# Longitudinal Mammogram Exam-based Breast Cancer Diagnosis Models: Vulnerability to Adversarial Attacks

arXiv: https://arxiv.org/abs/2411.00837 · HTML: https://mlsanity.com/paper/2411.00837/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 16 of its 26 references that are in the map.
- First posted on arXiv 29 Oct 2024.

## Builds on (most cited first, 16 of 16)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Very Deep Convolutional Networks for Large-Scale Image Recognition](https://mlsanity.com/paper/1409.1556/) (2014)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Distilling the Knowledge in a Neural Network](https://mlsanity.com/paper/1503.02531/) (2015)
- [Explaining and Harnessing Adversarial Examples](https://mlsanity.com/paper/1412.6572/) (2014)
- [Towards Deep Learning Models Resistant to Adversarial Attacks](https://mlsanity.com/paper/1706.06083/) (2017)
- [Intriguing properties of neural networks](https://mlsanity.com/paper/1312.6199/) (2013)
- [Towards Evaluating the Robustness of Neural Networks](https://mlsanity.com/paper/1608.04644/) (2016)
- [Adversarial examples in the physical world](https://mlsanity.com/paper/1607.02533/) (2016)
- [Reliable evaluation of adversarial robustness with an ensemble of diverse parameter-free attacks](https://mlsanity.com/paper/2003.01690/) (2020)
- [Adversarial Machine Learning at Scale](https://mlsanity.com/paper/1611.01236/) (2016)
- [Ensemble Adversarial Training: Attacks and Defenses](https://mlsanity.com/paper/1705.07204/) (2017)
- [CT-GAN: Malicious Tampering of 3D Medical Imagery using Deep Learning](https://mlsanity.com/paper/1901.03597/) (2019)
- [Boosting the Transferability of Adversarial Attacks with Global Momentum Initialization](https://mlsanity.com/paper/2211.11236/) (2022)
- [Enhancing Breast Cancer Risk Prediction by Incorporating Prior Images](https://mlsanity.com/paper/2303.15699/) (2023)
- [Adversarial Attack Based on Prediction-Correction](https://mlsanity.com/paper/2306.01809/) (2023)

## Abstract (arXiv)

In breast cancer detection and diagnosis, the longitudinal analysis of mammogram images is crucial. Contemporary models excel in detecting temporal imaging feature changes, thus enhancing the learning process over sequential imaging exams. Yet, the resilience of these longitudinal models against adversarial attacks remains underexplored. In this study, we proposed a novel attack method that capitalizes on the feature-level relationship between two sequential mammogram exams of a longitudinal model, guided by both cross-entropy loss and distance metric learning, to achieve significant attack efficacy, as implemented using attack transferring in a black-box attacking manner. We performed experiments on a cohort of 590 breast cancer patients (each has two sequential mammogram exams) in a case-control setting. Results showed that our proposed method surpassed several state-of-the-art adversarial attacks in fooling the diagnosis models to give opposite outputs. Our method remained effective even if the model was trained with the common defending method of adversarial training.