Evidence map›Paper›PMID 29899550›Full record

ArticleModern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc2018

Using deep convolutional neural networks to identify and classify tumor-associated stroma in diagnostic breast biopsies.

Babak Ehteshami Bejnordi, Maeve Mullooly, Ruth M Pfeiffer, Shaoqi Fan, Pamela M Vacek, Donald L Weaver, Sally Herschorn, Louise A Brinton, Bram van Ginneken, Nico Karssemeijer and 4 more

Open access · bronzeAbstract read
In one paragraph

Article in Modern pathology : an official journal of the United States and Canadian Academy of Pathology, Inc, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 91 papers.

0numbers the graph read from it
0cells of the map it votes in
91citing papers in PubMed
17.1field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

91 citing papers in PubMed, 214 citations in OpenAlex.

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31 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 6 institutions in 2 countries.

Babak Ehteshami BejnordiDiagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.ORCID http://orcid.org/0000-0002-6258-5687
Maeve MulloolyDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Ruth M PfeifferDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Shaoqi FanDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Pamela M VacekDepartment of Medical Biostatistics, University of Vermont, Burlington, VT, USA.
Donald L WeaverDepartment of Pathology, University of Vermont, Burlington, VT, USA.
Sally HerschornUniversity of Vermont Cancer Center, Burlington, VT, USA.
Louise A BrintonDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Bram van GinnekenDiagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Nico KarssemeijerDiagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands.
Andrew H BeckBeth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
Gretchen L GierachDivision of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA.
Jeroen A W M van der LaakDiagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands. Jeroen.vanderLaak@radboudumc.nl.ORCID http://orcid.org/0000-0001-7982-0754
Mark E ShermanMayo Clinic, Jacksonville, FL, USA.
National Cancer Institute · USRadboud University Nijmegen · NLBeth Israel Deaconess Medical Center · USUniversity of Vermont · USUniversity of Vermont Medical Center · USWinnMed · US

Funding

Hormone-Related CancersZIACP010126 · NCI · DIVISION OF CANCER EPIDEMIOLOGY AND GENETICS · PI GIERACH, GRETCHEN · 2009 to 2025
$103.5M
Vermont Breast Cancer Molecular Characterization LaboratoryU01CA196383 · NCI · UNIVERSITY OF VERMONT & ST AGRIC COLLEGE · PI SPRAGUE, BRIAN L, STEIN, JANET L · 2015 to 2020
$5.4M
Intramural NIH HHS ZIA CP010126NCI NIH HHS U01 CA196383
6 · The paper itself

Abstract

The breast stromal microenvironment is a pivotal factor in breast cancer development, growth and metastases. Although pathologists often detect morphologic changes in stroma by light microscopy, visual classification of such changes is subjective and non-quantitative, limiting its diagnostic utility. To gain insights into stromal changes associated with breast cancer, we applied automated machine learning techniques to digital images of 2387 hematoxylin and eosin stained tissue sections of benign and malignant image-guided breast biopsies performed to investigate mammographic abnormalities among 882 patients, ages 40-65 years, that were enrolled in the Breast Radiology Evaluation and Study of Tissues (BREAST) Stamp Project. Using deep convolutional neural networks, we trained an algorithm to discriminate between stroma surrounding invasive cancer and stroma from benign biopsies. In test sets (928 whole-slide images from 330 patients), this algorithm could distinguish biopsies diagnosed as invasive cancer from benign biopsies solely based on the stromal characteristics (area under the receiver operator characteristics curve = 0.962). Furthermore, without being trained specifically using ductal carcinoma in situ as an outcome, the algorithm detected tumor-associated stroma in greater amounts and at larger distances from grade 3 versus grade 1 ductal carcinoma in situ. Collectively, these results suggest that algorithms based on deep convolutional neural networks that evaluate only stroma may prove useful to classify breast biopsies and aid in understanding and evaluating the biology of breast lesions.

Indexed as

Deep LearningTumor MicroenvironmentAdultAgedBiopsyBreast NeoplasmsFemaleHumansMiddle Aged

Identifiers

PMID29899550
PMCPMC6752036
OpenAlexW2808210572

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.