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The British Journal of Radiology Feb 2023Screening mammography identifies early-stage breast cancers and is associated with reduced breast cancer mortality. An unintended consequence of breast screening is the...
Screening mammography identifies early-stage breast cancers and is associated with reduced breast cancer mortality. An unintended consequence of breast screening is the detection and diagnosis of multiple incidental benign and malignant breast lesions, including the heterogenous group of incidental benign (B3) lesions with uncertain biological outcomes and malignant potential, for which management remains controversial. Recent shifts toward more conservative management approaches, including the identification of patients who can undergo observation after vacuum-assisted excision, has gained interest. This commentary provides an overview of incidental B3 lesions and summarizes the current management paradigms for them.
Topics: Humans; Female; Breast Neoplasms; Mammography; Early Detection of Cancer; Breast; Diagnosis, Differential
PubMed: 35451861
DOI: 10.1259/bjr.20211326 -
Breast Cancer Research and Treatment Jul 2022Mammographic Density (MD) refers to the amount of fibroglandular breast tissue present in the breast and is an established risk factor for developing breast cancer. The...
PURPOSE
Mammographic Density (MD) refers to the amount of fibroglandular breast tissue present in the breast and is an established risk factor for developing breast cancer. The ability to evaluate treatment response dynamically renders neoadjuvant chemotherapy (NACT) the preferred treatment option in many clinical scenarios. Previous studies have suggested that MD can predict patients likely to achieve a pathological complete response (pCR) to NACT. We aimed to determine whether there is a causal relationship between BI-RADS breast composition categories for breast density at diagnosis and the pCR rate and residual cancer burden score (RCB) by performing a retrospective review on consecutive breast cancer patients who received NACT in a tertiary referral centre from 2015 to 2021.
METHODS
The Mann-Whitney U Test was used to test for differences between two independent groups (i.e. those who achieved pCR and those who did not). A binary logistic regression model was used to estimate odds ratios (OR) and corresponding 95% confidence intervals (CI) for an association between the independent variables of molecular subtype, MD, histological grade and FNA positivity and the dependant variable of pCR. Statistical analysis was conducted with SPSS (IBM SPSS for Mac, Version 26.0; IBM Corp).
RESULTS
292 patients were included in the current study. There were 124, 155 and 13 patients in the BI-RADS MD category b, c and d, respectively. There were no patients in the BI-RADS MD category a. The patients with less dense breast composition (MD category b) were significantly older than patients with denser breast composition (MD category c, d) (p = 0.001) and patients who had a denser breast composition (MD category d) were more likely to have ER+ tumours. There was no significant difference in PgR status, HER2 status, pathological complete response (pCR), FNA positivity, or RCB class dependent upon the three MD categories. A binary logistic regression revealed that patients with HER2-enriched breast cancer and triple-negative breast cancer are more likely to achieve pCR with an OR of 3.630 (95% CI 1.360-9.691, p = 0.010) and 2.445 (95% CI 1.131-5.288, p = 0.023), respectively.
CONCLUSION
Whilst dense MD was associated with ER positivity and these women were less likely to achieve a pCR, MD did not appear to independently predict pCR post-NACT.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Neoadjuvant Therapy
PubMed: 35606616
DOI: 10.1007/s10549-022-06616-1 -
Diagnostic and Interventional Imaging Oct 2019Three-dimensional automated breast ultrasound system (3D ABUS) is an innovation in breast ultrasound that has been developed to uncouple detection from image acquisition... (Review)
Review
Three-dimensional automated breast ultrasound system (3D ABUS) is an innovation in breast ultrasound that has been developed to uncouple detection from image acquisition and to address the limitations of handheld ultrasound (HHUS). 3D ABUS provides a large field of view using high frequency transducers, producing high-resolution images and covering a large portion of the breast with one sweep. As more data become available on breast density and the impact of supplemental screening, 3D ABUS has gained wider acceptance as an adjunct tool to mammography. Computer-aided detection software significantly reduces interpretation time, improving the workflow for the utilization of 3D ABUS as a supplemental screening tool. In the diagnostic setting, 3D ABUS offers valuable impact in the detectability of breast lesions and the differentiation of malignant from benign lesions, with a high inter-observer agreement. State-of-the art technique, including uniform compression and proper positioning, tends to reduce artifactual posterior shadowing, while combined 3D ABUS-mammography interpretation improves radiologists' diagnostic performance. Promising results have supported the enhanced efficiency of 3D ABUS in detecting the extent of breast cancer and assessing response to neoadjuvant chemotherapy, whereas its correlation with molecular subtypes of breast cancer is remarkable. Future perspectives include the integration of radiomics and deep learning in the further development of 3D ABUS.
