Foundation model embeddings capture pre-diagnostic changes on screening mammograms
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The study examined whether embeddings from four foundation models—Mammo-CLIP, HOPPR, MedImageInsight, and BiomedCLIP—could detect pre‑diagnostic changes in screening mammograms. Using 1,773 biopsied women and matched controls, the researchers measured the speed of movement along a data‑derived “cancer direction” in embedding space over successive screening intervals. They found that embeddings from clinically grounded models (Mammo‑CLIP, HOPPR, MedImageInsight) showed faster drift in malignant cases compared to controls, while the general biomedical model BiomedCLIP did not, indicating that foundation model embeddings can encode early tissue changes without task‑specific fine‑tuning.
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The paper introduces SEM‑HD, a framework that leverages longitudinal mammography history as privileged information during training to improve risk prediction while requiring only a single current exam at inference. By having a student model predict latent representations of past visits and using teacher supervision from actual longitudinal data, SEM‑HD preserves temporal modeling benefits without needing prior exams at deployment. Experiments on three cohorts and two backbone architectures show consistent gains in long‑horizon AUC and pAUC, especially in low false‑positive‑rate regions, and recover much of the performance gap to full‑history models.
arXiv:2607. 10358v1 Announce Type: cross Abstract: Foundation models are increasingly used as image feature extractors for mammography, but their robustness under external domain shift remains unclear.
arXiv:2608.24688v1 Announce Type: new Abstract: Precision oncology necessitates a longitudinal model of patient state that captures cancer evolution and treatment over time, integrating multimodal ob...
The study evaluates whether mammography foundation models, pretrained for breast cancer tasks, can predict 5‑year major adverse cardiovascular events (MACE) in women using only screening mammograms. In a cohort of 22,497 women (500 MACE events), the models achieved AUROCs of 0.823 and 0.822, outperforming an age‑only baseline. The models also identified higher risk in patients with radiologist‑documented breast arterial calcifications, despite never being trained on that label.