Abstract

Radiologists worldwide use mammography as a reliable tool for breast cancer screening. However, mammography assessment is challenging even for well-trained radiologists, leading to a pressing need for Computer Aided Diagnosis (CAD) systems. In this work, a novel technique for the detection and classification of breast Micro-Calcifications (MCs), which are diagnostically significant but difficult to detect findings, is presented. The proposed method is based on the subtraction of temporally sequential mammogram pairs, after pre-processing and image registration, followed by machine-learning. The classification was performed using several features extracted from the subtracted mammograms and selected during training to optimize the accuracy of the results. Six classifiers were tested in a leave-one-patient-out, 4, 5 and 10 fold cross-validation process. This technique was evaluated on a unique dataset, consisting of temporal sequences of mammograms from 80 patients taken between 1 to 6 years apart. The resulting 320 mammograms were reviewed by 2 radiologists who precisely marked each MC location. The accuracy of classifying MCs as benign or suspicious improved from 91.42% without temporal subtraction and an Ensemble of Decision Trees (EDT), to 99.55% with the use of sequential mammograms and Support Vector Machines (SVMs) with leave-one-patient-out validation. The improvement was statistically significant (p-value <; 0.005). These results verify the accuracy and the effectiveness of the proposed technique should to be further evaluated on a larger dataset.

Highlights

  • Breast cancer is the most common cancer and the second leading cause of death in women in the United States [1]

  • 80 pairs of full-field digital sequential mammograms were collected from 80 women following their routine screening mammography examinations

  • Machine-learning techniques were used to eliminate the large number of False Positives (FPs) and classify the MCs as benign or suspicious

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Summary

Introduction

Breast cancer is the most common cancer and the second leading cause of death in women in the United States [1]. Carcinogenesis in the breast leads to an uncontrolled growth of cells, usually forming a tumor. The process, by which the cancer initially appears and later develops, can vary between patients. For the detection of breast cancer, radiologists use mammography as the key screening tool [2]. After the mammograms are acquired, expert radiologists review the images to determine whether the patient has any. Current protocols require reading of the mammogram by two radiologists (and a third, if consensus is not reached), which is an indication of the challenges faced when attempting to identify probable abnormalities in a mammogram. Appearance of Micro-Calcifications (MCs), which are microscopic deposits of calcium that commonly appear in the breast, is one of the suspicious signs that require further investigation. Micro-Calcification Clusters (MCCs) might indicate an increased chance to develop breast cancer. The morphology of the calcifications is the most crucial parameter in their

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