Topics: Artifacts; Breast; Breast Density; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Image Interpretation, Computer-Assisted; Imaging, Three-Dimensional; Observer Variation; Ultrasonography, Mammary
PubMed: 30962169
DOI: 10.1016/j.diii.2019.03.012 -
Diagnostic and Interventional Radiology... 2017High social awareness of breast diseases and the rise in breast imaging facilities have led to an increase in the detection of even rare benign and malignant breast... (Review)
Review
High social awareness of breast diseases and the rise in breast imaging facilities have led to an increase in the detection of even rare benign and malignant breast lesions. Breast lesions are associated with a broad spectrum of imaging characteristics, and each radiologic imaging technique reflects different characteristics of them. We aimed to increase familiarity of the radiologist with these uncommon lesions as well as correlate histopathologic findings with the radiologic imaging features of the tumors. Histopathologic examination is necessary in the evaluation of such breast lesions, particularly when radiologic images are not definitive for a specific diagnosis.
Topics: Breast; Breast Diseases; Female; Humans; Mammography
PubMed: 28508760
DOI: 10.5152/dir.2017.16085 -
Journal of Cancer Research and... 2020The study aimed to assess breast density as a risk factor for breast malignancy using automated volumetric breast density software and to study the relationship of...
PURPOSE
The study aimed to assess breast density as a risk factor for breast malignancy using automated volumetric breast density software and to study the relationship of breast density with tumor histopathological characteristics.
MATERIALS AND METHODS
One hundred and thirty-four women with unilateral core biopsy-proven breast cancer were taken in the "case group." Two hundred and one women with normal bilateral screening mammograms were enrolled in the "control group." The cases and controls were further divided into pre- and post-menopausal subgroups. The mammograms of the contralateral breast of the cases and bilateral breasts of the controls were evaluated by automated volumetric breast density software and classified into four density grades. The tumor histopathological characteristics in the various density grades were also evaluated.
RESULTS
In premenopausal women, the odds of having breast cancer was significantly higher for Grade 3 breasts (odds ratio [OR] 3.03; 95% confidence interval [CI]: [1.19-7.71]) versus Grade 1 and 2 breasts. Grade 4 premenopausal breasts also had greater odds (OR 3.09; 95% CI [0.89-10.78]) of developing breast cancer. No such relationship was established for postmenopausal women. No significant difference was seen in the histopathology of breast cancer among various breast density groups.
CONCLUSION
Increased breast density can be considered as an inherent, independent risk factor for breast cancer in premenopausal women.
Topics: Adult; Aged; Breast; Breast Density; Breast Neoplasms; Case-Control Studies; Early Detection of Cancer; Female; Humans; Mammography; Middle Aged; Odds Ratio; Premenopause; Risk Factors; Software
PubMed: 33342781
DOI: 10.4103/jcrt.JCRT_568_18 -
The British Journal of Radiology Feb 2023Despite its unparalleled sensitivity for aggressive breast cancer, breast MRI continually excites criticism for a specificity that lags behind that of modern... (Review)
Review
Despite its unparalleled sensitivity for aggressive breast cancer, breast MRI continually excites criticism for a specificity that lags behind that of modern mammographic techniques. Radiologists reporting breast MRI need to recognise the range of benign appearances on breast MRI to avoid unnecessary biopsy. This review summarises the reported diagnostic accuracy of breast MRI with particular attention to the technique's specificity, provides a referenced reporting strategy and discusses factors that compromise diagnostic confidence. We then present a pictorial review of benign findings on breast MRI. Enhancing radiological skills to discriminate malignant from benign findings will minimise false positive biopsies, enabling optimal use of multiparametric breast MRI for the benefit of screening clients and breast cancer patients.
Topics: Humans; Female; Sensitivity and Specificity; Breast; Magnetic Resonance Imaging; Breast Neoplasms; Mammography
PubMed: 36488196
DOI: 10.1259/bjr.20220280 -
Sensors (Basel, Switzerland) Aug 2018Women's breasts are susceptible to developing cancer; this is supported by a recent study from 2016 showing that 2.8 million women worldwide had already been diagnosed... (Review)
Review
Women's breasts are susceptible to developing cancer; this is supported by a recent study from 2016 showing that 2.8 million women worldwide had already been diagnosed with breast cancer that year. The medical care of a patient with breast cancer is costly and, given the cost and value of the preservation of the health of the citizen, the prevention of breast cancer has become a priority in public health. Over the past 20 years several techniques have been proposed for this purpose, such as mammography, which is frequently used for breast cancer diagnosis. However, false positives of mammography can occur in which the patient is diagnosed positive by another technique. Additionally, the potential side effects of using mammography may encourage patients and physicians to look for other diagnostic techniques. Our review of the literature first explored infrared digital imaging, which assumes that a basic thermal comparison between a healthy breast and a breast with cancer always shows an increase in thermal activity in the precancerous tissues and the areas surrounding developing breast cancer. Furthermore, through our research, we realized that a Computer-Aided Diagnostic (CAD) undertaken through infrared image processing could not be achieved without a model such as the well-known hemispheric model. The novel contribution of this paper is the production of a comparative study of several breast cancer detection techniques using powerful computer vision techniques and deep learning models.
