MammoSeek: A Mammography Agent with selective zooming for grounded reports

Abstract

Radiologists read a screening mammogram by first forming a global impression of the four views and then selectively magnifying suspicious regions before assigning a BI-RADS assessment. MLLMs, in contrast, see the whole image at a fixed, reduced resolution, which makes sub-millimeter calcifications invisible, and they perform close to chance on mammography. Therefore, we present MammoSeek, a mammography agent that reproduces this reading process. After forming an impression of each breast, the agent performs selective zooming: it decides by itself which detector candidates deserve a closer look and inspects only those on full-resolution views. Guided by a BI-RADS assessment skill, it then assigns a category and generates a localized, lexicon-structured report for each breast; its assessment is combined with image-model scores in a decision layer to decide recall. On an internal (EMBED) and an external (VinDr-Mammo) dataset, \ours reaches exam-level AUCs of 0.824 and 0.818, far above other MLLMs, mammography agent and CNN classifiers. Selective zooming also outperforms both no zooming and forced zooming in localization, structured-report F1 and recall decisions at low cost.