# The Impact of Longitudinal Mammogram Alignment on Breast Cancer Risk Assessment

arXiv: https://arxiv.org/abs/2511.08328 · HTML: https://mlsanity.com/paper/2511.08328/

## Key facts

- Cited by 1 papers in the map (data through 14 Oct 2026).
- Builds on 13 of its 49 references that are in the map.
- First posted on arXiv 11 Nov 2025.

## Builds on (most cited first, 13 of 13)

- [Attention Is All You Need](https://mlsanity.com/paper/1706.03762/) (2017)
- [Deep Residual Learning for Image Recognition](https://mlsanity.com/paper/1512.03385/) (2015)
- [Adam: A Method for Stochastic Optimization](https://mlsanity.com/paper/1412.6980/) (2014)
- [PyTorch: An Imperative Style, High-Performance Deep Learning Library](https://mlsanity.com/paper/1912.01703/) (2019)
- [Swin Transformer: Hierarchical Vision Transformer using Shifted Windows](https://mlsanity.com/paper/2103.14030/) (2021)
- [Batch Normalization: Accelerating Deep Network Training by Reducing Internal Covariate Shift](https://mlsanity.com/paper/1502.03167/) (2015)
- [VoxelMorph: A Learning Framework for Deformable Medical Image Registration](https://mlsanity.com/paper/1809.05231/) (2018)
- [A survey on deep learning in medical image registration: new technologies, uncertainty, evaluation metrics, and beyond](https://mlsanity.com/paper/2307.15615/) (2023)
- [Enhancing Breast Cancer Risk Prediction by Incorporating Prior Images](https://mlsanity.com/paper/2303.15699/) (2023)
- [Time-distance vision transformers in lung cancer diagnosis from longitudinal computed tomography](https://mlsanity.com/paper/2209.01676/) (2022)
- [Longitudinal Mammogram Risk Prediction](https://mlsanity.com/paper/2404.19083/) (2024)
- [Ordinal Learning: Longitudinal Attention Alignment Model for Predicting Time to Future Breast Cancer Events from Mammograms](https://mlsanity.com/paper/2409.06887/) (2024)
- [Reconsidering Explicit Longitudinal Mammography Alignment for Enhanced Breast Cancer Risk Prediction](https://mlsanity.com/paper/2506.19363/) (2025)

## Built on by (most cited first, 1 of 1)

- [Longitudinal Multi-View Breast Cancer Risk Prediction](https://mlsanity.com/paper/2607.11343/) (2026)

## Abstract (arXiv)

Regular mammography screening is crucial for early breast cancer detection. By leveraging deep learning-based risk models, screening intervals can be personalized, especially for high-risk individuals. While recent methods increasingly incorporate longitudinal information from prior mammograms, accurate spatial alignment across time points remains a key challenge. Misalignment can obscure meaningful tissue changes and degrade model performance. In this study, we provide insights into various alignment strategies, image-based registration, feature-level (representation space) alignment with and without regularization, and implicit alignment methods, for their effectiveness in longitudinal deep learning-based risk modeling. Using two large-scale mammography datasets, we assess each method across key metrics, including predictive accuracy, precision, recall, and deformation field quality. Our results show that image-based registration consistently outperforms the more recently favored feature-based and implicit approaches across all metrics, enabling more accurate, temporally consistent predictions and generating smooth, anatomically plausible deformation fields. Although regularizing the deformation field improves deformation quality, it reduces the risk prediction performance of feature-level alignment. Applying image-based deformation fields within the feature space yields the best risk prediction performance. These findings underscore the importance of image-based deformation fields for spatial alignment in longitudinal risk modeling, offering improved prediction accuracy and robustness. This approach has strong potential to enhance personalized screening and enable earlier interventions for high-risk individuals. The code is available at https://github.com/sot176/Mammogram_Alignment_Study_Risk_Prediction.git, allowing full reproducibility of the results.