Breast cancer classification based on breast tissue structures using the Jigsaw puzzle task in self-supervised learning

Self-supervised learning (SSL) has gained attention in the medical field as a deep learning approach utilizing unlabeled data. The Jigsaw puzzle task in SSL enables models to learn both features of images and the positional relationships within images. In breast cancer diagnosis, radiologists evaluate not only lesion-specific features but also the surrounding breast structures. However, deep learning models that adopt a diagnostic approach similar to human radiologists are still limited. This study aims to evaluate the effectiveness of the Jigsaw puzzle task in characterizing breast tissue structures for breast cancer classification on mammographic images. Using the Chinese Mammography Database (CMMD), we compared four pre-training pipelines: (1) IN-Jig, pre-trained with both the ImageNet classification task and the Jigsaw puzzle task, (2) Scratch-Jig, pre-trained only with the Jigsaw puzzle task, (3) IN, pre-trained only with the ImageNet classification task, and (4) Scratch, that is trained from random initialization without any pre-training tasks. All pipelines were fine-tuned using binary classification to distinguish between the presence or absence of breast cancer. Performance was evaluated based on the area under the receiver operating characteristic curve (AUC), sensitivity, and specificity. Additionally, detailed analysis was conducted for performance across different radiological findings, breast density, and regions of interest were visualized using gradient-weighted class activation mapping (Grad-CAM). The AUC for the four models were 0.925, 0.921, 0.918, 0.909, respectively. Our results suggest the Jigsaw puzzle task is an effective pre-training method for breast cancer classification, with the potential to enhance diagnostic accuracy with limited data.