Hybrid Cross-Modal Attention Network for Early Breast Cancer Detection in Low-Resource Clinical Settings

Abstract

Breast cancer is the leading cause of cancer-related mortality among women in Sub-Saharan Africa, where delayed diagnosis results from limited radiology expertise and fragmented clinical data systems. Although deep learning models have demonstrated strong performance in mammographic analysis, most rely solely on imaging data and are trained on Western populations, limiting their applicability in African healthcare settings. This paper presents a Hybrid Cross-Modal Attention Network (HCMAN) that integrates mammogram images with structured clinical data using transformer-based cross-modal attention mechanisms. The model was developed and validated using a locally collected dataset of 2,560 mammogram images from 1,024 patients across four Ethiopian referral hospitals, with biopsy-confirmed ground truth labels. The proposed framework achieves 97.8% accuracy, 97.2% sensitivity, 98.3% specificity, and an AUC of 0.987, significantly outperforming image-only baselines. The system demonstrates robustness to low-quality images typical of resource-limited settings, with only 3.2% performance degradation compared to 8.7% for image-only models. Cross-modal attention analysis reveals clinically appropriate behavior: higher reliance on clinical features for ambiguous cases such as dense breasts and young patients. The model's lightweight architecture enables deployment on standard hospital workstations (<2 seconds inference on CPU). This work advances sustainable, context-aware AI solutions for equitable breast cancer diagnostics in Africa.