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.

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.