Huina Wang, Lan Wei, Jianqiang Li, Bo Liu, Juan Fang, Catherine Mooney
BACKGROUND AND OBJECTIVE: Developing multimodal data-driven diagnostic systems has become a key clinical strategy for improving breast cancer outcomes. However, effectively modeling multimodal features remains challenging due to substantial semantic heterogeneity, scale discrepancies, and the inherent difficulty of cross-modal alignment. Although existing studies have proposed various multimodal fusion methods, most rely on direct feature concatenation or shallow integration, which fail to capture fine-grained intra-modality semantics as well as the complex interactions between histopathological and genomic modalities. METHODS: In this study, we propose a multimodal diagnostic framework based on Feature Enhancement and Semantic Collaborative Alignment (FESCA). The method incorporates a semantic-guided modality feature enhancement mechanism that effectively extracts and strengthens diagnostic cues from both pathological images and genomic data. In addition, a contrastive-learning-based cross-modal alignment strategy is introduced to map heterogeneous modalities into a unified semantic space and achieve deep semantic collaboration through contrastive optimization. To ensure robust breast cancer classification under varying modality availability, a multimodal collaborative diagnostic strategy is employed to dynamically adapt the feature representations. RESULTS: We evaluate FESCA on the TCGA-BRCA dataset, and the experimental results demonstrate that it outperforms state-of-the-art methods in breast cancer classification while significantly improving both intra-modality representation quality and cross-modal semantic alignment. CONCLUSION: To enhance accessibility and practical application, we developed a web-based breast cancer pathological staging diagnosis system to visualize and deploy the FESCA model, demonstrating a step toward clinical application and providing a benchmark for other research methods.