Christopher Brett

Jiahao Shao, Xudong Wang, Anam Nawaz Khan et al.

Breast cancer recurrence, a leading cause of long-term mortality among survivors, requires timely and accurate risk assessment to guide follow-up care and treatment planning. Traditional predictive models, often limited to either structured or unstructured data alone, struggle to capture the full clinical context. This study examines the impact of integrating multi-modal clinical data, including treatment records, pathology reports, and clinician notes, on recurrence prediction. By integrating a rule-based regular expression extraction mechanism with a rigorous precedence-based conflict reconciliation strategy, our approach effectively recovers definitive tumor characteristics from free-text pathology narratives to augment structured records. We also benchmark performance against commonly used feature sets from prior breast cancer studies to assess the added value of multi-modal integration. Single-source and multi-modal inputs are evaluated across a range of machine learning models. Results show that multi-modal integration consistently improves predictive accuracy compared to single-modal methods.

Jiahao Shao, Anam Nawaz Khan, Christopher Brett et al.

Pathology reports serve as the definitive record for breast cancer staging, yet their unstructured format impedes large-scale data curation. While Large Language Models (LLMs) offer semantic reasoning, their deployment is often limited by high computational costs and hallucination risks. This study introduces a parameter-efficient, multi-task framework for automating the extraction of Tumor-Node-Metastasis (TNM) staging, histologic grade, and biomarkers. We fine-tune a Llama-3-8B-Instruct encoder using Low-Rank Adaptation (LoRA) on a curated, expert-verified dataset of 10,677 reports. Unlike generative approaches, our architecture utilizes parallel classification heads to enforce consistent schema adherence. Experimental results demonstrate that the model achieves a Macro F1 score of 0.976, successfully resolving complex contextual ambiguities and heterogeneous reporting formats that challenge traditional extraction methods including rule-based natural language processing (NLP) pipelines, zero-shot LLMs, and single-task LLM baselines. The proposed adapter-efficient, multi-task architecture enables reliable, scalable pathology-derived cancer staging and biomarker profiling, with the potential to enhance clinical decision support and accelerate data-driven oncology research.