# The MAMA-MIA Challenge: Advancing Generalizability and Fairness in Breast MRI Tumor Segmentation and Treatment Response Prediction

arXiv: https://arxiv.org/abs/2603.01250 · HTML: https://mlsanity.com/paper/2603.01250/

## Key facts

- Cited by 2 papers in the map (data through 14 Oct 2026).
- Builds on 26 of its 113 references that are in the map.
- First posted on arXiv 1 Mar 2026.

## Builds on (most cited first, 26 of 26)

- [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)
- [An Image is Worth 16x16 Words: Transformers for Image Recognition at Scale](https://mlsanity.com/paper/2010.11929/) (2020)
- [U-Net: Convolutional Networks for Biomedical Image Segmentation](https://mlsanity.com/paper/1505.04597/) (2015)
- [A Simple Framework for Contrastive Learning of Visual Representations](https://mlsanity.com/paper/2002.05709/) (2020)
- [XGBoost: A Scalable Tree Boosting System](https://mlsanity.com/paper/1603.02754/) (2016)
- [Mamba: Linear-Time Sequence Modeling with Selective State Spaces](https://mlsanity.com/paper/2312.00752/) (2023)
- [V-Net: Fully Convolutional Neural Networks for Volumetric Medical Image Segmentation](https://mlsanity.com/paper/1606.04797/) (2016)
- [A Closer Look at Spatiotemporal Convolutions for Action Recognition](https://mlsanity.com/paper/1711.11248/) (2017)
- [Generalizing to Unseen Domains: A Survey on Domain Generalization](https://mlsanity.com/paper/2103.03097/) (2021)
- [Identifying the Best Machine Learning Algorithms for Brain Tumor Segmentation, Progression Assessment, and Overall Survival Prediction in the BRATS Challenge](https://mlsanity.com/paper/1811.02629/) (2018)
- [Tune: A Research Platform for Distributed Model Selection and Training](https://mlsanity.com/paper/1807.05118/) (2018)
- [3D MRI brain tumor segmentation using autoencoder regularization](https://mlsanity.com/paper/1810.11654/) (2018)
- [nnU-Net Revisited: A Call for Rigorous Validation in 3D Medical Image Segmentation](https://mlsanity.com/paper/2404.09556/) (2024)
- [Codabench: Flexible, Easy-to-Use and Reproducible Benchmarking Platform](https://mlsanity.com/paper/2110.05802/) (2021)
- [FUTURE-AI: International consensus guideline for trustworthy and deployable artificial intelligence in healthcare](https://mlsanity.com/paper/2309.12325/) (2023)
- [CrossMoDA 2021 challenge: Benchmark of Cross-Modality Domain Adaptation techniques for Vestibular Schwannoma and Cochlea Segmentation](https://mlsanity.com/paper/2201.02831/) (2022)
- [A large-scale multicenter breast cancer DCE-MRI benchmark dataset with expert segmentations](https://mlsanity.com/paper/2406.13844/) (2024)
- [A generalizable 3D framework and model for self-supervised learning in medical imaging](https://mlsanity.com/paper/2501.11755/) (2025)
- [High-resolution synthesis of high-density breast mammograms: Application to improved fairness in deep learning based mass detection](https://mlsanity.com/paper/2209.09809/) (2022)
- [Domain generalization in deep learning-based mass detection in mammography: A large-scale multi-center study](https://mlsanity.com/paper/2201.11620/) (2022)
- [Fairness-Aware Data Augmentation for Cardiac MRI using Text-Conditioned Diffusion Models](https://mlsanity.com/paper/2403.19508/) (2024)
- [HCMA-UNet: A Hybrid CNN-Mamba UNet with Axial Self-Attention for Efficient Breast Cancer Segmentation](https://mlsanity.com/paper/2501.00751/) (2025)
- [Temporal Representation Learning of Phenotype Trajectories for pCR Prediction in Breast Cancer](https://mlsanity.com/paper/2509.14872/) (2025)
- [Federated nnU-Net for Privacy-Preserving Medical Image Segmentation](https://mlsanity.com/paper/2503.02549/) (2025)
- [Single Image Test-Time Adaptation via Multi-View Co-Training](https://mlsanity.com/paper/2506.23705/) (2025)

## Built on by (most cited first, 2 of 2)

- [CoM3eT: A foundation model for medical image analysis through federated, multidimensional context integration](https://mlsanity.com/paper/2608.16268/) (2026)
- [Subtraction-Based Tumor Segmentation and Lesion-Centered pCR Prediction for the MAMA-MIA Challenge](https://mlsanity.com/paper/2608.29162/) (2026)

## Abstract (arXiv)

Breast cancer is the most frequently diagnosed malignancy among women worldwide and a leading cause of cancer-related mortality. Dynamic contrast-enhanced magnetic resonance imaging plays a central role in tumor characterization and treatment monitoring, particularly in patients receiving neoadjuvant chemotherapy. However, existing artificial intelligence models for breast magnetic resonance imaging are typically developed and evaluated using heterogeneous datasets, study populations, and assessment protocols, making direct comparison difficult and limiting understanding of model robustness across institutions and clinically relevant patient subgroups. The MAMA-MIA Challenge was designed to address these challenges by providing a standardized benchmark for the joint evaluation of primary tumor segmentation and prediction of pathologic complete response using pre-treatment magnetic resonance imaging only. The training cohort comprised 1,506 patients from multiple institutions in the United States, while evaluation was conducted on an external test set of 574 patients from three independent European centers to assess cross-continental and cross-institutional generalization. A unified scoring framework combined predictive performance with subgroup consistency across age, menopausal status, and breast density. Twenty-six international teams participated in the final evaluation phase. Results demonstrate substantial performance variability under a common external evaluation framework and reveal trade-offs between overall accuracy and subgroup fairness. The challenge provides standardized datasets, evaluation protocols, and public resources to promote the development of robust and equitable artificial intelligence systems for breast cancer imaging.