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BRACS: A Dataset for BReAst Carcinoma Subtyping |
in H&E Histology Images |
Nadia Brancati1* , Anna Maria Anniciello2 , Pushpak Pati3,5 , Daniel Riccio1,4 , Giosuè |
Scognamiglio2 , Guillaume Jaume3,6 , Giuseppe De Pietro1 , Maurizio Di Bonito2 , Antonio |
Foncubierta3 , Gerardo Botti2 , Maria Gabrani3 , Florinda Feroce2 , and Maria Frucci1 |
1 Institute for High Performance Computing and Networking of the Research Council of Italy, ICAR-CNR, Naples, |
Italy |
arXiv:2111.04740v1 [q-bio.QM] 8 Nov 2021 |
2 National Cancer Institute – IRCCS – Fondazione Pascale, Naples, Italy |
3 IBM Research – Zurich, Switzerland |
4 University of Naples Federico II, Naples, Italy |
5 ETH Zurich, Switzerland |
6 EPFL Lausanne, Switzerland |
* Corresponding author: nadia.brancati@cnr.it |
ABSTRACT |
Breast cancer is the most commonly diagnosed cancer and registers the highest number of deaths for women with cancer. |
Recent advancements in diagnostic activities combined with large-scale screening policies have significantly lowered the |
mortality rates for breast cancer patients. However, the manual inspection of tissue slides by pathologists is cumbersome, |
time-consuming, and is subject to significant inter- and intra-observer variability. Recently, the advent of whole-slide scanning |
systems have empowered the rapid digitization of pathology slides, and enabled to develop digital workflows. These progress |
further enable to leverage Artificial Intelligence (AI) to assist, automate, and augment pathological diagnosis. But AI techniques, |
especially Deep Learning (DL), require a large amount of high-quality annotated data to learn from. Constructing such |
task-specific datasets poses several challenges, such as, data-acquisition level constrains, time-consuming and expensive |
annotations, and anonymization of patient information, etc. In this paper, we introduce the BReAst Carcinoma Subtyping |
(BRACS) dataset, a large cohort of annotated Hematoxylin & Eosin (H&E)-stained images to advance the characterization |
of breast lesions. BRACS contains 547 Whole-Slide Images (WSIs), and 4539 Regions of Interest (RoIs) extracted from the |
WSIs. Each WSI, and respective RoIs, are annotated by the consensus of three board-certified pathologists into different lesion |
categories. Specifically, BRACS includes three lesion types, i.e., benign, malignant and atypical, which are further subtyped |
into seven categories. The included RoIs exhibit large variability in dimensions, and incorporate the usual tissue-preparation |
and staining artifacts to bestow a realistic breast cancer diagnosis. It is, to the best of our knowledge, the largest annotated |
dataset for breast cancer subtyping both at WSI- and RoI-level. Further, by including the understudied atypical lesions, BRACS |
offers an unique opportunity for leveraging AI to better understand their characteristics. We encourage AI practitioners to |
develop and evaluate novel algorithms on the BRACS dataset to further breast cancer diagnosis and patient care. |
Background & Summary |
Histology images contain both complex and ambiguous information, thus challenging pathologists to perform a robust, |
reproducible and efficient analysis. Further, histology images are very large, which makes their analysis cumbersome and time- |
consuming. With advances in Computer-Aided-Diagnosis (CAD), AI techniques, especially Machine Learning (ML) and DL, |
have the potential to address the aforementioned bottlenecks1–4 . These techniques can identify discriminative morphological |
patterns from large datasets to diagnose histology images in a standardized and objective manner. However, there exist several |
challenges in adopting such techniques in digital pathology, such as, (i) the requirement of large annotated datasets, (ii) the need |
for sufficiently variable data to set up cross-patient experiments, (iii) the inclusion of diagnostically challenging lesions, that are |
generally difficult and expensive to acquire, (iv) the utilization of sub-region annotations to delineate RoI, (v) the coverage of |
diagnostic spectrum, and (vi) coping with data leakage and noisy annotations. Recent advancements in DL have demonstrated |
superior capabilities compared to classical ML approaches for CAD5–11 . The crucial advantage of DL approaches is their ability |
to learn task-specific salient features directly from the training data. However, this superiority comes at the cost of acquiring |
large, high-quality, variable, and unbiased annotated training datasets. Although several datasets for diagnosing breast histology |
