Predicting Breast Cancer Events in Ductal Carcinoma In Situ (DCIS) using Generative Adversarial Network Augmented Deep Learning Model

Standard clinicopathological parameters (age, growth pattern, tumor size, margin status and grade) have been shown to have limited value in predicting recurrence in ductal carcinoma in situ (DCIS) patients. Early and accurate recurrence prediction would facilitate a more aggressive treatment policy for high-risk patients (mastectomy or adjuvant radiation therapy), and simultaneously reduce over-treatment of low-risk patients. Generative adversarial networks (GAN) are a class of DL models in which two adversarial neural networks, generator and discriminator, compete with each other to generate high quality images. In this work, we have developed a deep learning (DL) classification network that predicts breast cancer events (BCEs) in DCIS patients using hematoxylin and eosin (H&E) images. The DL classification model was trained on 67 patients using image patches from the actual DCIS cores and GAN generated image patches to predict breast cancer events (BCEs). The hold-out validation dataset (n= 66) had an AUC of 0.82. Bayesian analysis further confirmed the independence of the model from classical clinico-pathological parameters. DL models of H&E images may be used as a risk stratification strategy for DCIS patients to personalize therapy. Simple Summary Ductal carcinoma in situ (DCIS) patients have an excellent overall survival rate and over-treatment is always a cause for concern due to potential side-effects. Standard clinicopathological parameters have limited value in predicting breast cancer events (BCEs) and stratification of high and low risk patients. Herein, we have developed a deep learning (DL) classification framework to predict BCEs in DCIS patients. A generative adversarial network (GAN) augmented deep learning (DL) classification of histological features associated with aggressive disease was trained on hematoxylin and eosin (H&E) tissue microarray (TMA) images of DCIS to predict BCEs. The area under the curve (AUC) for BCE’s in the validation set was 0.82. Early and accurate prediction of DCIS BCEs would facilitate a personalized approach to therapy.