Invasive ductal carcinoma (IDC) is the most prevalent form of breast cancer, and early, accurate diagnosis is critical to improving patient survival rates by guiding treatment decisions. Combining medical expertise with artificial intelligence (AI) holds significant promise for enhancing the precision and efficiency of IDC detection. In this work, we propose a human-in-the-loop (HITL) deep learning system designed to detect IDC in histopathology images. The system begins with an initial diagnosis provided by a high-performance EfficientNetV2S model, offering feedback from AI to the human expert. Medical professionals then review the AI-generated results, correct any misclassified images, and integrate the revised labels into the training dataset, forming a feedback loop from the human back to the AI. This iterative process refines the model's performance over time. The EfficientNetV2S model itself achieves state-of-the-art performance compared to existing methods in the literature, with an overall accuracy of 93.65\%. Incorporating the human-in-the-loop system further improves the model's accuracy using four experimental groups with misclassified images. These results demonstrate the potential of this collaborative approach to enhance AI performance in diagnostic systems. This work contributes to advancing automated, efficient, and highly accurate methods for IDC detection through human-AI collaboration, offering a promising direction for future AI-assisted medical diagnostics.

Large language models (LLMs) have shown remarkable progress in encoding clinical knowledge and responding to complex medical queries with appropriate clinical reasoning. However, their applicability in subspecialist or complex medical settings remains underexplored. In this work, we probe the performance of AMIE, a research conversational diagnostic AI system, in the subspecialist domain of breast oncology care without specific fine-tuning to this challenging domain. To perform this evaluation, we curated a set of 50 synthetic breast cancer vignettes representing a range of treatment-naive and treatment-refractory cases and mirroring the key information available to a multidisciplinary tumor board for decision-making (openly released with this work). We developed a detailed clinical rubric for evaluating management plans, including axes such as the quality of case summarization, safety of the proposed care plan, and recommendations for chemotherapy, radiotherapy, surgery and hormonal therapy. To improve performance, we enhanced AMIE with the inference-time ability to perform web search retrieval to gather relevant and up-to-date clinical knowledge and refine its responses with a multi-stage self-critique pipeline. We compare response quality of AMIE with internal medicine trainees, oncology fellows, and general oncology attendings under both automated and specialist clinician evaluations. In our evaluations, AMIE outperformed trainees and fellows demonstrating the potential of the system in this challenging and important domain. We further demonstrate through qualitative examples, how systems such as AMIE might facilitate conversational interactions to assist clinicians in their decision making. However, AMIE's performance was overall inferior to attending oncologists suggesting that further research is needed prior to consideration of prospective uses.

To evaluate the use of artificial intelligence (AI) to shorten digital breast tomosynthesis (DBT) reading time while maintaining or improving accuracy. A deep learning AI system was developed to identify suspicious soft-tissue and calcified lesions in DBT images. A reader study compared the performance of 24 radiologists (13 of whom were breast subspecialists) reading 260 DBT examinations (including 65 cancer cases) both with and without AI. Readings occurred in two sessions separated by at least 4 weeks. Area under the receiver operating characteristic curve (AUC), reading time, sensitivity, specificity, and recall rate were evaluated with statistical methods for multireader, multicase studies. Radiologist performance for the detection of malignant lesions, measured by mean AUC, increased 0.057 with the use of AI (95% confidence interval [CI]: 0.028, 0.087; P .01), Reading time decreased 52.7% (95% CI: 41.8%, 61.5%; P .01), Sensitivity increased from 77.0% without AI to 85.0% with AI (8.0%; 95% CI: 2.6%, 13.4%; P .01), The concurrent use of an accurate DBT AI system was found to improve cancer detection efficacy in a reader study that demonstrated increases in AUC, sensitivity, and specificity and a reduction in recall rate and reading time. See also the commentary by Hsu and Hoyt in this issue. Reading times were significantly reduced, and sensitivity, specificity, and recall rate improved in a nonclinical reader study when an artificial intelligence system was utilized concurrently with image interpretation for digital breast tomosynthesis.

Rationale and objectives: This study aimed to determine whether mammographic features assessed by radiologists and using computer algorithms are prognostic of occult invasive disease for patients showing ductal carcinoma in situ (DCIS) only in core biopsy. Materials and methods: In this retrospective study, we analyzed data from 99 subjects with DCIS (74 pure DCIS, 25 DCIS with occult invasion). We developed a computer-vision algorithm capable of extracting 113 features from magnification views in mammograms and combining these features to predict whether a DCIS case will be upstaged to invasive cancer at the time of definitive surgery. In comparison, we also built predictive models based on physician-interpreted features, which included histologic features extracted from biopsy reports and Breast Imaging Reporting and Data System-related mammographic features assessed by two radiologists. The generalization performance was assessed using leave-one-out cross validation with the receiver operating characteristic curve analysis.

