Abstract

Breast cancer is one of the most common cancers in women, with more than 1,300,000 cases and 450,000 deaths each year worldwide. In this context, recent studies showed that early breast cancer detection, along with suitable treatment, could significantly reduce breast cancer death rates in the long term. X-ray mammography is still the instrument of choice in breast cancer screening. In this context, the false-positive and false-negative rates commonly achieved by radiologists are extremely arduous to estimate and control although some authors have estimated figures of up to 20% of total diagnoses or more. The introduction of novel artificial intelligence (AI) technologies applied to the diagnosis and, possibly, prognosis of breast cancer could revolutionize the current status of the management of the breast cancer patient by assisting the radiologist in clinical image interpretation. Lately, a breakthrough in the AI field has been brought about by the introduction of deep learning techniques in general and of convolutional neural networks in particular. Such techniques require no a priori feature space definition from the operator and are able to achieve classification performances which can even surpass human experts. In this paper, we design and validate an ad hoc CNN architecture specialized in breast lesion classification from imaging data only. We explore a total of 260 model architectures in a train-validation-test split in order to propose a model selection criterion which can pose the emphasis on reducing false negatives while still retaining acceptable accuracy. We achieve an area under the receiver operatic characteristics curve of 0.785 (accuracy 71.19%) on the test set, demonstrating how an ad hoc random initialization architecture can and should be fine tuned to a specific problem, especially in biomedical applications.

Highlights

  • Breast cancer is one of the most common cancers in women, with more than 1,300,000 cases and 450,000 deaths each year worldwide [1]

  • In view of the above, the introduction of novel artificial intelligence (AI) technologies applied to the diagnosis and possibly prognosis of breast cancer could revolutionize the current status of the management of the breast cancer patient. e support of arti cial intelligence (AI) in the diagnostic path of breast cancer patients can potentially both reduce the healthcare costs due to misdiagnosis and promote the achievement of new precision medicine protocols [14]

  • We heuristically explored the space of number of possible architectures and trained them in order to gain insights into what an optimal convolutional neural networks (CNNs) architecture for classification of breast lesions may be

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Summary

Introduction

Breast cancer is one of the most common cancers in women, with more than 1,300,000 cases and 450,000 deaths each year worldwide [1]. In the era of precision medicine [2], the identi cation and strati cation of breast lesions in the early stage of cancer development is an essential starting point for increasing the probability of therapeutic success In this context, early detection of breast lesions through mammography has been seen to be associated with an extremely high probability of cure, with a 97% survival in ve years [3]. The mammographic exam does not provide any indication about probable disease evolution and/or outcome (and neither does it provide clues about possibly appropriate therapeutic choices) In this context, it is not surprising that the rate of false-negative or -positive results for mammography described in the literature is extremely variable. In presence of false-positive cases, patients are frequently subjected to repeated invasive (bioptic examination) and/or stringent follow-up programs, such as additional mammography exams mammography or equivalent medical procedures which, on top of possibly generating health detriment on their own, carry significant financial burden. e direct breast-care costs in the year following a false-positive screening mammogram are approximately 500$ higher than in the case of a truenegative result [13]

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