Background/Objectives: Breast cancer is a leading cause of mortality among women in Taiwan and globally. Non-invasive imaging methods, such as mammography and ultrasound, are critical for early detection, yet standalone modalities have limitations in regard to their diagnostic accuracy. This study aims to enhance breast cancer detection through a cross-modality fusion approach combining mammography and ultrasound imaging, using advanced convolutional neural network (CNN) architectures. Materials and Methods: Breast images were sourced from public datasets, including the RSNA, the PAS, and Kaggle, and categorized into malignant and benign groups. Data augmentation techniques were used to address imbalances in the ultrasound dataset. Three models were developed: (1) pre-trained CNNs integrated with machine learning classifiers, (2) transfer learning-based CNNs, and (3) a custom-designed 17-layer CNN for direct classification. The performance of the models was evaluated using metrics such as accuracy and the Kappa score. Results: The custom 17-layer CNN outperformed the other models, achieving an accuracy of 0.964 and a Kappa score of 0.927. The transfer learning model achieved moderate performance (accuracy 0.846, Kappa 0.694), while the pre-trained CNNs with machine learning classifiers yielded the lowest results (accuracy 0.780, Kappa 0.559). Cross-modality fusion proved effective in leveraging the complementary strengths of mammography and ultrasound imaging. Conclusions: This study demonstrates the potential of cross-modality imaging and tailored CNN architectures to significantly improve diagnostic accuracy and reliability in breast cancer detection. The custom-designed model offers a practical solution for early detection, potentially reducing false positives and false negatives, and improving patient outcomes through timely and accurate diagnosis.

According to the Health Promotion Administration in the Ministry of Health and Welfare statistics in Taiwan, over ten thousand women have breast cancer every year. Mammography is widely used to detect breast cancer. However, it is limited by the operator’s technique, the cooperation of the subjects, and the subjective interpretation by the physician. It results in inconsistent identification. Therefore, this study explores the use of a deep neural network algorithm for the classification of mammography images. In the experimental design, a retrospective study was used to collect imaging data from actual clinical cases. The mammography images were collected and classified according to the breast image reporting and data-analyzing system (BI-RADS). In terms of model building, a fully convolutional dense connection network (FC-DCN) is used for the network backbone. All the images were obtained through image preprocessing, a data augmentation method, and transfer learning technology to build a mammography image classification model. The research results show the model’s accuracy, sensitivity, and specificity were 86.37%, 100%, and 72.73%, respectively. Based on the FC-DCN model framework, it can effectively reduce the number of training parameters and successfully obtain a reasonable image classification model for mammography.