Recent advances in computer vision, foundation models, and transformer architectures have transformed computational pathology, enabling deep learning systems to extract clinically actionable information directly from digitized tissue slides. This seminar explores how these technologies come together in modern digital pathology frameworks, and presents two studies demonstrating their clinical impact.
The first study addresses a critical diagnostic gap in low-resource settings, showing that convolutional neural networks applied to Giemsa-stained bone marrow aspirates can predict B/T-cell lineage and ETV6–RUNX1 translocation status in pediatric acute lymphoblastic leukemia — tasks that traditionally require expensive molecular assays unavailable in many parts of the world.
The second study tackles overtreatment in breast cancer. The TAILORx trial established that adjuvant chemotherapy can be spared for postmenopausal HR+/HER2− node-negative breast cancer patients with a 21-gene Recurrence Score (RS) of 11–25. However, among premenopausal women with RS 16–25, a small benefit from chemotherapy could not be ruled out. Consequently, guidelines suggest considering chemotherapy for this population, creating a therapeutic dilemma and leading to widespread overtreatment of patients who may not benefit from chemotherapy. Using deep survival analysis on H&E whole-slide images, we identify which women in this group truly benefit from adjuvant chemotherapy. Our model stratifies 76% of this population as low-risk, for whom chemotherapy can be safely omitted, while correctly identifying the high-risk subset that benefits from treatment.
Together, these works illustrate how digital pathology can democratize access to precision diagnostics and enable more personalized, less toxic cancer care.