{rfName}
Va

Licencia y uso

Licencia Icono OpenAccess

Investigadores/as Institucionales

Naranjo, ValeryAutor o CoautorMorales-Martinez, SandraAutor o Coautor

Compartir

23 de octubre de 2025
Publicaciones
>
Artículo

Validation of an Artificial Intelligence Model for Breast Cancer Molecular Subtyping Using Hematoxylin and Eosin-Stained Whole-Slide Images in a Population-Based Cohort

Publicado en: Cancers. 17 (19): 1-13 - 2025-01-01 17(19), DOI: 10.3390/cancers17193234

Autores:

Kiraz, Umay; Fernández-Martín, Claudio; Rewcastle, Emma; Gudlaugsson, Einar G.; Skaland, Ivar; Naranjo Ornedo, Valeriana; Morales, Sandra; Janssen, Emiel A. M.
[+]

Afiliaciones

Griffith Univ, Inst Biomed & Glyc, Southport, Qld 4215, Australia - Autor o Coautor
Stavanger Univ Hosp, Dept Pathol, N-4011 Stavanger, Norway - Autor o Coautor
Univ Politecn Valencia, HUMAN Tech, Inst Univ Invest Tecnol Centrada Ser Humano, Valencia 46022, Spain - Autor o Coautor
Univ Stavanger, Dept Chem Biosci & Environm Engn, N-4021 Stavanger, Norway - Autor o Coautor
Ver más

Resumen

Simple Summary Breast cancer is a complex disease that can be classified into different biological subtypes. Correctly identifying these subtypes is essential in determining the most effective treatment for each patient. However, current methods such as gene expression testing and immunohistochemistry are either expensive, time-consuming, or not widely available in all healthcare settings. In this study, we explored whether a computer-based approach using artificial intelligence can accurately predict breast cancer subtypes by analyzing routine pathology slides stained with hematoxylin and eosin. This real-world validation study shows that this method can identify certain subtypes with promising accuracy, offering a faster and more accessible alternative to existing techniques. This research may help improve diagnostic processes, especially in hospitals with limited resources, and support more personalized treatment decisions for patients with breast cancer.Abstract Background/Objectives: Breast cancer (BC) is the most commonly diagnosed cancer in women and the leading cause of cancer-related deaths globally. Molecular subtyping is crucial for prognosis and treatment planning, with immunohistochemistry (IHC) being the most commonly used method. However, IHC has limitations, including observer variability, a lack of standardization, and a lack of reproducibility. Gene expression profiling is considered the ground truth for molecular subtyping; unfortunately, this is expensive and inaccessible to many institutions. This study investigates the potential of an artificial intelligence (AI) model to predict BC molecular subtypes directly from hematoxylin and eosin (H&E)-stained whole-slide images (WSIs). Methods: A pretrained deep learning framework based on multiple-instance learning (MIL) was validated on the Stavanger Breast Cancer (SBC) dataset, consisting of 538 BC cases. Three classification tasks were assessed, including two-class [triple negative BC (TNBC) vs. non-TNBC], three-class (luminal vs. HER2-positive vs. TNBC), and four-class (luminal A vs. luminal B vs. HER2-positive vs. TNBC) groups. Performance metrics were used for the evaluation of the AI model. Results: The AI model demonstrated strong performance in distinguishing TNBC from non-TNBC (AUC = 0.823, accuracy = 0.833, F1-score = 0.824). However, performance declined with an increasing number of classes. Conclusions: The study highlights the potential of AI in BC molecular subtyping from H&E WSIs, offering an easily applicable and standardized method to IHC. Future improvements should focus on optimizing multi-class classification and validating AI-based methods against gene expression analyses for enhanced clinical applicability.
[+]

Palabras clave

Breast cancerComputational pathologyDeep learningHematoxylin and eosin-stainedMolecular subtype predictionWhole-slide images

Indicios de calidad

Impacto bibliométrico. Análisis de la aportación y canal de difusión

El trabajo ha sido publicado en la revista Cancers debido a la progresión y el buen impacto que ha alcanzado en los últimos años, según la agencia Scopus (SJR), se ha convertido en una referencia en su campo. En el año de publicación del trabajo, 2025, se encontraba en la posición , consiguiendo con ello situarse como revista Q1 (Primer Cuartil), en la categoría Oncology.

[+]

Impacto y visibilidad social

Es fundamental presentar evidencias que respalden la plena alineación con los principios y directrices institucionales en torno a la Ciencia Abierta y la Conservación y Difusión del Patrimonio Intelectual. Un claro ejemplo de ello es:

  • El trabajo se ha enviado a una revista cuya política editorial permite la publicación en abierto Open Access.
[+]

Análisis de liderazgo de los autores institucionales

Este trabajo se ha realizado con colaboración internacional, concretamente con investigadores de: Australia; Norway.

[+]

Reconocimientos ligados al ítem

This work was funded by the Horizon 2020 European Union research and innovation program under the Marie Sklodowska Curie grant agreement No 860627 (CLARIFY Project). This work was partially funded by Ayuda a Primeros Proyectos de Investigacion (PAID-06-23), Vicerrectorado de Investigacion of the Universitat Politecnica de Valencia.
[+]