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Automated breast cancer cell counting: comparing multi-class segmentation and two-stage classification strategies
Corresponding Author(s) : Dzaky Hanif Arjuna
Kinetik: Game Technology, Information System, Computer Network, Computing, Electronics, and Control,
Vol. 11, No. 3, August 2026 (Article in Progress)
Abstract
The manual interpretation of Hematoxylin and Eosin (H&E) histopathology images for breast cancer diagnosis is hindered by time limitations and observer bias. This research seeks to create an automated system using Deep Learning for cell detection and classification, evaluating two key approaches: Multi-class Segmentation (single-stage) and Segmentation followed by Classification (two-stage). U-Net architecture was employed for segmentation, while MobileNetV2 and VGG16 were used for classification. The models were tested on the public IHC4BC dataset and primary data from Airlangga University Hospital (RSUA). The study also evaluated the impact of Resizing versus Tiling data processing strategies. Experimental results showed that while MobileNetV2 and VGG16 classification models achieved a high testing accuracy of 98.80%, the two-stage integrated system revealed a high counting error with a Mean Absolute Error (MAE) of 119.87 for positive cells, primarily due to under-segmentation of overlapping cells. In contrast, the Multi-class Segmentation approach utilizing the Tiling strategy demonstrated superior performance. This model effectively preserved spatial resolution and distinguished cell types simultaneously, achieving the lowest positive cell MAE of 18.46 and a negative cell MAE of 1.66. This study concluded that multi-class segmentation with a Tiling strategy was the most effective and accurate approach for automated cell counting in histopathology images.
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References
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N. Harbeck, F. Penault-Llorca, J. Cortés, M. Gnant, N. Houssami, P. Poortmans, K. Ruddy, J. Tsang, and F. Cardoso, "Breast cancer," Nature Reviews Disease Primers, vol. 5, no. 1, pp. 1–31, 2019. https://doi.org/10.1038/s41572-019-0111-2
R. L. Siegel, K. D. Miller, and A. Jemal, "Cancer statistics, 2020," CA: A Cancer Journal for Clinicians, vol. 70, no. 1, pp. 7–30, 2020. https://doi.org/10.3322/caac.21590
K. Tehrani, J. Park, E. Chaney, H. Tu, and S. Boppart, "Nonlinear imaging histopathology: A pipeline to correlate gold-standard hematoxylin and eosin staining with modern nonlinear microscopy," IEEE Journal of Selected Topics in Quantum Electronics, vol. 29, no. 4, pp. 1–12, 2023. https://doi.org/10.1109/JSTQE.2023.3241234
M. Feng, Y. Deng, L. Yang, Q. Jing, Z. Zhang, L. Xu, and H. Bu, "Automated quantitative analysis of Ki-67 staining and HE images recognition and registration based on whole tissue sections in breast carcinoma," Diagnostic Pathology, vol. 15, no. 1, p. 55, 2020. https://doi.org/10.1186/s13000-020-00971-8
J. Nunes, D. Montezuma, D. Oliveira, T. Pereira, and J. Cardoso, "A survey on cell nuclei instance segmentation and classification: Leveraging context and attention," Medical Image Analysis, vol. 99, p. 103360, 2024. https://doi.org/10.1016/j.media.2023.103360
P. Wang, X. Hu, Y. Li, Q. Liu, and X. Zhu, "Automatic cell nuclei segmentation and classification of breast cancer histopathology images," Signal Processing, vol. 122, pp. 1–13, 2016. https://doi.org/10.1016/j.sigpro.2015.11.019
H. Yu, L. Yang, Q. Zhang, D. Armstrong, and M. Deen, "Convolutional neural networks for medical image analysis: State-of-the-art, comparisons, improvement and perspectives," Neurocomputing, vol. 444, pp. 92–110, 2021. https://doi.org/10.1016/j.neucom.2021.03.014
S. Dong, P. Wang, and K. Abbas, "A survey on deep learning and its applications," Computer Science Review, vol. 40, p. 100379, 2021. https://doi.org/10.1016/j.cosrev.2021.100379
