Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers
Abstract Background Breast cancer subtypes Luminal A and Luminal B are classified by the expression of PAM50 genes and may benefit from different treatment strategies. Machine learning models based on H&E images may contain features associated with subtype, allowing early identification of tumor...
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BMC
2024-12-01
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| Series: | Breast Cancer Research |
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| Online Access: | https://doi.org/10.1186/s13058-024-01915-5 |
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| author | Dong Neuck Lee Yao Li Linnea T. Olsson Alina M. Hamilton Benjamin C. Calhoun Katherine A. Hoadley J. S. Marron Melissa A. Troester |
| author_facet | Dong Neuck Lee Yao Li Linnea T. Olsson Alina M. Hamilton Benjamin C. Calhoun Katherine A. Hoadley J. S. Marron Melissa A. Troester |
| author_sort | Dong Neuck Lee |
| collection | DOAJ |
| description | Abstract Background Breast cancer subtypes Luminal A and Luminal B are classified by the expression of PAM50 genes and may benefit from different treatment strategies. Machine learning models based on H&E images may contain features associated with subtype, allowing early identification of tumors with higher risk of recurrence. Methods H&E images (n = 630 ER+/HER2-breast cancers) were pixel-level segmented into epithelium and stroma. Convolutional neural network and multiple instance learning were used to extract image features from original and segmented images. Patient-level classification models were trained to discriminate Luminal A versus B image features in tenfold cross-validation, with or without grade adjustment. The best-performing visual classifier was incorporated into envisioned diagnostic protocols as an alternative to genomic testing (PAM50). The protocols were then compared in time-to-recurrence models. Results Among ER+/HER2-tumors, the image-based protocol differentiated recurrence times with a hazard ratio (HR) of 2.81 (95% CI: 1.73–4.56), which was similar to the HR for PAM50 (2.66, 95% CI: 1.65–4.28). Grade adjustment did not improve subtype prediction accuracy, but did help balance sensitivity and specificity. Among high grade participants, sensitivity and specificity (0.734 and 0.474, respectively) became more similar (0.732 and 0.624, respectively) in grade-adjusted models. The original and epithelium-specific images had similar performance and highest accuracy, followed by stroma or binarized images showing only the epithelial-stromal interface. Conclusions Given low rates of genomic testing uptake nationally, image-based methods may help identify ER+/HER2-patients who could benefit from testing. |
| format | Article |
| id | doaj-art-d6d419adfead42c48cb70ca307eb738a |
| institution | Kabale University |
| issn | 1465-542X |
| language | English |
| publishDate | 2024-12-01 |
| publisher | BMC |
| record_format | Article |
| series | Breast Cancer Research |
| spelling | doaj-art-d6d419adfead42c48cb70ca307eb738a2024-12-08T12:50:06ZengBMCBreast Cancer Research1465-542X2024-12-0126111110.1186/s13058-024-01915-5Image analysis-based identification of high risk ER-positive, HER2-negative breast cancersDong Neuck Lee0Yao Li1Linnea T. Olsson2Alina M. Hamilton3Benjamin C. Calhoun4Katherine A. Hoadley5J. S. Marron6Melissa A. Troester7Department of Biostatistics, University of North CarolinaDepartment of Statistics and Operations Research, University of North CarolinaDepartment of Epidemiology, University of North CarolinaLineberger Comprehensive Cancer Center, University of North CarolinaDepartment of Pathology and Laboratory Medicine, University of North CarolinaDepartment of Genetics, University of North CarolinaDepartment of Statistics and Operations Research, University of North CarolinaDepartment of Epidemiology, University of North CarolinaAbstract Background Breast cancer subtypes Luminal A and Luminal B are classified by the expression of PAM50 genes and may benefit from different treatment strategies. Machine learning models based on H&E images may contain features associated with subtype, allowing early identification of tumors with higher risk of recurrence. Methods H&E images (n = 630 ER+/HER2-breast cancers) were pixel-level segmented into epithelium and stroma. Convolutional neural network and multiple instance learning were used to extract image features from original and segmented images. Patient-level classification models were trained to discriminate Luminal A versus B image features in tenfold cross-validation, with or without grade adjustment. The best-performing visual classifier was incorporated into envisioned diagnostic protocols as an alternative to genomic testing (PAM50). The protocols were then compared in time-to-recurrence models. Results Among ER+/HER2-tumors, the image-based protocol differentiated recurrence times with a hazard ratio (HR) of 2.81 (95% CI: 1.73–4.56), which was similar to the HR for PAM50 (2.66, 95% CI: 1.65–4.28). Grade adjustment did not improve subtype prediction accuracy, but did help balance sensitivity and specificity. Among high grade participants, sensitivity and specificity (0.734 and 0.474, respectively) became more similar (0.732 and 0.624, respectively) in grade-adjusted models. The original and epithelium-specific images had similar performance and highest accuracy, followed by stroma or binarized images showing only the epithelial-stromal interface. Conclusions Given low rates of genomic testing uptake nationally, image-based methods may help identify ER+/HER2-patients who could benefit from testing.https://doi.org/10.1186/s13058-024-01915-5Breast cancerCBCS3HistologyMultiple instance learningImage segmentationDistance weighted learning |
| spellingShingle | Dong Neuck Lee Yao Li Linnea T. Olsson Alina M. Hamilton Benjamin C. Calhoun Katherine A. Hoadley J. S. Marron Melissa A. Troester Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers Breast Cancer Research Breast cancer CBCS3 Histology Multiple instance learning Image segmentation Distance weighted learning |
| title | Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers |
| title_full | Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers |
| title_fullStr | Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers |
| title_full_unstemmed | Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers |
| title_short | Image analysis-based identification of high risk ER-positive, HER2-negative breast cancers |
| title_sort | image analysis based identification of high risk er positive her2 negative breast cancers |
| topic | Breast cancer CBCS3 Histology Multiple instance learning Image segmentation Distance weighted learning |
| url | https://doi.org/10.1186/s13058-024-01915-5 |
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