Abstract
Breast cancer (BC) remains the most common malignancy among women worldwide. One of the key priorities in combating this disease is early tumor detection, accurate interpretation, and identification of factors guiding optimal treatment selection. Current healthcare realities — including limited human resources, existing regulatory frameworks, and the need to process vast amounts of data — necessitate the development of novel, effective diagnostic tools for BC. In this context, the integration of high-performance technologies based on artificial intelligence (AI) into breast imaging is of paramount importance and relevance. Growing interest in this topic is reflected in the steadily increasing number of scientific publications, which has quadrupled over the past six years. However, the lack of widespread implementation of research findings into routine clinical practice underscores the need to assess the current state of the field, evaluate scientific output, and identify future prospects. This study aims to structure and systematize data from the scientific literature on the application of AI-based mathematical models for the analysis of conventional and multimodal breast imaging in determining the molecular biological subtype of BC, assessing tumor response to drug therapy, and addressing other diagnostic aspects that support a personalized approach to prognosis, treatment planning, and patient management. The most widely used and promising neural network models and training algorithms employed in recent years were analyzed. Their potential for developing unified approaches to integrating AI into the automation of multimodal BC diagnostics was evaluated. The findings enabled the identification of key trends in ongoing research and provided an indirect assessment of their potential effectiveness in predicting diagnostic and treatment scenarios for BC.
References
IARC. IARC Biennial Report 2022–2023. Lyon, France: International Agency for Research on Cancer. Licence: CC BY-NC-ND 3.0 IGO. 2023.-URL: https://publications.iarc.who.int/633.
Состояние онкологической помощи населению России в 2024 году. Под ред. Каприна А.Д., Старинского В.В., Шахзадовой А.О. Москва: МНИОИ им. П.А. Герцена – филиал ФГБУ «НМИЦ радиологии» Минздрава России. 2025; 275.-ISBN: 978-5-85502-309-1. [The state of cancer care in Russia in 2024. Edited by Kaprin A.D., Starinsky V.V., and Shakhzadova A.O. Moscow: P.A. Herzen Moscow Oncology Research Institute — branch of the National Medical Research Center of Radiology of the Ministry of Health of the Russian Federation. 2025; 275.-ISBN: 978-5-85502-309-1 (In Rus)].
Рожкова Н.И., Мазо М.Л., Бородина М.Е., et al. Медицинская логистика выявления рака молочной железы. Под ред. Каприна А.Д., Рожковой Н.И. Москва: ГЭОТАР-Медиа. 2024; 352.-EDN: ASRGMO.-ISBN: 978-5-9704-7805-9.-URL: https://elibrary.ru/asrgmo. [Rozhkova N.I., Mazo M.L., Borodina M.E., et al. Medical logistics of breast cancer detection. Ed. by Kaprin A.D., Rozhkova N.I. Moscow: GEOTAR-Media. 2024; 352.-EDN: ASRGMO.-ISBN: 978-5-9704-7805-9.-URL: https://elibrary.ru/asrgmo (In Rus)].
Xu K., You K., Zhu B., et al. Masked modeling-based ultrasound image classification via self-supervised learning. IEEE Open J Eng Med Biol. 2024; 5: 226-237.-DOI: https://doi.org/10.1109/OJEMB.2024.3374966.
Shoshan Y., Bakalo R., Gilboa-Solomon F., et al. Artificial intelligence for reducing workload in breast cancer screening with digital breast tomosynthesis. Radiology. 2022; 303(1): 69-77.-DOI: https://doi.org/10.1148/radiol.211105.
Braman N., Prasanna P., Whitney J., et al. Association of peritumoral radiomics with tumor biology and pathologic response to preoperative targeted therapy for HER2 (ERBB2)-positive breast cancer. JAMA Netw Open. 2019; 2(4): e192561.-DOI: https://doi.org/10.1001/jamanetworkopen.2019.2561.
Cui W., Wu Y., Guo Y., et al. Construction and evaluation of a multifactorial clinical model for discriminating benign and malignant breast tumors using LASSO algorithm based on retrospective cohort study. Am J Cancer Res. 2024; 14(12): 5628-5643.-DOI: https://doi.org/10.62347/ILIJ7959.
Tahmassebi A., Wengert G.J., Helbich T.H., et al. Impact of machine learning with multiparametric magnetic resonance imaging of the breast for early prediction of response to neoadjuvant chemotherapy and survival outcomes in breast cancer patients. Invest Radiol. 2019; 54(2): 110-117.-DOI: https://doi.org/10.1097/RLI.0000000000000518.
Cui X., Wang N., Zhao Y., et al. Preoperative prediction of axillary lymph node metastasis in breast Cancer using radiomics features of DCE- MRI. Sci Rep. 2019; 9(2240): 1-8.-DOI: https://doi.org/10.1038/s41598-019-38502-0.
Zhu Y., Yang L., Shen H. Value of the Application of CE-MRI radiomics and machine learning in preoperative prediction of sentinel lymph node metastasis in breast cancer. Front Oncol. 2021; 11: 757111.-DOI: https://doi.org/10.3389/fonc.2021.757111.
