Feature fusion Siamese network for breast cancer detection comparing current and prior mammograms

Purpose Automatic detection of very small and nonmass abnormalities from mammogram images has remained challenging. In clinical practice for each patient, radiologists commonly not only screen the mammogram images obtained during the examination, but also compare them with previous mammogram images to make a clinical decision. To design an artificial intelligence (AI) system to mimic radiologists for better cancer detection, in this work we proposed an end-to-end enhanced Siamese convolutional neural network to detect breast cancer using previous year and current year mammogram images. Methods The proposed Siamese-based network uses high-resolution mammogram images and fuses features of pairs of previous year and current year mammogram images to predict cancer probabilities. The proposed approach is developed based on the concept of one-shot learning that learns the abnormal differences between current and prior images instead of abnormal objects, and as a result can perform better with small sample size data sets. We developed two variants of the proposed network. In the first model, to fuse the features of current and previous images, we designed an enhanced distance learning network that considers not only the overall distance, but also the pixel-wise distances between the features. In the other model, we concatenated the features of current and previous images to fuse them. Results We compared the performance of the proposed models with those of some baseline models that use current images only (ResNet and VGG) and also use current and prior images (long short-term memory [LSTM] and vanilla Siamese) in terms of accuracy, sensitivity, precision, F1 score, and area under the curve (AUC). Results show that the proposed models outperform the baseline models and the proposed model with the distance learning network performs the best (accuracy: 0.92, sensitivity: 0.93, precision: 0.91, specificity: 0.91, F1: 0.92 and AUC: 0.95). Conclusions Integrating prior mammogram images improves automatic cancer classification, specially for very small and nonmass abnormalities. For classification models that integrate current and prior mammogram images, using an enhanced and effective distance learning network can advance the performance of the models.