Breast cancer risk prediction combining a convolutional neural network-based mammographic evaluation with clinical factors

A hybrid explainable federated-based vision transformer framework for breast cancer prediction via risk factors

Breast cancer remains a leading cause of mortality in women, underscoring the need for timely and accurate diagnosis. This paper addresses this challenge by introducing a comprehensive explainable federated learning framework for breast cancer prediction. We evaluate three deep learning approaches in both centralized and federated scenario settings: (1) individual artificial intelligence (AI) models, (2) high-level feature space ensemble models, and (3) a hybrid model combining global Vision Transformer (ViT) and local convolutional neural network (CNN) features. These models are assessed on binary, multi-class, and Breast Imaging Reporting and Data System (BI-RADS) classification tasks using a unique dataset encompassing real-world risk factors. In the federated scenario, we employ three clients with the same approaches as the centralized setting, aggregating their predictions using an AI global model. Explainable AI (XAI) technique is incorporated to enhance AI models' transparency. Our federated learning approach demonstrates superior performance, achieving accuracies of 98.65%, 97.30%, and 95.59% for binary, multi-class, and BI-RADS tasks, respectively. The proposed model, evaluated with a 95% Confidence Interval (CI) and Areas Under Curve (AUC) curves, registers top classifiers with an AUC of 0.970 [0.917-1]. Local Interpretable Model-Agnostic Explanations (LIME) XAI-based federated learning framework offers a promising solution for privacy-preserving and accurate breast cancer prediction in both research and clinical practice.

Deep Learning: A Heuristic Three-Stage Mechanism for Grid Searches to Optimize the Future Risk Prediction of Breast Cancer Metastasis Using EHR-Based Clinical Data

Background: A grid search, at the cost of training and testing a large number of models, is an effective way to optimize the prediction performance of deep learning models. A challenging task concerning grid search is time management. Without a good time management scheme, a grid search can easily be set off as a "mission" that will not finish in our lifetime. In this study, we introduce a heuristic three-stage mechanism for managing the running time of low-budget grid searches with deep learning, sweet-spot grid search (SSGS) and randomized grid search (RGS) strategies for improving model prediction performance, in an application of predicting the 5-year, 10-year, and 15-year risk of breast cancer metastasis. Methods: We develop deep feedforward neural network (DFNN) models and optimize the prediction performance of these models through grid searches. We conduct eight cycles of grid searches in three stages, focusing on learning a reasonable range of values for each of the adjustable hyperparameters in Stage 1, learning the sweet-spot values of the set of hyperparameters and estimating the unit grid search time in Stage 2, and conducting multiple cycles of timed grid searches to refine model prediction performance with SSGS and RGS in Stage 3. We conduct various SHAP analyses to explain the prediction, including a unique type of SHAP analyses to interpret the contributions of the DFNN-model hyperparameters. Results: The grid searches we conducted improved the risk prediction of 5-year, 10-year, and 15-year breast cancer metastasis by 18.6%, 16.3%, and 17.3%, respectively, over the average performance of all corresponding models we trained using the RGS strategy. Conclusions: Grid search can greatly improve model prediction. Our result analyses not only demonstrate best model performance but also characterize grid searches from various aspects such as their capabilities of discovering decent models and the unit grid search time. The three-stage mechanism worked effectively. It not only made our low-budget grid searches feasible and manageable but also helped improve the model prediction performance of the DFNN models. Our SHAP analyses not only identified clinical risk factors important for the prediction of future risk of breast cancer metastasis, but also DFNN-model hyperparameters important to the prediction of performance scores.

Researching public health datasets in the era of deep learning: a systematic literature review

Objective: Explore deep learning applications in predictive analytics for public health data, identify challenges and trends, and then understand the current landscape. Materials and Methods: A systematic literature review was conducted in June 2023 to search articles on public health data in the context of deep learning, published from the inception of medical and computer science databases through June 2023. The review focused on diverse datasets, abstracting applications, challenges, and advancements in deep learning. Results: 2004 articles were reviewed, identifying 14 disease categories. Observed trends include explainable-AI, patient embedding learning, and integrating different data sources and employing deep learning models in health informatics. Noted challenges were technical reproducibility and handling sensitive data. Discussion: There has been a notable surge in deep learning applications on public health data publications since 2015. Consistent deep learning applications and models continue to be applied across public health data. Despite the wide applications, a standard approach still does not exist for addressing the outstanding challenges and issues in this field. Conclusion: Guidelines are needed for applying deep learning and models in public health data to improve FAIRness, efficiency, transparency, comparability, and interoperability of research. Interdisciplinary collaboration among data scientists, public health experts, and policymakers is needed to harness the full potential of deep learning.