Lenga L., Bernatz S., Martin S.S., et al. Iodine map radiomics in breast cancer: Prediction of metastatic status. Cancers (Basel). 2021; 13(10): 2431.-DOI: https://doi.org/10.3390/cancers13102431.
Mall S., Brennan P.C, Mello-Thoms C., Can A. Machine learn from radiologists' visual search behaviour and their interpretation of mammograms-a deep-learning study. J Digit Imaging. 2019; 32(5): 746-760.-DOI: https://doi.org/10.1007/s10278-018-00174-z.
Li H., Mendel K.R., Lan L., et al. Digital mammography in breast Cancer: additive value of radiomics of breast parenchyma. Radiology. 2019; 291: 15-20.-DOI: https://doi.org/10.1148/radiol.2019181113.
Tsai HY., Kao YW., Wang JC., et al. Multitask deep learning on mammography to predict extensive intraductal component in invasive breast cancer. Eur Radiol. 2024; 34(4): 2593-260.-DOI: https://doi.org/10.1007/s00330-023-10254-6.
Xie T., Wang Z., Zhao Q., et al. Machine learning-based analysis of MR Multiparametric Radiomics for the subtype classification of breast Cancer. Front Oncol. 2019; (9): 9: 505.-DOI: https://doi.org/10.3389/fonc.2019.00505.
Whitney H.M., Taylor N.S., K. Drukker K., et al. Additive benefit of radiomics over size alone in the distinction between benign lesions and luminal a cancers on a large clinical breast MRI dataset. Acad Radiol. 2019; 26: 202-209.-DOI: https://doi.org/10.1016/j.acra.2018.04.019.
Hatamikia S., George G., Schwarzhans F., et al. Breast MRI radiomics and machine learning-based predictions of response to neoadjuvant chemotherapy - How are they affected by variations in tumor delineation? Comput Struct Biotechnol J. 2023; 23: 52-63.-DOI: https://doi.org/10.1016/j.csbj.2023.11.016.
Renard F., Guedria S., Palma N., Vuillerme N. Variability and reproducibility in deep learning for medical image segmentation. Sci Rep. 2020; 10: 13724.-DOI: https://doi.org/10.1038/s41598-020-69920-0.
Whitney H.M., Drukker K., Vieceli M., et al. Role of sureness in evaluating AI/CADx: Lesion-based repeatability of machine learning classification performance on breast MRI. Med Phys. 2024; 51(3): 1812-1821.-DOI: https://doi.org/10.1002/mp.16673.
Ma W., Zhao Y., Ji Y., Guo X., et al. Breast cancer molecular subtype prediction by mammographic radiomic features. Acad Radiol. 2019; 26: 196-201.-DOI: https://doi.org/10.1016/j.acra.2018.01.023.
Johnson K.S., Conat E.F., Soo M.S. Molecular subtypes of breast cancer: a review for breast radiologists. Breast Image. 2021; 3(1): 12-24.-DOI: https://doi.org/10.1093/jbi/wbaa110.
Romeo V., Cavaliere C., Imbriaco M., et al. Tumor segmentation analysis at different post-contrast time points: A possible source of variability of quantitative DCE-MRI parameters in locally advanced breast cancer. Eur J Radiol. 2020; 126: 108907.-DOI: https://doi.org/10.1016/j.ejrad.2020.108907.
Ma M., Liu R., Wen C., et al. Predicting the molecular subtype of breast cancer and identifying interpretable imaging features using machine learning algorithms. Eur Radiol. 2022; 32(3): 1652-1662.-DOI: https://doi.org/10.1007/s00330-021-08271-4.
Huang Y.T., Chen T.V., Chen L.Y., et al. The application of 18 F-FES PET in clinical cancer care: A systematic review. Clin Nucl Med. 2023; 48(9): 785-795.-DOI: https://doi.org/10.1097/RLU.0000000000004760.
Wang C., Zhao Y., Wan M., et al. Prediction of sentinel lymph node metastasis in breast cancer by using deep learning radiomics based on ultrasound images. Medicine (Baltimore). 2023; 102(44): e35868.-DOI: https://doi.org/10.1097/MD.0000000000035868.
Doran S.J., Kumar S., Orton M., et al. «Real-world» radiomics from multi-vendor MRI: an original retrospective study on the prediction of nodal status and disease survival in breast cancer, as an exemplar to promote discussion of the wider issues. Cancer Imaging. 2021; 21(1): 37.-DOI: https://doi.org/10.1186/s40644-021-00406-6.
Mao N., Yin P., Wang Q., et al. Added value of radiomics on mammography for breast cancer diagnosis: a feasibility study. J Am Coll Radiol. 2019; 16: 485-491.-DOI: https://doi.org/10.1016/j.jacr.2018.09.041.