images exist12–16 , they do not meet all the aforementioned criteria. For instance, some datasets focus on specific diseases that |
include only binary classes12, 14 , while others handling multiple classes13, 15 include only a small number of training samples |
(both at WSI- and RoI-level) collected from a few patients, thus limiting the dataset variability. Further, the set of considered |
classes in a dataset is crucial. Most of the public datasets aim to categorize lesions into benign and malignant classes, which do |
not depict the complete spectrum of classes in breast cancer diagnosis. Many of these datasets contain standardized images |
without clinical artifacts, e.g., staining anomalies, ink marks, tissue folding, blurred regions, tears etc. Consequently, these |
datasets do not comprehensively represent the real-world breast cancer diagnosis. Thus, it is necessary to develop a breast |
cancer dataset consisting of heterogeneous images across the diagnostic spectrum which is comparable to real-world diagnosis |
performed by the pathologists. |
To this end, we introduce BRACS, a large cohort of H&E-stained images to advance CAD of breast lesions. BRACS |
features the following advantages over the extant breast cancer image datasets, (i) it includes a large and heterogeneous set of |
realistic breast histology images (both at WSI- and RoI-level), (ii) RoIs range over variable dimensions by entirely including |
the diagnostic lesion, thus avoiding the loss of diagnostically relevant information, (iii) the images are acquired from a large |
number of patients encompassing large variability, and (iv) two atypical lesion categories, also known as precancerous lesions, |
are included along with other categories. In particular, we consider the following lesion types, Normal (N), Pathological Benign |
(PB), Usual Ductal Hyperplasia (UDH), Flat Epithelial Atypia (FEA), Atypical Ductal Hyperplasia (ADH), Ductal Carcinoma |
in Situ (DCIS), and Invasive Carcinoma (IC). Thus, BRACS represents a more realistic benchmark for breast cancer diagnosis |
by including several types of typical and atypical tissue samples over a wide variety of WSIs and RoIs extracted from a large |
number of patients. |
Methods |
The BRACS dataset is created to support the development of breast cancer diagnostic methods through the automatic analysis |
of histology images. The dataset was developed through the collaboration of the National Cancer Institute - Scientific Institute |
for Research, Hospitalization and Healthcare (IRCCS) "Fondazione G. Pascale", the Institute for High Performance Computing |
and Networking (ICAR) of National Research Council (CNR), and IBM Research – Zurich. The dataset was acquired from |
patients between 2019 and 2020, by board-certified pathologists of the Department of Pathology at the National Cancer Institute |
- IRCCS "Fondazione G. Pascale" in Naples (Italy). The samples were generated from H&E-stained breast tissue biopsy slides, |
and were selected based on the diagnostic reports of the patients. The age of the patients range from 16 to 86 years, with about |
61% of patients in the range of 40-60 years, and only a few patients aging less than 20 years or above 80 years. |
WSI- and RoI-level annotations |
The curation of rich and comprehensively annotated histology images is a complex and time-consuming task, while being prone |
to observer variability. The inclusion of atypical breast lesions at both WSI- and RoI-level further increases the task complexity |
by requiring annotations of specialized expert pathologists. Moreover, a WSI typically includes several lesions of different |
subtypes. To address the aforementioned challenges, we started by extracting and annotating RoIs in WSIs, and subsequently |
derived the WSI-level label as the most severe cancerous lesion detected within the slide. Specifically, the RoI-level annotations |
were conducted in a two-step procedure. First, a set of representative RoIs in each WSI was identified. Three board-certified |
pathologists independently annotated the RoIs, i.e., either as normal tissue or as one of the six lesion subtypes. Each extracted |
RoI corresponds to a unique category, and can include single or multiple glandular structures. Then, the annotations with |
disagreement were further discussed and re-annotated by the consensus of three pathologists. This process ensures reliable |
annotations, and allows to alleviate inter- and intra-observer variability. Figure 1 presents the annotation procedure for a sample |
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