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Deciphering the morphology of tumor-stromal features in invasive breast cancer using artificial intelligence

Research Authors
Nehal M Atallah, Noorul Wahab, Michael S Toss, Shorouk Makhlouf, Asmaa Y Ibrahim, Ayat G Lashen, Suzan Ghannam, Nigel P Mongan, Mostafa Jahanifar, Simon Graham, Mohsin Bilal, Abhir Bhalerao, Shan E Ahmed Raza, David Snead, Fayyaz Minhas, Nasir Rajpoot, Em
Research Date
Research Department
Research Journal
Modern Pathology
Research Member
Research Year
2023
Research Abstract

Tumor-associated stroma in breast cancer (BC) is complex and exhibits a high degree of heterogeneity. To date, no standardized assessment method has been established. Artificial intelligence (AI) could provide an objective morphologic assessment of tumors and stroma, with the potential to identify new features not discernible by visual microscopy. In this study, we used AI to assess the clinical significance of (1) stroma-to-tumor ratio (S:TR) and (2) the spatial arrangement of stromal cells, tumor cell density, and tumor burden in BC. Whole-slide images of a large cohort (n = 1968) of well-characterized luminal BC cases were examined. Region and cell-level annotation was performed, and supervised deep learning models were applied for automated quantification of tumor and stromal features. S:TR was calculated in terms of surface area and cell count ratio, and the S:TR heterogeneity and spatial distribution …