Gloria Bueno

HER2 overexpression is a prognostic and predictive factor observed in about 15% to 20% of breast cancer cases. The assessment of its expression directly affects the selection of treatment and prognosis. The measurement of HER2 status is performed by an expert pathologist who assigns a score of 0, 1, 2+, or 3+ based on the gene expression. There is a high probability of interobserver variability in this evaluation, especially when it comes to class 2+. This is reasonable as the primary cause of error in multiclass classification problems typically arises in the intermediate classes. This work proposes a novel approach to expand the decision limit and divide it into two additional classes, that is 1.5+ and 2.5+. This subdivision facilitates both feature learning and pathology assessment. The method was evaluated using various neural networks models capable of performing patch-wise grading of HER2 whole slide images (WSI). Then, the outcomes of the 7-class classification were merged back into 5 classes in accordance with the pathologists’ criteria and to compare the results with the initial 5-class model. Optimal outcomes were achieved by employing colour transfer for data augmentation, and the ResNet-101 architecture with 7 classes. A sensitivity of 0.91 was achieved for class 2+ and 0.97 for 3+. Furthermore, this model offers the highest level of confidence, ranging from 92% to 94% for 2+ and 96% to 97% for 3+. In contrast, a dataset containing only 5 classes demonstrates a sensitivity performance that is 5% lower for the same network.