  We propose a new method for breast cancer screening from DCE-MRI based on a
post-hoc approach that is trained using weakly annotated data (i.e., labels are
available only at the image level without any lesion delineation). Our proposed
post-hoc method automatically diagnosis the whole volume and, for positive
cases, it localizes the malignant lesions that led to such diagnosis.
Conversely, traditional approaches follow a pre-hoc approach that initially
localises suspicious areas that are subsequently classified to establish the
breast malignancy -- this approach is trained using strongly annotated data
(i.e., it needs a delineation and classification of all lesions in an image).
Another goal of this paper is to establish the advantages and disadvantages of
both approaches when applied to breast screening from DCE-MRI. Relying on
experiments on a breast DCE-MRI dataset that contains scans of 117 patients,
our results show that the post-hoc method is more accurate for diagnosing the
whole volume per patient, achieving an AUC of 0.91, while the pre-hoc method
achieves an AUC of 0.81. However, the performance for localising the malignant
lesions remains challenging for the post-hoc method due to the weakly labelled
dataset employed during training.
