Discrimination between phyllodes tumor and fibro-adenoma: Does artificial intelligence-aided mammograms have an impact?

Abstract

Background: The indulgence of artificial intelligence (AI) has been considered recently in the work up for the detection and diagnosis of breast cancer through algorithms that could supply diagnosis as the radiologist do. The algorithm learns from a supervised and continuous input of large and new data sets unlike the standard programming, which requires clear step-by-step instructions. The aim of this study is to assess the ability of AI scanned mammograms to aid the ultrasound in the discrimination between phyllodes tumors and fibro-adenomas. Results: This is a retrospective analysis included 374 proven phyllodes tumors (PT) and fibro-adenomas (FA). Digital mammogram and breast ultrasound was performed for all the cases and each breast was given a “Breast Imaging Reporting and Data System” (BI-RADS) score. Included mammograms were scanned by AI with resultant a qualitative heatmap and a quantitative abnormality scoring of suspicion percentage. The study included 164 PT (43.9%) and 210 FA (56.1%). BI-RADS category 2 was assigned in 40.1%, category 3 in 38.2%, category 4 in 18.5% and category 5 in 3.2% with median value of the AI abnormality scoring of 23%, 44%, 65% and 90% respectively. Sensitivity and specificity of the conventional imaging were 59.2% and 75.8% respectively. The AI abnormality scoring of 49.5% upgraded the sensitivity to 89.6% and specificity to 94.8% in the ability to discriminate PT from FA masses. Conclusion: Artificial intelligence-aided mammograms could be used as method of distinction between PT from FA detected on sono-mammogram. The color hue and the quantification of the abnormality scoring percentage could be used as a one setting method for specification and so guide clinicians in their decision of conservative management or the choice of the surgical procedure.