Breast cancer, a prevalent and diverse form of cancer, is characterized by unique clinicopathologic features. Accurate classification of its molecular subtype, essential for targeted treatment and improved survival rates, relies on testing molecular biomarkers such as estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and Ki67 antigen. This study introduces an innovative two-stage machine learning pipeline for breast cancer PR molecular biomarker classification using whole slide immunohistochemistry images. Our approach consists of two specialized stages. In the first stage, a watershed algorithm segments the Cells from the input image. Morphological and statistical features extracted from these segments are then used by machine learning classifiers to distinguish between tumor and nontumor tissues [1] –[3]. The second stage focuses on the tumor tissues that were identified in the first stage, extracting texture and appearance features to classify them into positive or negative biomarker responses, again using machine learning classifiers [4], [5]. This method not only automates the classification of PR biomarkers in tumor regions but also generates a detailed image map for each cell in the Whole Slide Image (WSI). By doing so, it can determine whether the tissue represents tumor cells and whether the tumor tissue exhibits positive or negative PR status. The results show the ability of our machine learning-based approach to augment pathologists’ diagnostic capabilities, offering significant advancements in the automated classification of histopathological images.

Breast cancer is a highly complex disease that requires precise molecular subtyping to guide tailored treatment strategies. In this study, we employed a marker-based watershed segmentation technique on a breast cancer dataset, enabling the extraction of essential morphometric parameters. These included area, perimeter, circularity, maximal and minimal calipers, and eccentricity, along with hematoxylin and diaminobenzidine (DAB) staining characteristics for individual cells, nuclei, and cytoplasm. We utilized Support Vector Machine (SVM) and Random Forest (RF) models to classify molecular biomarker response scores to identify their molecular subtypes, leveraging these extracted features as discriminative factors. The dataset comprised whole-slide images (WSI) annotated with Progestin Receptors (PR) molecular biomarker response scores, categorizing cell regions into different classes: "other", "tumor: negative", "tumor: +1", "tumor: +2", and "tumor: +3". These detailed annotations enhanced the AI-driven classification of breast cancer molecular biomarkers response score detection on cell level. Performance evaluation of the proposed framework demonstrated substantial classification accuracy, with SVM achieving over 93% in precision, recall, F1-score, and overall accuracy, while RF exceeded 96% across these metrics. The study's findings highlight the efficacy of integrating marker-based watershed segmentation with morphometric and staining analysis for precise breast cancer molecular biomarkers response score classification. This approach provides deeper insights into tumor heterogeneity, reinforcing the importance of incorporating morphometric and staining parameters in molecular biomarkers response score classification and hence improved personalized treatment and prognosis.

We propose a novel AI-based system for breast cancer (BCa) assessment to predict response to neoadjuvant chemotherapy (NAC) into one of three responses: Partial Response (PR), Complete Response (CR), and Stationary Disease (SD), providing a full insight for medical experts about treatment regimens. The proposed AI-based system integrates machine learning (ML) and deep learning (DL) approaches to incorporate both global and local markers for more accurate prediction. The ML approach, based on a decision tree model, learns patterns from global markers extracted through pathology assessments to determine molecular subtypes. This analysis incorporates four standard tests: ER, PR, HER2, and Ki-67. Additionally, it integrates global radiomics descriptors, including tumor morphology, lesion count, and radiologist assessments for axillary nodes (benign vs. suspicious). In addition to assessing global markers, we employed a pre-trained Vision Transformer (ViT-b16) with a multihead adaptive self-attention mechanism to extract local markers from the Region of Interest (ROI) around the breast tumor. This approach eliminates the need for segmentation, which could impact the accuracy of the local AI model’s prediction. The outputs of both models are fused using a GradientBoosting algorithm to predict the response to NAC. The proposed system was tested on 736 2D images along with their corresponding radiomics and pathological markers (CR = 156, PR = 353, and SD = 227). The developed AI-based system achieved an accuracy of 98.91%. Explainability was enabled through heatmaps which visually highlight areas with high attention for decision-making. These results demonstrate promising potential for AI-based early assessment in BCa management.

Breast cancer is a prevalent and diverse type of cancer that exhibits unique clinicopathologic characteristics, making the correct identification of its subtype critical to providing targeted treatment and increasing survival rates. This identification process involves testing for the presence of four key molecular biomarkers, namely estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 2 (HER2), and antigen Ki67. For accurate diagnosis ,the expertise of a pathologist and immunohistochemistry is required. To overcome this diagnostic challenge, we present a novel approach based on a deep learning pipeline for automated classification. Our approach can detect tumor and non-tumoral regions of the HER2 biomarker. Our deep learning framework comprises a Dense Convolutional Network (DenseNet), which process whole slide images (WSIs) of breast tissues, dividing them into patches for input into the network. Moreover, our approach provides both patchwise and pixelwise classification and analyzes ten WSIs of breast cancer histology. Our proposed approach generates an image map that classifies slide images on the pixel-level, detecting the status of hormone HER2 receptor as either positive or negative. The obtained results show that our deep learning-based approach has the potential to enhance the pathologist’s capabilities in diagnosing histopathological images with automated classification.