Annotation-efficient deep learning for breast cancer whole-slide image classification using tumour infiltrating lymphocytes and slide-level labels

Abstract

Tumour-Infiltrating Lymphocytes (TILs) are pivotal in the immune response against cancer cells. Existing deep learning methods for TIL analysis in whole-slide images (WSIs) demand extensive patch-level annotations, often requiring labour-intensive specialist input. To address this, we propose a framework named annotation-efficient segmentation and attention-based classifier (ANSAC). ANSAC requires only slide-level labels to classify WSIs as having high vs. low TIL scores, with the binary classes divided by an expert-defined threshold. ANSAC automatically segments tumour and stroma regions relevant to TIL assessment, eliminating extensive manual annotations. Furthermore, it uses an attention ..