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Updated: Dec 24, 2025

Introduction of an Integrated Pathology Image Management, Artificial Intelligence, and Reporting System
Published on: July 11, 2025
A decision support system for mammography reports interpretation
Marzieh Esmaeili1,2, Seyed Mohammad Ayyoubzadeh1,2, Nasrin Ahmadinejad3,4
11Department of Health Information Management, School of Allied Medical Sciences, Tehran University of Medical Sciences, 3rd Floor, No #17, Farredanesh Alley, Ghods St, Enghelab Ave, Tehran, Iran.
Purpose:
Mammography plays a key role in the diagnosis of breast cancer; however, decision-making based on mammography reports is still challenging. This paper aims to addresses the challenges regarding decision-making based on mammography reports and propose a Clinical Decision Support System (CDSS) using data mining methods to help clinicians to interpret mammography reports.
Methods:
For this purpose, 2441 mammography reports were collected from Imam Khomeini Hospital from March 21, 2018, to March 20, 2019. In the first step, these mammography reports are analyzed and program code is developed to transform the reports into a dataset. Then, the weight of every feature of the dataset is calculated. Random Forest, Naïve Bayes, K-nearest neighbor (K-NN), Deep Learning classifiers are applied to the dataset to build a model capable of predicting the need for referral to biopsy. Afterward, the models are evaluated using cross-validation with measuring Area Under Curve (AUC), accuracy, sensitivity, specificity indices.
Results:
The mammography type (diagnostic or screening), mass and calcification features mentioned in the reports are the most important features for decision-making. Results reveal that the K-NN model is the most accurate and specific classifier with the accuracy and specificity values of 84.06% and 84.72% respectively. The Random Forest classifier has the best sensitivity and AUC with the sensitivity and AUC values of 87.74% and 0.905 respectively.
Conclusions:
Accordingly, data mining approaches are proved to be a helpful tool to make the final decision as to whether patients should be referred to biopsy or not based on mammography reports. The developed CDSS may also be helpful especially for less experienced radiologists.

