Aligning Cellular Sheaves with Classifier Attention for Interpretable Weakly-Supervised Pathology Localization

Abstract

Weakly-supervised classification of whole-slide images with attention-based multiple instance learning (ABMIL) on top of foundation features now reaches near-saturation on Camelyon16 slide-level performance, but the corresponding attention maps are an imperfect localization signal: in clinical interpretation, a model that classifies correctly without firing on the actual lesion is hard to trust. We address this gap with cellular sheaves, which equip each vertex and edge of a graph with a finite-dimensional vector space and consistent linear maps between them, providing a principled way to detect local disagreement on graph-structured data. We apply cellular sheaves to weakly-supervised tumour localization on whole-slide images, combining a sheaf disagreement field with ABMIL. The natural training objective, encouraging consistency between similar features, produces a disagreement field that tracks tissue-level texture rather than diagnostic content. We propose attention-conditional consistency, which uses the classifier's attention to define which neighbouring patches should agree. Joint training of the classifier and the sheaf under this objective produces a disagreement field with patch-level AUC 0.940 on Camelyon16 and raises the attention head from its ABMIL-alone level of 0.717 to 0.953. Two-stage ablation with the classifier frozen at its ABMIL values reaches only 0.727 on the disagreement field and leaves attention at 0.717, confirming that the gain comes from the projector co-adapting under both objectives, not from the loss change in isolation. The trained model transfers without retraining to annotated slides from Camelyon17, maintaining Delta AUC 0.932 +/- 0.083 and attention AUC 0.955 +/- 0.099. The result is an attention map and a sheaf-disagreement map that fire on the same diagnostic regions, giving clinicians two complementary explanations for each slide-level prediction.