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Technology in Cancer Research &... 2022Iterative (eg, simultaneous algebraic reconstruction technique [SART]) and analytical (eg, filtered back projection [FBP]) image reconstruction techniques have been...
Iterative (eg, simultaneous algebraic reconstruction technique [SART]) and analytical (eg, filtered back projection [FBP]) image reconstruction techniques have been suggested to provide adequate three-dimensional (3D) images of the breast for capturing microcalcifications in digital breast tomosynthesis (DBT). To decide on the reconstruction method in clinical DBT, it must first be tested in a simulation resembling the real clinical environment. The purpose of this study is to introduce a 3D realistic breast phantom for determining the reconstruction method in clinical applications. We designed a 3D realistic breast phantom with varying dimensions (64-512) mimicking some structures of a real breast such as milk ducts, lobules, and ribs using TomoPhantom software. We generated microcalcifications, which mimic cancerous cells, with a separate MATLAB code and embedded them into the phantom for testing and benchmark studies in DBT. To validate the characterization of the phantom, we tested the distinguishability of microcalcifications by performing 3D image reconstruction methods (SART and FBP) using Laboratory of Computer Vision (LAVI) open-source reconstruction toolbox. The creation times of the proposed realistic breast phantom were seconds of 2.5916, 8.4626, 57.6858, and 472.1734 for 64, 128, 256, and 512, respectively. We presented reconstructed images and quantitative results of the phantom for SART (1-2-4-8 iterations) and FBP, with 11 to 23 projections. We determined qualitatively and quantitatively that SART (2-4 iter.) yields better results than FBP. For example, for 23 projections, the contrast-to-noise ratio (CNR) values of SART (2 iter.) and FBP were 2.871 and 0.497, respectively. We created a computationally efficient realistic breast phantom that is eligible for reconstruction and includes anatomical structures and microcalcifications, successfully. By proposing this breast phantom, we provided the opportunity to test which reconstruction methods can be used in clinical applications vary according to various parameters such as the No. of iterations and projections in DBT.
Topics: Algorithms; Breast; Calcinosis; Humans; Imaging, Three-Dimensional; Mammography
PubMed: 36071652
DOI: 10.1177/15330338221104567 -
Breast Cancer Research : BCR 2005Epidemiological, clinical, and experimental data indicate that the risk of developing breast cancer is strongly dependent on the ovary and on endocrine conditions... (Review)
Review
Epidemiological, clinical, and experimental data indicate that the risk of developing breast cancer is strongly dependent on the ovary and on endocrine conditions modulated by ovarian function, such as early menarche, late menopause, and parity. Women who gave birth to a child when they were younger than 24 years of age exhibit a decrease in their lifetime risk of developing breast cancer, and additional pregnancies increase the protection. The breast tissue of normally cycling women contains three identifiable types of lobules, the undifferentiated Lobules type 1 (Lob 1) and the more developed Lobules type 2 and Lobules type 3. The breast attains its maximum development during pregnancy and lactation (Lobules type 4). After menopause the breast regresses in both nulliparous and parous women containing only Lob 1. Despite the similarity in the lobular composition of the breast at menopause, the fact that nulliparous women are at higher risk of developing breast cancer than parous women indicates that Lob 1 in these two groups of women might be biologically different, or might exhibit different susceptibility to carcinogenesis. Based on these observations it was postulated that Lob 1 found in the breast of nulliparous women and of parous women with breast cancer never went through the process of differentiation, retaining a high concentration of epithelial cells that are targets for carcinogens and are therefore susceptible to undergo neoplastic transformation. These epithelial cells are called Stem cells 1, whereas Lob 1 structures found in the breast of early parous postmenopausal women free of mammary pathology, on the contrary, are composed of an epithelial cell population that is refractory to transformation, called Stem cells 2. It was further postulated that the degree of differentiation acquired through early pregnancy has changed the 'genomic signature' that differentiates Lob 1 of the early parous women from that of the nulliparous women by shifting the Stem cells 1 to Stem cells 2 that are refractory to carcinogenesis, making this the postulated mechanism of protection conferred by early full-term pregnancy. The identification of a putative breast stem cell (Stem cells 1) has, in the past decade, reached a significant impulse, and several markers also reported for other tissues have been found in the mammary epithelial cells of both rodents and humans. Although further work needs to be carried out in order to better understand the role of the Stem cells 2 and their interaction with the genes that confer them a specific signature, collectively the data presently available provide evidence that pregnancy, through the process of cell differentiation, shifts Stem cells 1 to Stem cells 2 - cells that exhibit a specific genomic signature that could be responsible for the refractoriness of the mammary gland to carcinogenesis.
Topics: Adult; Aged; Breast; Breast Neoplasms; Carcinogens; Cell Differentiation; Cell Transformation, Neoplastic; Female; Humans; Incidence; Menopause; Middle Aged; Parity; Pregnancy; Stem Cells
PubMed: 15987443
DOI: 10.1186/bcr1029 -
Pharmaceutics May 2021Metastatic cancer disease is the major cause of death in cancer patients. Because those small secondary tumors are clinically hardly detectable in their early stages,...