D. R. Chandranegara, F. H. Pratama, S. Fajrianur, M. R. E. Putra, and Z. Sari, "Automated Detection of Breast Cancer Histopathology Image Using Convolutional Neural Network and Transfer Learning," MATRIK: Jurnal Manajemen, Teknik Informatika dan Rekayasa Komputer, vol. 22, no. 3, pp. 455–468, 2023. https://doi.org/10.30812/matrik.v22i3.2876
D. Albashish, R. Al-Sayyed, A. Abdullah, M. H. Ryalat, and N. A. Almansour, "Deep CNN Model Based on VGG16 for Breast Cancer Classification," in 2021 International Conference on Information Technology (ICIT), Amman, Jordan, 2021, pp. 805–810. https://doi.org/10.1109/ICIT52682.2021.9491631
K. Munir, H. Elahi, A. Ayub, F. Frezza, and A. Rizzi, "Cancer Diagnosis Using Deep Learning: A Bibliographic Review," Cancers, vol. 11, no. 9, p. 1235, 2019. https://doi.org/10.3390/cancers11091235
K. AnbuDevi and K. Suganthi, "Review of Semantic Segmentation of Medical Images Using Modified Architectures of UNet," Diagnostics, vol. 12, no. 10, p. 2309, 2022. https://doi.org/10.3390/diagnostics12102309
O. Ronneberger, P. Fischer, and T. Brox, "U-Net: Convolutional Networks for Biomedical Image Segmentation," in Medical Image Computing and Computer-Assisted Intervention (MICCAI), Munich, Germany, 2015, pp. 234–241. https://doi.org/10.1007/978-3-319-24574-4_28
A. G. Howard, M. Zhu, B. Chen, D. Kalenichenko, W. Wang, T. Weyand, M. Andreetto, and H. Adam, "MobileNets: Efficient Convolutional Neural Networks for Mobile Vision Applications," arXiv preprint arXiv:1704.04861, 2017. https://doi.org/10.48550/arXiv.1704.04861
K. Simonyan and A. Zisserman, "Very Deep Convolutional Networks for Large-Scale Image Recognition," arXiv preprint arXiv:1409.1556, 2014. https://doi.org/10.48550/arXiv.1409.1556
D. P. Kingma and J. Ba, "Adam: A Method for Stochastic Optimization," arXiv preprint arXiv:1412.6980, 2014. https://doi.org/10.48550/arXiv.1412.6980
T.-Y. Lin, P. Goyal, R. Girshick, K. He, and P. Dollár, "Focal Loss for Dense Object Detection," in Proceedings of the IEEE International Conference on Computer Vision (ICCV), Venice, Italy, 2017, pp. 2980–2988. https://doi.org/10.1109/ICCV.2017.324
T. Eelbode, J. Bertels, M. Berman, D. Vandermeulen, F. Maes, R. Bisschops, and M. Blaschko, "Optimization for Medical Image Segmentation: Theory and Practice When Evaluating With Dice Score or Jaccard Index," IEEE Transactions on Medical Imaging, vol. 39, no. 11, pp. 3679–3690, 2020. https://doi.org/10.1109/TMI.2020.2989417
A. A. Taha and A. Hanbury, "Metrics for evaluating 3D medical image segmentation: analysis, selection, and tool," BMC Medical Imaging, vol. 15, no. 1, p. 29, 2015. https://doi.org/10.1186/s12880-015-0068-x
M. Veta, P. J. van Diest, R. Kornegoor, A. Huisman, M. A. Viergever, and J. P. W. Pluim, "Automatic Nuclei Segmentation in H&E Stained Breast Cancer Histopathology Images," PLoS ONE, vol. 8, no. 7, p. e70221, 2013. https://doi.org/10.1371/journal.pone.0070221
N. Hatipoglu and G. Bilgin, "Cell segmentation in histopathological images with deep learning algorithms by utilizing spatial relationships," Medical & Biological Engineering & Computing, vol. 55, no. 10, pp. 1829–1848, 2017. https://doi.org/10.1007/s11517-017-1632-3
K. He, G. Gkioxari, P. Dollár, and R. Girshick, "Mask R-CNN," in Proceedings of the IEEE International Conference on Computer Vision (ICCV), Venice, Italy, 2017, pp. 2961–2969. https://doi.org/10.1109/ICCV.2017.322
S. Dong, P. Wang, and K. Abbas, "A survey on deep learning and its applications," Computer Science Review, vol. 40, p. 100379, 2021. https://doi.org/10.1016/j.cosrev.2021.100379
M. Tan and Q. V. Le, "EfficientNet: Rethinking Model Scaling for Convolutional Neural Networks," Proceedings of the 36th International Conference on Machine Learning (ICML), vol. 97, pp. 6105–6114, 2019. Available: http://proceedings.mlr.press/v97/tan19a.html