Transformer optimization with meta learning on pathology images for breast cancer lymph node micrometastasis.

Lymph node micro-metastasis represents the initial stage of breast cancer spread or metastasis. However, the limited size of these hidden lesions restricts dataset expansion, presenting a significant challenge for manual examination and conventional deep learning techniques. By harnessing the power of meta-learning on limited datasets, we developed a novel network named MetaTrans, equipped with a 34-category dataset (MT-MCD) to effectively pinpoint micro-metastases in lymph nodes from pathological images. MetaTrans demonstrated superior performance on two different multi-center datasets and excelled in the 0-shot task for intraoperative frozen section diagnosis. Beyond breast cancer, MetaTrans efficiently identifies micro-metastases in thyroid and colorectal cancers and can be directly applied to recognize images captured by digital cameras under a microscope. Across all clinical validation scenarios, our method surpasses state-of-the-art baselines, exhibiting robust cross-domain adaptation and task-specific reliability, which highlight its translational potential in diverse pathological settings.