# CorePath: A Breast-Specialized Pathology Foundation Model for Core Needle Biopsy Diagnosis and Risk-Controlled Report Generation

arXiv: https://arxiv.org/abs/2608.03079 · HTML: https://mlsanity.com/paper/2608.03079/

## Key facts

- No citing papers in the map yet (data through 14 Oct 2026).
- Builds on 19 of its 56 references that are in the map.
- First posted on arXiv 4 Aug 2026.

## Builds on (most cited first, 19 of 19)

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- [VL-Adapter: Parameter-Efficient Transfer Learning for Vision-and-Language Tasks](https://mlsanity.com/paper/2112.06825/) (2021)
- [Least Ambiguous Set-Valued Classifiers with Bounded Error Levels](https://mlsanity.com/paper/1609.00451/) (2016)
- [Learn then Test: Calibrating Predictive Algorithms to Achieve Risk Control](https://mlsanity.com/paper/2110.01052/) (2021)
- [Multimodal Whole Slide Foundation Model for Pathology](https://mlsanity.com/paper/2411.19666/) (2024)
- [BRACS: A Dataset for BReAst Carcinoma Subtyping in H&E Histology Images](https://mlsanity.com/paper/2111.04740/) (2021)
- [PRISM: A Multi-Modal Generative Foundation Model for Slide-Level Histopathology](https://mlsanity.com/paper/2405.10254/) (2024)
- [Mitosis domain generalization in histopathology images -- The MIDOG challenge](https://mlsanity.com/paper/2204.03742/) (2022)
- [Improving Radiology Report Generation Systems by Removing Hallucinated References to Non-existent Priors](https://mlsanity.com/paper/2210.06340/) (2022)
- [Predicting Axillary Lymph Node Metastasis in Early Breast Cancer Using Deep Learning on Primary Tumor Biopsy Slides](https://mlsanity.com/paper/2112.02222/) (2021)
- [Semantic Consistency-Based Uncertainty Quantification for Factuality in Radiology Report Generation](https://mlsanity.com/paper/2412.04606/) (2024)
- [ModalTune: Fine-Tuning Slide-Level Foundation Models with Multi-Modal Information for Multi-task Learning in Digital Pathology](https://mlsanity.com/paper/2503.17564/) (2025)

## Abstract (arXiv)

Breast core needle biopsy (CNB) is central to breast cancer diagnosis yet remains challenging because limited tissue sampling, lesion heterogeneity, and subtle morphologic overlap can obscure subtype distinctions. We developed CorePath, a breast-specialized multimodal pathology foundation model fine-tuned from PRISM using 7901 paired CNB whole-slide images and diagnostic reports from two centers. Evaluated across six CNB cohorts and two public breast pathology benchmarks without task-specific retraining, CorePath consistently outperformed PRISM across cancer detection, invasion assessment, and histological subtyping. It achieved weighted area under the receiver operating characteristic curves (AUCs) of 0.9526-0.9735 for five-class CNB histological subtyping across private centers. On public benchmarks, CorePath outperformed leading pathology foundation models, achieving the highest weighted AUCs of 0.7780 for BCNB invasive carcinoma subtyping, 0.8178 for BRACS lesion stratification, and 0.8252 for BRACS fine-grained classification. In report generation, CorePath reduced the overall non-breast hallucinations from 30.1% to 2.8%, demonstrating improved domain fidelity after breast-specific adaptation. CorePath-CRG further combined conformal filtering of subtype and binary cancer status predictions with Learn-Then-Test-based threshold calibration to support selective narrative release, diagnostic fallback, and deferral. CorePath-CRG achieved zero non-breast hallucinations among released outputs and showed the strongest overall performance in pathologist-validated LLM-based Evaluation Scores and quantitative report-generation metrics across most centers. These results demonstrate that domain-specialized foundation models with statistical risk control offer a promising approach for accurate breast CNB diagnosis and reliable report generation.