UGB-SegNet: Uncertainty-Guided Multi-Scale Attention and Boundary-Aware Learning for Breast Ultrasound Lesion Segmentation

Accurate breast lesion segmentation in ultrasound is difficult because speckle noise, heterogeneous lesion appearance, and poorly defined margins can obscure clinically relevant boundaries. This work presents UGB-SegNet, an uncertainty-guided breast ultrasound segmentation network that combines four components: multi-scale convolutional block attention (CBAM) at three EfficientNet-B0 encoder stages, a learnable feature pyramid network for adaptive multi-scale fusion, an entropy-guided decoder that routes fine-grained encoder information toward uncertain regions, and a boundary-aware composite loss with deep supervision. The model was evaluated on the public BUSI dataset (647 annotated lesion images) using a stratified 454/64/129 train/validation/test split. On the held-out test set, UGB-SegNet achieved 81.30% Dice, 68.49% IoU, 81.71% sensitivity, 98.14% specificity, and 15.63-pixel HD95. Under identical training conditions it outperformed five directly trained baselines: U-Net, Attention U-Net, SegNet, DeepLabV3+, and TransUNet. A five-fold resampling experiment over the development set with the held-out test set fixed yielded a mean Dice of 76.36% +/-1.66% (95% CI 74.90-77.81). Reported ablations attribute gains of +2.06 Dice points to multi-scale CBAM, +1.52 to learnable FPN fusion, +1.22 to the uncertainty-guided decoder, and +1.24 to boundary-aware training. UGB-SegNet contains 14.00M parameters and runs at 62.4 FPS at 224 × 224 resolution on the tested NVIDIA GPU, providing a compact accuracy-efficiency trade-off for future prospective clinical validation.