Objective To examine the accuracy of artificial intelligence (AI) for the detection of breast cancer in mammography screening practice. Design Systematic review of test accuracy studies. Data sources Medline, Embase, Web of Science, and Cochrane Database of Systematic Reviews from 1 January 2010 to 17 May 2021. Eligibility criteria Studies reporting test accuracy of AI algorithms, alone or in combination with radiologists, to detect cancer in women’s digital mammograms in screening practice, or in test sets. Reference standard was biopsy with histology or follow-up (for screen negative women). Outcomes included test accuracy and cancer type detected. Study selection and synthesis Two reviewers independently assessed articles for inclusion and assessed the methodological quality of included studies using the QUality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. A single reviewer extracted data, which were checked by a second reviewer. Narrative data synthesis was performed. Results Twelve studies totalling 131 822 screened women were included. No prospective studies measuring test accuracy of AI in screening practice were found. Studies were of poor methodological quality. Three retrospective studies compared AI systems with the clinical decisions of the original radiologist, including 79 910 women, of whom 1878 had screen detected cancer or interval cancer within 12 months of screening. Thirty four (94%) of 36 AI systems evaluated in these studies were less accurate than a single radiologist, and all were less accurate than consensus of two or more radiologists. Five smaller studies (1086 women, 520 cancers) at high risk of bias and low generalisability to the clinical context reported that all five evaluated AI systems (as standalone to replace radiologist or as a reader aid) were more accurate than a single radiologist reading a test set in the laboratory. In three studies, AI used for triage screened out 53%, 45%, and 50% of women at low risk but also 10%, 4%, and 0% of cancers detected by radiologists. Conclusions Current evidence for AI does not yet allow judgement of its accuracy in breast cancer screening programmes, and it is unclear where on the clinical pathway AI might be of most benefit. AI systems are not sufficiently specific to replace radiologist double reading in screening programmes. Promising results in smaller studies are not replicated in larger studies. Prospective studies are required to measure the effect of AI in clinical practice. Such studies will require clear stopping rules to ensure that AI does not reduce programme specificity. Study registration Protocol registered as PROSPERO CRD42020213590. No additional data available.

Invasive ductal carcinoma is a prevalent, potentially deadly disease associated with a high rate of morbidity and mortality. Its malignancy is the second leading cause of death from cancer in women. The mammogram is an extremely useful resource for mass detection and invasive ductal carcinoma diagnosis. We are proposing a method for Invasive ductal carcinoma that will use convolutional neural networks (CNN) on mammograms to assist radiologists in diagnosing the disease. Due to the varying image clarity and structure of certain mammograms, it is difficult to observe major cancer characteristics such as microcalcification and mass, and it is often difficult to interpret and diagnose these attributes. The aim of this study is to establish a novel method for fully automated feature extraction and classification in invasive ductal carcinoma computer-aided diagnosis (CAD) systems. This article presents a tumor classification algorithm that makes novel use of convolutional neural networks on breast mammogram images to increase feature extraction and training speed. The algorithm makes two contributions.

Case in point: recently, a team of researchers at the University of California Los Angeles (UCLA) developed an AI model that was better at differentiating between "preinvasive lesions of the breast" -- abnormal growths in breast cells -- than doctors with years of experience. They published their findings in the JAMA Network Open, a science journal, on 9 August. Machine learning is the capacity of a machine to learn from its mistakes, just like people do. Machines are also able to compute and assess different scenarios much faster, and more accurately than people. Incorrect breast cancer diagnoses are still quite common, leading to anxiety and depression in women.

New research at Case Western Reserve University could help better determine which patients diagnosed with the pre-malignant breast cancer commonly referred to as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone. Once a lumpectomy of breast tissue reveals this pre-cancerous tumor, most women have surgery to remove the remainder of the affected tissue and some are given radiation therapy as well, said Anant Madabhushi, the F. Alex Nason Professor II of Biomedical Engineering at the Case School of Engineering. "Current testing places patients in high risk, low risk and indeterminate risk--but then treats those indeterminates with radiation, anyway," said Madabhushi, whose Center for Computational Imaging and Personalized Diagnostics (CCIPD) conducted the new research. "They err on the side of caution, but we're saying that it appears that it should go the other way--the middle should be classified with the lower risk. "In short, we're probably overtreating patients," Madabhushi continued.

To determine whether deep learning-based algorithms applied to breast MR images can aid in the prediction of occult invasive disease following the diagnosis of ductal carcinoma in situ (DCIS) by core needle biopsy. The data was collected from 2000 to 2014. In this institutional review board-approved study, we analyzed dynamic contrast-enhanced fat-saturated T1-weighted MRI sequences from 131 patients with a core needle biopsy-confirmed diagnosis of DCIS. We explored two different deep learning approaches to predict whether there was an occult invasive component in the analyzed tumors that was ultimately identified at surgical excision. In the first approach, we adopted the transfer learning strategy.

UCLA researchers have developed an artificial intelligence system that could help pathologists read biopsies more accurately and to better detect and diagnose breast cancer. The new system, described in a study published today in JAMA Network Open, helps interpret medical images used to diagnose breast cancer that can be difficult for the human eye to classify, and it does so nearly as accurately or better as experienced pathologists. "It is critical to get a correct diagnosis from the beginning so that we can guide patients to the most effective treatments," said Dr. Joann Elmore, the study's senior author and a professor of medicine at the David Geffen School of Medicine at UCLA. A 2015 study led by Elmore found that pathologists often disagree on the interpretation of breast biopsies, which are performed on millions of women each year. That earlier research revealed that diagnostic errors occurred in about one out of every six women who had ductal carcinoma in situ (a noninvasive type of breast cancer), and that incorrect diagnoses were given in about half of the biopsy cases of breast atypia (abnormal cells that are associated with a higher risk for breast cancer).