{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T10:27:50Z","timestamp":1786530470949,"version":"build-2736575974"},"reference-count":24,"publisher":"MDPI AG","issue":"8","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Imaging"],"abstract":"<jats:p>Breast cancer is the most common cancer among women, and early detection through mammography is essential for reducing mortality. Artificial intelligence can support radiologists by improving diagnostic accuracy. To develop and evaluate a two-stage ensemble machine learning pipeline for breast cancer diagnosis from digital mammograms. The proposed framework combines image preprocessing, multiple convolutional neural networks trained under different conditions, and a second-stage classifier that integrates the CNN outputs. Several machine learning models and feature selection techniques were evaluated using publicly available mammography datasets. Results: The ensemble approach consistently outperformed the individual CNN models. The MLP classifier achieved the best overall balance between precision and recall, while the heuristic fusion method provided the highest sensitivity. Feature selection reduced model complexity while maintaining comparable performance, and cross-validation confirmed the robustness of the proposed methodology. Combining complementary information from multiple CNNs with classical machine learning improves diagnostic performance and provides a robust framework for computer-aided breast cancer diagnosis. The proposed two-stage ensemble offers an effective and interpretable approach for mammographic breast cancer classification. A demonstration application incorporating Grad-CAM explainability further supports its potential use as a clinical decision-support tool.<\/jats:p>","DOI":"10.3390\/jimaging12080378","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T09:11:36Z","timestamp":1786525896000},"page":"378","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["A Two-Stage Ensemble Machine Learning Pipeline for Breast Cancer Diagnosis from Digital Mammograms"],"prefix":"10.3390","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5323-7744","authenticated-orcid":false,"given":"Fernando","family":"Mart\u00edn-Rodr\u00edguez","sequence":"first","affiliation":[{"name":"atlantTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Freire-Bouza","sequence":"additional","affiliation":[{"name":"atlantTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3650-6068","authenticated-orcid":false,"given":"M\u00f3nica","family":"Fern\u00e1ndez-Barciela","sequence":"additional","affiliation":[{"name":"atlantTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2576-8019","authenticated-orcid":false,"given":"Ainhoa","family":"Morales-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"atlantTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0006-7844-0390","authenticated-orcid":false,"given":"Mar\u00eda","family":"Marante-Boado","sequence":"additional","affiliation":[{"name":"atlantTTic Research Center for Telecommunication Technologies, University of Vigo, 36310 Vigo, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"ref_1","unstructured":"World Health Organization (WHO) (2021). 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