HER2 Expression Prediction with Flexible Multi-Modal Inputs via Dynamic Bidirectional Reconstruction

In breast cancer HER2 assessment, clinical evaluation relies on combined H&E and IHC images, yet acquiring both modalities is often hindered by clinical constraints and cost. We propose an adaptive bimodal prediction framework that flexibly supports single- or dual-modality inputs through two core innovations: a dynamic branch selector activating modality completion or joint inference based on input availability, and a cross-modal GAN (CM-GAN) enabling feature-space reconstruction of missing modalities. This design dramatically improves H&E-only accuracy from 71.44% to 94.25%, achieves 95.09% with full dual-modality inputs, and maintains 90.28% reliability under single-modality conditions. The "dual-modality preferred, single-modality compatible" architecture delivers near-dual-modality accuracy without mandatory synchronized acquisition, offering a cost-effective solution for resource-limited regions and significantly improving HER2 assessment accessibility.