Metastatic cancer disease is the major cause of death in cancer patients. Because those small secondary tumors are clinically hardly detectable in their early stages, little is known about drug biodistribution and permeation into those metastatic tumors potentially contributing to insufficient clinical success against metastatic disease. Our recent studies indicated that breast cancer liver metastases may have compromised perfusion of intratumoral capillaries hindering the delivery of therapeutics for yet unknown reasons. To understand the microcirculation of small liver metastases, we have utilized computational simulations to study perfusion and oxygen concentration fields in and around the metastases smaller than 700 µm in size at the locations of portal vessels, central vein, and liver lobule acinus. Despite tumor vascularization, the results show that blood flow in those tumors can be substantially reduced indicating the presence of inadequate blood pressure gradients across tumors. A low blood pressure may contribute to the collapsed intratumoral capillary lumen limiting tumor perfusion that phenomenologically corroborates with our previously published in vivo studies. Tumors that are smaller than the liver lobule size and originating at different lobule locations may possess a different microcirculation environment and tumor perfusion. The acinus and portal vessel locations in the lobule were found to be the most beneficial to tumor growth based on tumor access to blood flow and intratumoral oxygen. These findings suggest that microcirculation states of small metastatic tumors can potentially contribute to physiological barriers preventing efficient delivery of therapeutic substances into small tumors.
PubMed: 34065867
DOI: 10.3390/pharmaceutics13050703 -
Acta Bio-medica : Atenei Parmensis Jan 2019Idiopathic granulomatous mastitis (IGM) is a chronic benign inflammatory disease of the breast that may mimic breast cancer. It is most common in parous young fertile... (Review)
Review
Idiopathic granulomatous mastitis (IGM) is a chronic benign inflammatory disease of the breast that may mimic breast cancer. It is most common in parous young fertile women, although it can occur in nulliparous women and in men. IGM is an idiopathic disease due to the influence of some environmental factors in genetically predisposed subjects. Several pathogenic hypothesis have been proposed in the last years (autoimmune, hormonal, infective genesis). IGM presents as a painful palpable mass located in one of the two udders. The skin is usually normal but could present signs of inflammation with or without lymph nodes involvement. Ultrasonography, mammography, magnetic resonance can be diagnosed an IGM, but pathognomonic radiological signs has not yet reported in literature. Biopsy findings show granulomatous lesion centered on the breast lobule, as in granulomatous mastitis induced by tuberculosis or sarcoidosis. The aim of this review of literature is to verify the development of new advanced diagnostic techniques and multidisciplinary approach for this condition. In the last years innovative approaches have modified IGM diagnosis and therapy, avoiding surgery in most of cases, introducing a more conservative medical approach based on recent etiopathological hypothesis.
Topics: Female; Granulomatous Mastitis; Humans; Selective Serotonin Reuptake Inhibitors
PubMed: 30889150
DOI: 10.23750/abm.v90i1.6607 -
The Malaysian Journal of Pathology Apr 2015Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, presenting as a soft, mobile and well-defined mass. The typical...
Adenolipoma of the breast is an uncommon mammary lesion classified as a hamartomatous lesion, presenting as a soft, mobile and well-defined mass. The typical mammographic findings is of a well-circumscribed lesion containing both fat and soft tissue surrounded by a capsule. Microscopically, adenolipoma exhibits a hamartomatous mixture of ducts and lobules intermingled with adipose and fibroconnective tissue. Enucleation is the standard treatment and recurrences are rare. We report a 29-year-old woman with a mobile, tender and firm mass, 6x5 cm, in the upper inner quadrant of the right breast of 1 month duration. Mediolateral mammography images demonstrated a well-defined mass with mixed granular and fat density. Histopathology of the excised mass revealed well-circumscribed lobules of ducts and glandular structures haphazardly embedded in mature fatty tissue. Breast hamartoma should be differentiated from other benign lesions of the breast. Awareness among radiologists and pathologists of this benign lesion would help avoid an incorrect diagnosis and unnecessary intervention.
Topics: Adult; Biopsy; Breast Diseases; Diagnosis, Differential; Female; Hamartoma; Humans; Mammography; Mastectomy, Segmental; Predictive Value of Tests
PubMed: 25890618
DOI: No ID Found -
PloS One 2017Increased levels of pro-inflammatory markers and decreased levels of anti-inflammatory markers in the breast tissue can result in local inflammation. We aimed to...
Increased levels of pro-inflammatory markers and decreased levels of anti-inflammatory markers in the breast tissue can result in local inflammation. We aimed to investigate whether local inflammation in the breast tissue is associated with age-related lobular involution, a process inversely related to breast cancer risk. Levels of eleven pro- and anti-inflammatory markers were assessed by immunohistochemistry in normal breast tissue obtained from 164 pre- and postmenopausal breast cancer patients. Involution status of the breast (degree of lobular involution and the predominant lobule type) was microscopically assessed in normal breast tissue on hematoxylin-eosin stained mastectomy slides. Multivariate generalized linear models were used to assess the associations. In age-adjusted analyses, higher levels of pro-inflammatory markers IL-6, TNF-α, CRP, COX-2, leptin, SAA1 and IL-8; and anti-inflammatory marker IL-10, were inversely associated with the prevalence of complete lobular involution (all P≤0.04). Higher levels of the pro-inflammatory marker COX-2 were also associated with lower prevalence of predominant type 1/no type 3 lobules in the breast, an indicator of complete involution, in age-adjusted analysis (P = 0.017). Higher tissue levels of inflammatory markers, mainly the pro-inflammatory ones, are associated with less involuted breasts and may consequently be associated with an increased risk of developing breast cancer.
