# Breast Cancer Recurrence Risk Prediction Based on Multiple Instance Learning

arXiv: https://arxiv.org/abs/2512.18734 · HTML: https://mlsanity.com/paper/2512.18734/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 6 of its 22 references that are in the map.
- First posted on arXiv 21 Dec 2025.

## Builds on (most cited first, 6 of 6)

- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [A ConvNet for the 2020s](https://mlsanity.com/paper/2201.03545/) (2022)
- [Gaussian Error Linear Units (GELUs)](https://mlsanity.com/paper/1606.08415/) (2016)
- [Attention-based Deep Multiple Instance Learning](https://mlsanity.com/paper/1802.04712/) (2018)
- [Data Efficient and Weakly Supervised Computational Pathology on Whole Slide Images](https://mlsanity.com/paper/2004.09666/) (2020)
- [Deep neural network models for computational histopathology: A survey](https://mlsanity.com/paper/1912.12378/) (2019)

## Abstract (arXiv)

Predicting breast cancer recurrence risk is a critical clinical challenge. This study investigates the potential of computational pathology to stratify patients using deep learning on routine Hematoxylin and Eosin (H&E) stained whole-slide images (WSIs). We developed and compared three Multiple Instance Learning (MIL) frameworks -- CLAM-SB, ABMIL, and ConvNeXt-MIL-XGBoost -- on an in-house dataset of 210 patient cases. The models were trained to predict 5-year recurrence risk, categorized into three tiers (low, medium, high), with ground truth labels established by the 21-gene Recurrence Score. Features were extracted using the UNI and CONCH pre-trained models. In a 5-fold cross-validation, the modified CLAM-SB model demonstrated the strongest performance, achieving a mean Area Under the Curve (AUC) of 0.836 and a classification accuracy of 76.2%. Our findings demonstrate the feasibility of using deep learning on standard histology slides for automated, genomics-correlated risk stratification, highlighting a promising pathway toward rapid and cost-effective clinical decision support.