Pathology foundation models (PFMs) have rapidly advanced and are becoming a common backbone for downstream clinical tasks, offering strong transferability across tissues and institutions. However, for dense prediction (e.g., segmentation), practical deployment still lacks a clear, reproducible understanding of how different PFMs behave across datasets and how adaptation choices affect performance and stability. We present PFM-DenseBench, a large-scale benchmark for dense pathology prediction, evaluating 17 PFMs across 18 public segmentation datasets. Under a unified protocol, we systematically assess PFMs with multiple adaptation and fine-tuning strategies, and derive insightful, practice-oriented findings on when and why different PFMs and tuning choices succeed or fail across heterogeneous datasets. We release containers, configs, and dataset cards to enable reproducible evaluation and informed PFM selection for real-world dense pathology tasks. Project Website: https://m4a1tastegood.github.io/PFM-DenseBench
@article{arxiv.2602.03887,
title = {To What Extent Do Token-Level Representations from Pathology Foundation Models Improve Dense Prediction?},
author = {Weiming Chen and Xitong Ling and Xidong Wang and Zhenyang Cai and Yijia Guo and Mingxi Fu and Ziyi Zeng and Minxi Ouyang and Jiawen Li and Yizhi Wang and Tian Guan and Benyou Wang and Yonghong He},
journal= {arXiv preprint arXiv:2602.03887},
year = {2026}
}