# Towards Affordable Tumor Segmentation and Visualization for 3D Breast MRI Using SAM2

arXiv: https://arxiv.org/abs/2507.23272 · HTML: https://mlsanity.com/paper/2507.23272/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 15 of its 27 references that are in the map.
- First posted on arXiv 31 Jul 2025.

## Builds on (most cited first, 15 of 15)

- [SAM 2: Segment Anything in Images and Videos](https://mlsanity.com/paper/2408.00714/) (2024)
- [TransUNet: Transformers Make Strong Encoders for Medical Image Segmentation](https://mlsanity.com/paper/2102.04306/) (2021)
- [UNETR: Transformers for 3D Medical Image Segmentation](https://mlsanity.com/paper/2103.10504/) (2021)
- [XMem: Long-Term Video Object Segmentation with an Atkinson-Shiffrin Memory Model](https://mlsanity.com/paper/2207.07115/) (2022)
- [A Comprehensive Survey on Pretrained Foundation Models: A History from BERT to ChatGPT](https://mlsanity.com/paper/2302.09419/) (2023)
- [Pre-Trained Models: Past, Present and Future](https://mlsanity.com/paper/2106.07139/) (2021)
- [nnU-Net: Self-adapting Framework for U-Net-Based Medical Image Segmentation](https://mlsanity.com/paper/1809.10486/) (2018)
- [Medical SAM 2: Segment medical images as video via Segment Anything Model 2](https://mlsanity.com/paper/2408.00874/) (2024)
- [Foundational Models Defining a New Era in Vision: A Survey and Outlook](https://mlsanity.com/paper/2307.13721/) (2023)
- [MedSAM2: Segment Anything in 3D Medical Images and Videos](https://mlsanity.com/paper/2504.03600/) (2025)
- [A large-scale multicenter breast cancer DCE-MRI benchmark dataset with expert segmentations](https://mlsanity.com/paper/2406.13844/) (2024)
- [The Effect of Intrinsic Dataset Properties on Generalization: Unraveling Learning Differences Between Natural and Medical Images](https://mlsanity.com/paper/2401.08865/) (2024)
- [The Intrinsic Manifolds of Radiological Images and their Role in Deep Learning](https://mlsanity.com/paper/2207.02797/) (2022)
- [Evaluating Visual Explanations of Attention Maps for Transformer-based Medical Imaging](https://mlsanity.com/paper/2503.09535/) (2025)
- [Exploring Patient Data Requirements in Training Effective AI Models for MRI-based Breast Cancer Classification](https://mlsanity.com/paper/2502.18506/) (2025)

## Abstract (arXiv)

Breast MRI provides high-resolution volumetric imaging critical for tumor assessment and treatment planning, yet manual interpretation of 3D scans remains labor-intensive and subjective. While AI-powered tools hold promise for accelerating medical image analysis, adoption of commercial medical AI products remains limited in low- and middle-income countries due to high license costs, proprietary software, and infrastructure demands. In this work, we investigate whether the Segment Anything Model 2 (SAM2) can be adapted for low-cost, minimal-input 3D tumor segmentation in breast MRI. Using a single bounding box annotation on one slice, we propagate segmentation predictions across the 3D volume using three different slice-wise tracking strategies: top-to-bottom, bottom-to-top, and center-outward. We evaluate these strategies across a large cohort of patients and find that center-outward propagation yields the most consistent and accurate segmentations. Despite being a zero-shot model not trained for volumetric medical data, SAM2 achieves strong segmentation performance under minimal supervision. We further analyze how segmentation performance relates to tumor size, location, and shape, identifying key failure modes. Our results suggest that general-purpose foundation models such as SAM2 can support 3D medical image analysis with minimal supervision, offering an accessible and affordable alternative for resource-constrained settings.