Automated methods for breast cancer detection have focused on 2D mammography and have largely ignored 3D digital breast tomosynthesis (DBT), which is frequently used in clinical practice. The two key challenges in developing automated methods for DBT classification are handling the variable number of slices and retaining slice-to-slice changes. We propose a novel deep 2D convolutional neural network (CNN) architecture for DBT classification that simultaneously overcomes both challenges. Our approach operates on the full volume, regardless of the number of slices, and allows the use of pre-trained 2D CNNs for feature extraction, which is important given the limited amount of annotated training data. In an extensive evaluation on a real-world clinical dataset, our approach achieves 0.854 auROC, which is 28.80% higher than approaches based on 3D CNNs. We also find that these improvements are stable across a range of model configurations.
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