Abstract
Mammography is the mainstream imaging modality used for breast cancer screening. Identification of microcalcifications associated with malignancy may result in early diagnosis of breast cancer and aid in reducing the morbidity and mortality associated with the disease. Computer-aided diagnosis (CAD) is a promising technique due to its efficiency and accuracy. Here, we demonstrated that an automated deep-learning pipeline for microcalcification detection and classification on mammography can facilitate early diagnosis of breast cancer. This technique can not only provide the classification results of mammography, but also annotate specific calcification regions. A large mammography dataset was collected, including 4,810 mammograms with 6,663 microcalcification lesions based on biopsy results, of which 3,301 were malignant and 3,362 were benign. The system was developed and tested using images from multiple centers. The overall classification accuracy values for discriminating between benign and malignant breasts were 0.8124 for the training set and 0.7237 for the test set. The sensitivity values of malignant breast cancer prediction were 0.8891 for the training set and 0.7778 for the test set. In addition, we collected information regarding pathological sub-type (pathotype) and estrogen receptor (ER) status, and we subsequently explored the effectiveness of deep learning-based pathotype and ER classification. Automated artificial intelligence (AI) systems may assist clinicians in making judgments and improve their efficiency in breast cancer screening, diagnosis, and treatment.