Early signs of cancer present in the fine detail of mammograms

Sep 24, 2026

Study evaluates how different high-pass filters influence expert radiologists’ ability to detect the “gist of abnormality” in mammograms, including images acquired before any locally actionable lesions. Thirty-four radiologists assessed unaltered and filtered normal and abnormal mammograms, where abnormal cases included obvious, subtle findings, and currently normal images from women who developed cancer within 2–3 years. Performance stayed similar for 0.5 and 1.5 cpd, declined for 1 and 2 cpd, and significantly improved with filters removing low frequencies below 0.5–1.5 cpd, with differing decision criteria across filters.

LanguageEnglish

CategoryHealthcare

FormatPDF

Pages16

Reading Time40 min

AccessFree to download

Abstract

Introduction

PLOS ONE OPEN ACCESS Citation: Raat EM, Evans KK (2023) Early signs of cancer present in the fine detail of mammograms. PLoS ONE 18(4): e0282872 . [https://doi.org/](https://doi.org/)[ ](https://doi.org/)[10.1371/journal.pone](10.1371/journal.pone).0282872 Editor: Rahul Gomes, University of Wisconsin-Eau Claire, UNITED STATES Received: October 19, 2022 Accepted: February 25, 2023 Published: April 5, 2023 Copyright: © 2023 Raat, Evans. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Data Availability Statement: Data from the experiment is available on OSF under Creative Commons Attribution (CC BY) license at [https://](https://)[ ](https://)[osf.io/t8cdr/](osf.io/t8cdr/), as well as the main analysis scripts needed to extract the data and to perform the statistical analysis. Funding: KKE received a grant from Cancer Research UK ([https://www.cancerresearchuk.org/](https://www.cancerresearchuk.org/))& EPSRC ([https://www.ukri.org/councils/epsrc/](https://www.ukri.org/councils/epsrc/)) grant EDDCPJT\100027 . EMR received a departmental scholarship from the Psychology department, University of York. The funders had no role in study design, data collection and analysis, RESEARCH ARTICLE Early signs of cancer present in the fine detail of mammograms Emma M. Raat *, Karla K. Evans Department of Psychology, University of York, York, United Kingdom * [emma.raat@york.ac.uk](emma.raat@york.ac.uk) Abstract The gist of abnormality can be rapidly extracted by medical experts from global information in medical images, such as mammograms, to identify abnormal mammograms with abovechance accuracy—even before any abnormalities are localizable. The current study evaluated the effect of different high-pass filters on expert radiologists’ performance in detecting the gist of abnormality in mammograms, especially those acquired prior to any visibly actionable lesions. Thirty-four expert radiologists viewed unaltered and high-pass filtered versions of normal and abnormal mammograms. Abnormal mammograms consisted of obvious abnormalities, subtle abnormalities, and currently normal mammograms from women who would go to develop cancer in 2–3 years. Four levels of high-pass filtering were tested (0 .5, 1, 1.5, and 2 cycles per degree (cpd) after brightening and contrast normalizing to the unfiltered mammograms. Overall performance for 0.5 and 1.5 did not change compared to unfiltered but was reduced for 1 and 2 cpd. Critically, filtering that eliminated frequencies below 0.5 and 1.5 cpd significantly boosted performance on mammograms acquired years prior appearance of localizable abnormalities. Filtering at 0.5 did not change the radiologist’s decision criteria compared to unfiltered mammograms whereas other filters resulted in more conservative ratings. The findings bring us closer to identifying the characteristics of the gist of the abnormal that affords radiologists detection of the earliest signs of cancer. A 0.5 cpd high-pass filter significantly boosts subtle, global signals of future cancerous abnormalities, potentially providing an image enhancement strategy for rapid assessment of impending cancer risk. Introduction Breast cancer is (one of) the most prevalent and deadly cancers in women world-wide, according to global data from 1990 to 2015 [ 1] and 2020 GLOBOCAN cancer statistics [2] . As with most cancers, early detection is vital, as it allows for treatment before the disease progresses and improves clinical outcomes [3] . Currently, the most commonly used methods of screening and early detection are clinical breast exams and digital mammography, as they are effective and cost-efficient [3] and have been estimated to reduce mortality by 30% to 50%[4] . Digital mammography is especially for early detection, as it allow

FAQs

What was the main purpose of the study?

To test whether applying different high-pass filters improves expert radiologists’ detection of the gist of abnormality in mammograms, especially those obtained before any visible actionable lesions.

How were the mammograms categorized for evaluation?

Abnormal mammograms included obvious abnormalities, subtle abnormalities, and currently normal mammograms from women who later developed cancer within 2–3 years. Radiologists also reviewed unaltered normal and abnormal images.

Which filtering level most improved radiologists’ performance?

Filtering that eliminated frequencies below 0.5 and 1.5 cycles per degree (cpd) significantly boosted performance for mammograms acquired years earlier than localizable abnormalities, while a 0.5 cpd filter did not change decision criteria compared with unfiltered images.

Sep 24, 2026

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