Abstract 184: The utility of deep metric learning for breast cancer identification on mammographic images
Authors: Du Justin , Umrao Sachin , Chang Enoch , Joel Marina , Gilson Aidan , Janda Guneet , Choi Rachel , Hui Yongfeng , Aneja Sanjay 
Published: July 2021

Abstract
Purpose: Although deep learning (DL) models have shown increasing ability to accurately classify diagnostic images in oncology, significantly large amounts of well-curated data are often needed to match human level performance. Given the relative paucity of imaging datasets for less prevalent cancer types, there is an increasing need for methods which can improve the performance of deep learning models trained using limited diagnostic images. Deep metric learning (DML) is a potential method which can improve accuracy in deep learning models trained on limited datasets. Leveraging a triplet-loss function, DML exponentially increases training data compared to a traditional DL model. In this study, we investigated the utility of DML to improve the accuracy of DL models trained to classify cancerous lesions found on screening mammograms.
Methods: Using a dataset of 2620 lesions found on routine screening mammogram, we trained both a traditional DL and DML models to classify suspicious lesions as cancerous or benign. The VGG16 architecture was used as the basis for the DL and DML models. Model performance was compared by calculating model accuracy, sensitivity, and specificity on a blinded test set of 378 lesions. In addition to individual model performance, we also measured agreement accuracy when both the DL and DML models were combined. Sub-analyses were conducted to identify phenotypes which were best suited for each model type. Both models underwent hyperparameters optimization to identify ideal batch size, learning rate, and regularization to prevent overfitting.
Results: We found that the combination of the traditional DL model with DML model resulted in the highest overall accuracy (78.7%) representing a 7.1% improvement compared to the traditional DL model (p&lt;.001). Alone, the traditional DL model had an improved accuracy compared to the DML model (71.4% vs 66.4%). The traditional DL model had a higher sensitivity (94.8% vs 73.6 %) , but lower specificity (34.7% vs 55.1%) compared the DML model. Sub-analyses suggested the traditional DL model was more accurate on higher density breasts, whereas the DML model was more accurate on lower density breasts. Additionally, the traditional DL model had the highest accuracy on oval shaped lesions, compared to the DML model which was most accurate on irregularly shaped breast lesions.
Conclusion: Our study suggests that addition of DML models with traditional DL models can improve diagnostic image classification performance in cancer. Our results suggest DML models may provide increased specificity and help with classification of unique populations often misclassified by traditional DL models. Further studied investigating the utility of DML on other cancer imaging tasks are necessary to successfully build more robust DL models in cancer imaging.
Citation Format: Justin Du, Sachin Umrao, Enoch Chang, Marina Joel, Aidan Gilson, Guneet Janda, Rachel Choi, Yongfeng Hui, Sanjay Aneja. The utility of deep metric learning for breast cancer identification on mammographic images [abstract]. In: Proceedings of the American Association for Cancer Research Annual Meeting 2021; 2021 Apr 10-15 and May 17-21. Philadelphia (PA): AACR; Cancer Res 2021;81(13_Suppl):Abstract nr 184.