Improving classification with forced labeling of other related classes: Application to prediction of upstaged ductal carcinoma in situ using mammographic features

Rui Hou, Bibo Shi, Lars J. Grimm, MacIej A. Mazurowski, Jeffrey R. Marks, Lorraine M. King, Carlo Maley, E. Shelley Hwang, Joseph Y. Lo

Research output: Chapter in Book/Report/Conference proceedingConference contribution

1 Scopus citations


Predicting whether ductal carcinoma in situ (DCIS) identified at core biopsy contains occult invasive disease is an import task since these "upstaged" cases will affect further treatment planning. Therefore, a prediction model that better classifies pure DCIS and upstaged DCIS can help avoid overtreatment and overdiagnosis. In this work, we propose to improve this classification performance with the aid of two other related classes: Atypical Ductal Hyperplasia (ADH) and Invasive Ductal Carcinoma (IDC). Our data set contains mammograms for 230 cases. Specifically, 66 of them are ADH cases; 99 of them are biopsy-proven DCIS cases, of whom 25 were found to contain invasive disease at the time of definitive surgery. The remaining 65 cases were diagnosed with IDC at core biopsy. Our hypothesis is that knowledge can be transferred from training with the easier and more readily available cases of benign but suspicious ADH versus IDC that is already apparent at initial biopsy. Thus, embedding both ADH and IDC cases to the classifier will improve the performance of distinguishing upstaged DCIS from pure DCIS. We extracted 113 mammographic features based on a radiologist's annotation of clusters.Our method then added both ADH and IDC cases during training, where ADH were "force labeled" or treated by the classifier as pure DCIS (negative) cases, and IDC were labeled as upstaged DCIS (positive) cases. A logistic regression classifier was built based on the designed training dataset to perform a prediction of whether biopsy-proven DCIS cases contain invasive cancer. The performance was assessed by repeated 5-fold CrossValidation and Receiver Operating Characteristic(ROC) curve analysis. While prediction performance with only training on DCIS dataset had an average AUC of 0.607(%95CI, 0.479-0.721). By adding both ADH and IDC cases for training, we improved the performance to 0.691(95%CI, 0.581-0.801).

Original languageEnglish (US)
Title of host publicationMedical Imaging 2018
Subtitle of host publicationComputer-Aided Diagnosis
EditorsKensaku Mori, Nicholas Petrick
ISBN (Electronic)9781510616394
StatePublished - 2018
EventMedical Imaging 2018: Computer-Aided Diagnosis - Houston, United States
Duration: Feb 12 2018Feb 15 2018

Publication series

NameProgress in Biomedical Optics and Imaging - Proceedings of SPIE
ISSN (Print)1605-7422


OtherMedical Imaging 2018: Computer-Aided Diagnosis
Country/TerritoryUnited States


  • ADH
  • Breast cancer
  • IDC
  • digital mammogram
  • ductal carcinoma in situ

ASJC Scopus subject areas

  • Electronic, Optical and Magnetic Materials
  • Atomic and Molecular Physics, and Optics
  • Biomaterials
  • Radiology Nuclear Medicine and imaging


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