with AP values of 92.5 and 79.9. Fairness diagnostics showed stable discrimination across age groups, estrogen receptor status, molecular subtypes, and menopausal state. This work introduces a governance-oriented multimodal survival framework emphasizing calibration, fairness auditing, robustness, and reproducibility for high-dimensional clinical machine learning.

Toktam Khatibi

Faculty of Industrial and Systems Engineering, Tarbiat Modares University, Tehran, Iran

Cancer Survival PredictionMultimodal Survival AnalysisSurvival AnalysisBreast Cancer
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Nov 24, 2025

OncoVision: Integrating Mammography and Clinical Data through Attention-Driven Multimodal AI for Enhanced Breast Cancer Diagnosis

OncoVision is a privileged-information training framework that uses mammography images and clinical features during training and performs inference from mammographic images alone. Employing an attention-based encoder-decoder backbone, it jointly segments four regions of interest (masses, calcifications, axillary findings, and breast tissue) with accuracy exceeding the nnU-Net baseline and predicts ten structured clinical features, including BI-RADS category. We developed two late-fusion strategies, Independent and Dependent, that integrate imaging, radiomic, and clinical information during training to improve diagnostic precision and potentially reduce inter-observer variability. Radiomic features extracted from predicted masks provide shape, intensity, and texture descriptors that complement the learned CNN representations. We evaluated OncoVision in a retrospective multi-reader study with six board-certified radiologists, assessing diagnostic confidence, reading time, and segmentation accuracy with and without AI assistance. In a paired reader-assistance evaluation, OncoVision was associated with higher diagnostic confidence for junior and senior radiologists, reduced reading time by up to 61%, and achieved segmentation accuracy comparable to or exceeding that of radiologists for mass lesions. We operationalized OncoVision as a secure web application, now deployed at a partner hospital, that generates structured reports with dual-confidence scoring and attention-weighted visualizations for real-time diagnostic support. The platform is designed for integration into clinical workflows, with the goal of supporting screening access in underprivileged regions. By combining accurate segmentation with clinical intuition, OncoVision advances AI-assisted mammographic interpretation, offering a scalable and accessible approach to earlier and more consistent image interpretation.

Istiak Ahmed, Galib Ahmed, K. Shahriar Sanjid +10

Department Electrical and Computer Engineering, North South University, Dhaka, 1229, Bangladesh. · Big-Matrix Lab, North South University, Dhaka, 1229, Bangladesh. · Department of Mathematics and Physics, North South University, Dhaka, 1229, Bangladesh. +7

Breast CancerMedical Image SegmentationMammographyOncologyLearning Using Privileged Information
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Nov 11, 2025

The Impact of Longitudinal Mammogram Alignment on Breast Cancer Risk Assessment

Regular mammography screening is crucial for early breast cancer detection. By leveraging deep learning-based risk models, screening intervals can be personalized, especially for high-risk individuals. While recent methods increasingly incorporate longitudinal information from prior mammograms, accurate spatial alignment across time points remains a key challenge. Misalignment can obscure meaningful tissue changes and degrade model performance. In this study, we provide insights into various alignment strategies, image-based registration, feature-level (representation space) alignment with and without regularization, and implicit alignment methods, for their effectiveness in longitudinal deep learning-based risk modeling. Using two large-scale mammography datasets, we assess each method across key metrics, including predictive accuracy, precision, recall, and deformation field quality. Our results show that image-based registration consistently outperforms the more recently favored feature-based and implicit approaches across all metrics, enabling more accurate, temporally consistent predictions and generating smooth, anatomically plausible deformation fields. Although regularizing the deformation field improves deformation quality, it reduces the risk prediction performance of feature-level alignment. Applying image-based deformation fields within the feature space yields the best risk prediction performance. These findings underscore the importance of image-based deformation fields for spatial alignment in longitudinal risk modeling, offering improved prediction accuracy and robustness. This approach has strong potential to enhance personalized screening and enable earlier interventions for high-risk individuals. The code is available at https://github.com/sot176/Mammogram_Alignment_Study_Risk_Prediction.git, allowing full reproducibility of the results.

Solveig Thrun, Stine Hansen, Zijun Sun +8

Department of Physics and Technology, UiT The Arctic University of Norway, Tromsø, 9037, Norway · SPKI The Norwegian Centre for Clinical Artificial Intelligence, University Hospital of North Norway, Tromsø, 9019, Norway · Department of Computer Science and Engineering, University of Bologna, 40126, Bologna, Italy +4

Longitudinal Medical Image AnalysisMammographyBreast CancerMedical Image RegistrationDeformable Image RegistrationLatent Space Alignment
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