Effects of vitamin D supplementation on a deep learning-based mammographic evaluation in SWOG S0812

Deep learning-based mammographic evaluations could noninvasively assess response to breast cancer chemoprevention. We evaluated change in a convolutional neural network-based breast cancer risk model applied to mammograms among women enrolled in SWOG S0812, which randomly assigned 208 premenopausal high-risk women to receive oral vitamin D3 20 000 IU weekly or placebo for 12 months. We applied the convolutional neural network model to mammograms collected at baseline (n = 109), 12 months (n = 97), and 24 months (n = 67) and compared changes in convolutional neural network-based risk score between treatment groups. Change in convolutional neural network-based risk score was not statistically significantly different between vitamin D and placebo groups at 12 months (0.005 vs 0.002, P = .875) or at 24 months (0.020 vs 0.001, P = .563). The findings are consistent with the primary analysis of S0812, which did not demonstrate statistically significant changes in mammographic density with vitamin D supplementation compared with placebo. There is an ongoing need to evaluate biomarkers of response to novel breast cancer chemopreventive agents.

Deep Learning for Breast Cancer Risk Prediction: Application to a Large Representative UK Screening Cohort

Purpose To develop an artificial intelligence (AI) deep learning tool capable of predicting future breast cancer risk from a current negative screening mammographic examination and to evaluate the model on data from the UK National Health Service Breast Screening Program. Materials and Methods The OPTIMAM Mammography Imaging Database contains screening data, including mammograms and information on interval cancers, for more than 300 000 female patients who attended screening at three different sites in the United Kingdom from 2012 onward. Cancer-free screening examinations from women aged 50-70 years were performed and classified as risk-positive or risk-negative based on the occurrence of cancer within 3 years of the original examination. Examinations with confirmed cancer and images containing implants were excluded. From the resulting 5264 risk-positive and 191 488 risk-negative examinations, training (n = 89 285), validation (n = 2106), and test (n = 39 351) datasets were produced for model development and evaluation. The AI model was trained to predict future cancer occurrence based on screening mammograms and patient age. Performance was evaluated on the test dataset using the area under the receiver operating characteristic curve (AUC) and compared across subpopulations to assess potential biases. Interpretability of the model was explored, including with saliency maps. Results On the hold-out test set, the AI model achieved an overall AUC of 0.70 (95% CI: 0.69, 0.72). There was no evidence of a difference in performance across the three sites, between patient ethnicities, or across age groups. Visualization of saliency maps and sample images provided insights into the mammographic features associated with AI-predicted cancer risk. Conclusion The developed AI tool showed good performance on a multisite, United Kingdom-specific dataset. Keywords: Deep Learning, Artificial Intelligence, Breast Cancer, Screening, Risk Prediction Supplemental material is available for this article. ©RSNA, 2024.

Artificial Intelligence for Breast Cancer Risk Assessment

Breast cancer risk prediction models based on common clinical risk factors are used to identify women eligible for high-risk screening and prevention. Unfortunately, these models have only modest discriminatory accuracy with disparities in performance in underrepresented race and ethnicity groups. The field of artificial intelligence (AI) and deep learning are rapidly advancing the field of breast cancer risk prediction with the development of mammography-based AI breast cancer risk models. Early studies suggest mammography-based AI risk models may perform better than traditional risk factor-based models with more equitable performance.

Breast cancer risk prediction using machine learning: a systematic review

Background

Breast cancer is the leading cause of cancer-related fatalities among women worldwide. Conventional screening and risk prediction models primarily rely on demographic and patient clinical history to devise policies and estimate likelihood. However, recent advancements in artificial intelligence (AI) techniques, particularly deep learning (DL), have shown promise in the development of personalized risk models. These models leverage individual patient information obtained from medical imaging and associated reports. In this systematic review, we thoroughly investigated the existing literature on the application of DL to digital mammography, radiomics, genomics, and clinical information for breast cancer risk assessment. We critically analyzed these studies and discussed their findings, highlighting the promising prospects of DL techniques for breast cancer risk prediction. Additionally, we explored ongoing research initiatives and potential future applications of AI-driven approaches to further improve breast cancer risk prediction, thereby facilitating more effective screening and personalized risk management strategies.

Objective and methods

This study presents a comprehensive overview of imaging and non-imaging features used in breast cancer risk prediction using traditional and AI models. The features reviewed in this study included imaging, radiomics, genomics, and clinical features. Furthermore, this survey systematically presented DL methods developed for breast cancer risk prediction, aiming to be useful for both beginners and advanced-level researchers.

Results

A total of 600 articles were identified, 20 of which met the set criteria and were selected. Parallel benchmarking of DL models, along with natural language processing (NLP) applied to imaging and non-imaging features, could allow clinicians and researchers to gain greater awareness as they consider the clinical deployment or development of new models. This review provides a comprehensive guide for understanding the current status of breast cancer risk assessment using AI.

Conclusion

This study offers investigators a different perspective on the use of AI for breast cancer risk prediction, incorporating numerous imaging and non-imaging features.

Deep Learning Approaches with Digital Mammography for Evaluating Breast Cancer Risk, a Narrative Review

Breast cancer remains the leading cause of cancer-related deaths in women worldwide. Current screening regimens and clinical breast cancer risk assessment models use risk factors such as demographics and patient history to guide policy and assess risk. Applications of artificial intelligence methods (AI) such as deep learning (DL) and convolutional neural networks (CNNs) to evaluate individual patient information and imaging showed promise as personalized risk models. We reviewed the current literature for studies related to deep learning and convolutional neural networks with digital mammography for assessing breast cancer risk. We discussed the literature and examined the ongoing and future applications of deep learning techniques in breast cancer risk modeling.