Cristinacce P., Keaveney S., Aboagye E., et al. Clinical translation of quantitative magnetic resonance imaging biomarkers - An overview and gap analysis of current practice. Phys Med. 2022; 101: 165-182.-DOI: https://doi.org/10.1016/j.ejmp.2022.08.015.
Han C., Chen J., Hong M., et al. MRI radiomics for diagnosing small BI-RADS 4 breast lesions: an interpretable model. Quant Imaging Med Surg. 2025; 15(6): 5060-5072.-DOI: https://doi.org/10.21037/qims-24-1893.
Cain E.H., Saha A., Harowicz M.R., et al. Multivariate machine learning models for prediction of pathologic response to neoadjuvant therapy in breast cancer using MRI features: a study using an independent validation set. Breast Cancer Res Treat. 2019; 173(2): 455-463.-DOI: https://doi.org/10.1007/s10549-018-4990-9.
Petrillo A., Fusco R., Bernardo E., et al. Prediction of breast cancer histological outcome by radiomics and artificial intelligence analysis in contrast-enhanced mammography. Cancers (Basel). 2022; 4(9): 2132.-DOI: https://doi.org/10.3390/cancers14092132.
Zheng H., Jian L., Li L., et al. Clinico-radiological features informed multi-modal MR images convolution neural network: A novel deep learning framework for prediction of lymphovascular invasion in breast cancer. Cancer Med. 2024; 13(3): e6932.-DOI: https://doi.org/10.1002/cam4.6932.
Zheng X., Yao Z., Huang Y., et al. Deep learning radiomics can predict axillary lymph node status in early-stage breast cancer. Nat Commun. 2020; (1): 1236.-DOI: https://doi.org/10.1038/s41467-020-15027-z.
Li W., Partridge SC, Newitt D.C., Steingrimsson J., et al. Breast multiparametric MRI for prediction of neoadjuvant chemotherapy response in breast cancer: The BMMR2 challenge. Radiol Imaging Cancer. 2024; 6(1): e230033.-DOI: https://doi.org/10.1148/rycan.230033.
Jing X., Dorrius M.D., Zheng S., et al. Localization of contrast-enhanced breast lesions in ultrafast screening MRI using deep convolutional neural networks. Eur Radiol. 2024; 34(3): 2084-2092.-DOI: https://doi.org/10.1007/s00330-023-10184-3.
Castellote-Huguet P., Ruiz-Espana S., Galan-Auge C., et al. Breast cancer diagnosis using texture and shape features in MRI. Annu Int Conf IEEE Eng Med Biol Soc. 2023; 2023: 1-4.-DOI: https://doi.org/10.1109/EMBC40787.2023.10340385.
Ciobotaru A., Bota M.A, Goța D.I, Miclea L.C. Multi-Instance classification of breast tumor ultrasound images using convolutional neural networks and transfer learning. Bioengineering (Basel). 2023; 10(12): 1419.-DOI: https://doi.org/10.3390/bioengineering10121419.
O'Connell A.M., Bartolotta T.V., Orlando A., et al. Diagnostic performance of an artificial intelligence system in breast ultrasound. J Ultrasound Med. 2022; 41(1): 97-105.-DOI: https://doi.org/10.1002/jum.15684.
Chen Y., Chen S., Tang W., et al. Multiparametric MRI radiomics with machine learning for differentiating HER2-zero, -low, and -positive breast cancer: Model development, testing, and interpretability analysis. AJR Am J Roentgenol. 2025; 224(1): e2431717.-DOI: https://doi.org/10.2214/AJR.24.31717.
Huang G., Du S., Gao S., et al. Molecular subtypes of breast cancer identified by dynamically enhanced MRI radiomics: the delayed phase cannot be ignored. Insights Imaging. 2024; 15(1): 127.-DOI: https://doi.org/10.1186/s13244-024-01713-9.
Kayadibi Y., Kocak B., Ucar N., et al. Radioproteomics in breast cancer: Prediction of Ki-67 expression with MRI-based radiomic models. Acad Radiol. 2022; 29 Suppl 1: S116-S125.-DOI: https://doi.org/10.1016/j.acra.2021.02.001.
Lokaj B., Pugliese M.T., Kinkel K., et al. Barriers and facilitators of artificial intelligence conception and implementation for breast imaging diagnosis in clinical practice: a scoping review. Eur Radiol. 2024; 34(3): 2096-2109.-DOI: https://doi.org/10.1007/s00330-023-10181-6.
Мурашко М.А., Ваньков В.В., Панин А.И. et al. Внедрение технологий искусственного интеллекта в здравоохранении России: итоги 2024 г. Национальное здравоохранение. 2025; 6(3): 6-19.-EDN: OAKYDM.-DOI: https://doi.org/10.47093/2713-069X.2025.6.3.6-19. [Murashko M.A., Vankov V.V., Panin A.I., et al. Implementation of artificial intelligence technologies in Russian healthcare: results of 2024. National Healthcare. 2025; 6(3): 6-19.-EDN: OAKYDM.-DOI: https://doi.org/10.47093/2713-069X.2025.6.3.6-19 (In Rus)].

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