# MammoWise: Multi-Model Local RAG Pipeline for Mammography Report Generation

arXiv: https://arxiv.org/abs/2602.22462 · HTML: https://mlsanity.com/paper/2602.22462/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Placed in Medical and biomedical RAG, one of 15 directions in Retrieval-augmented generation.
- Builds on 29 of its 72 references that are in the map.
- First posted on arXiv 25 Feb 2026.

## Placed in

- Retrieval-augmented generation / [Medical and biomedical RAG](https://mlsanity.com/rag/medical-and-biomedical-rag/)

## Builds on (most cited first, 29 of 29)

- [LLaMA: Open and Efficient Foundation Language Models](https://mlsanity.com/paper/2302.13971/) (2023)
- [RoBERTa: A Robustly Optimized BERT Pretraining Approach](https://mlsanity.com/paper/1907.11692/) (2019)
- [Chain-of-Thought Prompting Elicits Reasoning in Large Language Models](https://mlsanity.com/paper/2201.11903/) (2022)
- [ReAct: Synergizing Reasoning and Acting in Language Models](https://mlsanity.com/paper/2210.03629/) (2022)
- [Visual Instruction Tuning](https://mlsanity.com/paper/2304.08485/) (2023)
- [Qwen2.5-VL Technical Report](https://mlsanity.com/paper/2502.13923/) (2025)
- [BERTScore: Evaluating Text Generation with BERT](https://mlsanity.com/paper/1904.09675/) (2019)
- [Qwen2-VL: Enhancing Vision-Language Model's Perception of the World at Any Resolution](https://mlsanity.com/paper/2409.12191/) (2024)
- [QLoRA: Efficient Finetuning of Quantized LLMs](https://mlsanity.com/paper/2305.14314/) (2023)
- [Tree of Thoughts: Deliberate Problem Solving with Large Language Models](https://mlsanity.com/paper/2305.10601/) (2023)
- [BioBERT: a pre-trained biomedical language representation model for biomedical text mining](https://mlsanity.com/paper/1901.08746/) (2019)
- [Gemma 3 Technical Report](https://mlsanity.com/paper/2503.19786/) (2025)
- [Visual Prompt Tuning](https://mlsanity.com/paper/2203.12119/) (2022)
- [LLaVA-Med: Training a Large Language-and-Vision Assistant for Biomedicine in One Day](https://mlsanity.com/paper/2306.00890/) (2023)
- [Vision-Language Models for Vision Tasks: A Survey](https://mlsanity.com/paper/2304.00685/) (2023)
- [MedCLIP: Contrastive Learning from Unpaired Medical Images and Text](https://mlsanity.com/paper/2210.10163/) (2022)
- [BiomedCLIP: a multimodal biomedical foundation model pretrained from fifteen million scientific image-text pairs](https://mlsanity.com/paper/2303.00915/) (2023)
- [MedGemma Technical Report](https://mlsanity.com/paper/2507.05201/) (2025)
- [A Survey of Hallucination in Large Foundation Models](https://mlsanity.com/paper/2309.05922/) (2023)
- [VL-Adapter: Parameter-Efficient Transfer Learning for Vision-and-Language Tasks](https://mlsanity.com/paper/2112.06825/) (2021)
- [The Effect of Sampling Temperature on Problem Solving in Large Language Models](https://mlsanity.com/paper/2402.05201/) (2024)
- [A Review of Generalized Zero-Shot Learning Methods](https://mlsanity.com/paper/2011.08641/) (2020)
- [On the Effectiveness of Parameter-Efficient Fine-Tuning](https://mlsanity.com/paper/2211.15583/) (2022)
- [A Closer Look at the Explainability of Contrastive Language-Image Pre-training](https://mlsanity.com/paper/2304.05653/) (2023)
- [VinDr-Mammo: A large-scale benchmark dataset for computer-aided diagnosis in full-field digital mammography](https://mlsanity.com/paper/2203.11205/) (2022)
- [Mammo-CLIP: A Vision Language Foundation Model to Enhance Data Efficiency and Robustness in Mammography](https://mlsanity.com/paper/2405.12255/) (2024)
- [Knowledge-grounded Adaptation Strategy for Vision-language Models: Building Unique Case-set for Screening Mammograms for Residents Training](https://mlsanity.com/paper/2405.19675/) (2024)
- [Intelligent Documentation in Medical Education: Can AI Replace Manual Case Logging?](https://mlsanity.com/paper/2601.12648/) (2026)
- [Leveraging Language Models to Discover Evidence-Based Actions for OSS Sustainability](https://mlsanity.com/paper/2602.11746/) (2026)

## Abstract (arXiv)

Screening mammography is high volume, time sensitive, and documentation heavy. Radiologists must translate subtle visual findings into consistent BI-RADS assessments, breast density categories, and structured narrative reports. While recent Vision Language Models (VLMs) enable image-to-text reporting, many rely on closed cloud systems or tightly coupled architectures that limit privacy, reproducibility, and adaptability. We present MammoWise, a local multi-model pipeline that transforms open source VLMs into mammogram report generators and multi-task classifiers. MammoWise supports any Ollama-hosted VLM and mammography dataset, and enables zero-shot, few-shot, and Chain-of-Thought prompting, with optional multimodal Retrieval Augmented Generation (RAG) using a vector database for case-specific context. We evaluate MedGemma, LLaVA-Med, and Qwen2.5-VL on VinDr-Mammo and DMID datasets, assessing report quality (BERTScore, ROUGE-L), BI-RADS classification, breast density, and key findings. Report generation is consistently strong and improves with few-shot prompting and RAG. Classification is feasible but sensitive to model and dataset choice. Parameter-efficient fine-tuning (QLoRA) of MedGemma improves reliability, achieving BI-RADS accuracy of 0.7545, density accuracy of 0.8840, and calcification accuracy of 0.9341 while preserving report quality. MammoWise provides a practical and extensible framework for deploying local VLMs for mammography reporting within a unified and reproducible workflow.