# BioFusionNet: Deep Learning-Based Survival Risk Stratification in ER+ Breast Cancer Through Multifeature and Multimodal Data Fusion

arXiv: https://arxiv.org/abs/2402.10717 · HTML: https://mlsanity.com/paper/2402.10717/

## Key facts

- Cited by 3 papers in the map (data through 14 Oct 2026).
- Builds on 9 of its 72 references that are in the map.
- First posted on arXiv 16 Feb 2024.

## Builds on (most cited first, 9 of 9)

- [Representation Learning with Contrastive Predictive Coding](https://mlsanity.com/paper/1807.03748/) (2018)
- [An Empirical Study of Training Self-Supervised Vision Transformers](https://mlsanity.com/paper/2104.02057/) (2021)
- [DeepSurv: Personalized Treatment Recommender System Using A Cox Proportional Hazards Deep Neural Network](https://mlsanity.com/paper/1606.00931/) (2016)
- [Pathomic Fusion: An Integrated Framework for Fusing Histopathology and Genomic Features for Cancer Diagnosis and Prognosis](https://mlsanity.com/paper/1912.08937/) (2019)
- [Benchmarking Self-Supervised Learning on Diverse Pathology Datasets](https://mlsanity.com/paper/2212.04690/) (2022)
- [A Petri Dish for Histopathology Image Analysis](https://mlsanity.com/paper/2101.12355/) (2021)
- [Self-Supervised Vision Transformers Learn Visual Concepts in Histopathology](https://mlsanity.com/paper/2203.00585/) (2022)
- [Multimodal fusion using sparse CCA for breast cancer survival prediction](https://mlsanity.com/paper/2103.05432/) (2021)
- [On-Device Document Classification using multimodal features](https://mlsanity.com/paper/2101.01880/) (2021)

## Built on by (most cited first, 3 of 3)

- [Navigating the landscape of multimodal AI in medicine: a scoping review on technical challenges and clinical applications](https://mlsanity.com/paper/2411.03782/) (2024)
- [Deep Survival Analysis in Multimodal Medical Data: A Parametric and Probabilistic Approach with Competing Risks](https://mlsanity.com/paper/2507.07804/) (2025)
- [A Systematic Review on the Generative AI Applications in Human Medical Genomics](https://mlsanity.com/paper/2508.20275/) (2025)

## Abstract (arXiv)

Breast cancer is a significant health concern affecting millions of women worldwide. Accurate survival risk stratification plays a crucial role in guiding personalised treatment decisions and improving patient outcomes. Here we present BioFusionNet, a deep learning framework that fuses image-derived features with genetic and clinical data to obtain a holistic profile and achieve survival risk stratification of ER+ breast cancer patients. We employ multiple self-supervised feature extractors (DINO and MoCoV3) pretrained on histopathological patches to capture detailed image features. These features are then fused by a variational autoencoder and fed to a self-attention network generating patient-level features. A co-dual-cross-attention mechanism combines the histopathological features with genetic data, enabling the model to capture the interplay between them. Additionally, clinical data is incorporated using a feed-forward network, further enhancing predictive performance and achieving comprehensive multimodal feature integration. Furthermore, we introduce a weighted Cox loss function, specifically designed to handle imbalanced survival data, which is a common challenge. Our model achieves a mean concordance index of 0.77 and a time-dependent area under the curve of 0.84, outperforming state-of-the-art methods. It predicts risk (high versus low) with prognostic significance for overall survival in univariate analysis (HR=2.99, 95% CI: 1.88--4.78, p<0.005), and maintains independent significance in multivariate analysis incorporating standard clinicopathological variables (HR=2.91, 95% CI: 1.80--4.68, p<0.005).