Topics: Breast; Breast Neoplasms; Female; Humans; Image Processing, Computer-Assisted; Infrared Rays; Machine Learning; Sensitivity and Specificity; Thermography
PubMed: 30149621
DOI: 10.3390/s18092799 -
European Journal of Radiology Oct 2022In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening... (Review)
Review
In X-ray breast imaging, Digital Mammography (DM) and Digital Breast Tomosynthesis (DBT), are the standard and largely used techniques, both for diagnostic and screening purposes. Other techniques, such as dedicated Breast Computed Tomography (BCT) and Contrast Enhanced Mammography (CEM) have been developed as an alternative or a complementary technique to the established ones. The performance of these imaging techniques is being continuously assessed to improve the image quality and to reduce the radiation dose. These imaging modalities are predominantly used in the diagnostic setting to resolve incomplete or indeterminate findings detected with conventional screening examinations and could potentially be used either as an adjunct or as a primary screening tool in select populations, such as for women with dense breasts. The aim of this review is to describe the radiation dosimetry for these imaging techniques, and to compare the mean glandular dose with standard breast imaging modalities, such as DM and DBT.
Topics: Breast; Breast Density; Breast Neoplasms; Female; Humans; Mammography; Radiometry; X-Rays
PubMed: 36087425
DOI: 10.1016/j.ejrad.2022.110509 -
BMC Cancer Oct 2023Mammographic density (MD) is a strong risk factor for breast cancer. We aimed to evaluate the association between MD and breast cancer related risk factors among...
BACKGROUND
Mammographic density (MD) is a strong risk factor for breast cancer. We aimed to evaluate the association between MD and breast cancer related risk factors among average-risk women in rural China.
METHODS
This is a population-based screening study. 12518 women aged 45-64 years with complete MD data from three maternal and childcare hospitals in China were included in the final analysis. ORs and 95%CIs were estimated using generalized logit model by comparing each higher MD (BI-RADS b, c, d) to the lowest group (BI-RADS a). The cumulative logistic regression model was used to estimate the OR (95%CI) and P by treating MD as an ordinal variable.
RESULTS
Older age (OR = 0.81, 95%CI: 0.79-0.81, per 2-year increase), higher BMI (OR = 0.73, 95%CI: 0.71-0.75, per 2 kg/m2), more births (OR = 0.47, 95%CI: 0.41-0.54, 3 + vs. 0-1), postmenopausal status (OR = 0.42, 95%CI: 0.38-0.46) were associated with lower MD. For parous women, longer duration of breastfeeding was found to be associated with higher MD when adjusting for study site, age, BMI, and age of first full-term birth (OR = 1.53, 95%CI: 1.27-1.85, 25 + months vs. no breastfeeding; OR = 1.45, 95%CI: 1.20-1.75, 19-24 months vs. no breastfeeding), however, the association became non-significant when adjusting all covariates. Associations between examined risk factors and MD were similar in premenopausal and postmenopausal women except for level of education and oral hormone drug usage. Higher education was only found to be associated with an increased proportion of dense breasts in postmenopausal women (OR = 1.08, 95%CI: 1.02-1.15). Premenopausal women who ever used oral hormone drug were less likely to have dense breasts, though the difference was marginally significant (OR = 0.54, P = 0.045). In postmenopausal women, we also found the proportion of dense breasts increased with age at menopause (OR = 1.31, 95%CI: 1.21-1.43).
CONCLUSIONS
In Chinese women with average risk for breast cancer, we found MD was associated with age, BMI, menopausal status, lactation, and age at menopausal. This finding may help to understand the etiology of breast cancer and have implications for breast cancer prevention in China.
Topics: Female; Humans; Infant; Breast Density; Breast Neoplasms; Mammography; Risk Factors; China; Hormones; Breast
PubMed: 37814233
DOI: 10.1186/s12885-023-11444-7 -
Seminars in Ultrasound, CT, and MR Feb 2018Dedicated breast computed tomography (CT) is the latest in a long history of breast imaging techniques dating back to the 1960s. Breast imaging is performed both for... (Review)
Review
Dedicated breast computed tomography (CT) is the latest in a long history of breast imaging techniques dating back to the 1960s. Breast imaging is performed both for cancer screening as well as for diagnostic evaluation of symptomatic patients. Dedicated breast CT received US Food and Drug Administration approval for diagnostic use in 2015 and is slowly gaining recognition for its value in diagnostic 3-dimensional imaging of the breast, and also for injected contrast-enhanced imaging applications. Conventional mammography has known limitations in sensitivity and specificity, especially in dense breasts. Breast tomosynthesis was US Food and Drug Administration approved in 2011 and is now widely used. Dedicated breast CT is the next technological advance, combining real 3-dimensional imaging with the ease of contrast administration. The lack of painful compression and manipulation of the breasts also makes dedicated breast CT much more acceptable for the patients.
Topics: Breast; Breast Neoplasms; Cone-Beam Computed Tomography; Female; Humans; Imaging, Three-Dimensional; Mammography; Sensitivity and Specificity
PubMed: 29317032
DOI: 10.1053/j.sult.2017.09.001