Topics: Adult; Age Factors; Aging; Breast Neoplasms; Carcinoma, Lobular; Cytokines; Female; Humans; Inflammation; Middle Aged; Postmenopause; Premenopause
PubMed: 28846716
DOI: 10.1371/journal.pone.0183579 -
Journal of Ultrasound in Medicine :... Nov 2015The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) atlas for ultrasound (US) qualitatively describes the echogenicity and attenuation...
OBJECTIVES
The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) atlas for ultrasound (US) qualitatively describes the echogenicity and attenuation of a mass, where fat lobules serve as a standard for comparison. This study aimed to estimate acoustic properties of breast fat under clinical imaging conditions to determine the degree to which properties vary among patients.
METHODS
Twenty-four women with solid breast masses scheduled for biopsy were scanned with a Siemens S2000 scanner and 18L6 linear array transducer (Siemens Medical Solutions, Malvern, PA). Offline analysis estimated the attenuation coefficient and backscatter coefficients (BSCs) from breast fat using the reference phantom method. The average BSC was calculated over 6 to 12 MHz to objectively quantify the BI-RADS US echo pattern descriptor, and effective scatterer diameters were also estimated.
RESULTS
A power law fit to the attenuation coefficient versus frequency yielded an attenuation coefficient of 1.28 dB·cm(-1) MHz(-0.73). The mean attenuation coefficient versus frequency slope ± SD at 7 MHz was 0.73 ± 0.23 dB·cm(-1) MHz(-1), in agreement with previously reported values. The BSC versus frequency showed close agreement among all patients, both in magnitude and frequency dependence, with a power law fit of (0.6 ± 0.25) ×10(-4) sr(-1) cm(-1) MHz(-2.49). The average backscatter in the 6-12-MHz range was 0.004 ± 0.002 sr(-1) cm(-1). The mean effective scatterer diameter for fat was 60.2 ± 9.5 μm.
CONCLUSIONS
The agreement in parameter estimates for breast fat among these patients supports the use of fat as a standard for comparison with tumors. Results also suggest that objective quantification of these BI-RADS US descriptors may reduce subjectivity when interpreting B-mode image data.
Topics: Absorption, Radiation; Adipose Tissue; Adult; Breast Neoplasms; Female; Humans; Image Interpretation, Computer-Assisted; Middle Aged; Reproducibility of Results; Scattering, Radiation; Sensitivity and Specificity; Ultrasonic Waves; Ultrasonography, Mammary
PubMed: 26446820
DOI: 10.7863/ultra.14.07039 -
Frontiers in Surgery 2022To describe the clinical imaging and pathological features of invasive micropapillary breast carcinoma (IMPC), including breast mammography, sonography, magnetic...
PURPOSE
To describe the clinical imaging and pathological features of invasive micropapillary breast carcinoma (IMPC), including breast mammography, sonography, magnetic resonance imaging (MRI), and molecular imaging findings.
PATIENTS AND METHODS
We retrospectively reviewed our institution's surgical pathology database and identified 65 patients with pathologically proven IMBC; 63/65 patients had available imaging results. Two radiologists retrospectively reviewed all imaging evaluations according to the Breast Imaging Reporting / Data System (BI-RADS) Lexicon. Clinical and histopathologic features, receptor statuses, and clinical follow-up data were recorded.
RESULTS
Sixty-three patients were admitted with palpable abnormalities; one patient's mammogram revealed no abnormality (3.3%, 1/32), whereas 31 had abnormal mammograms (31/32, 96.8%) demonstrating 37 lesions. Twenty-four had irregular, spiculated masses, 12 had microcalcifications, and 19 had architectural distortion. Sonography detected 69 masses (54 patients), characterized by irregular shapes (61/69, 88.4%), hypoechoic structures (50/69, 72.4%), angular or spiculated margins (38/69, 55.1%; 30/69, 43.4%), echogenic halo (8/69, 11.5%), and abnormal vascularity (52/69, 75.3%). MRI detected 68 lesions (52 patients); 59/68 (86.8%) appeared as masses with angular or spiculated margins (32/68, 47.1%; 35/68, 51.4%), 58 exhibited irregular or lobulated shapes (58/68, 89.7%), 29 displayed heterogeneous internal enhancement (29/68, 42.5%), and 64 demonstrated type II or III washout kinetic curves (37/68, 55%; 27/68, 40%). Breast molecular imaging showed mild-to-moderate radiotracer uptake in 15 focal areas among 13 patients. Thirty-two, 38, and 43 patients had abnormal lymph nodes identified mammographically, by breast sonography, and by MRI, respectively. Immunohistochemistry revealed high estrogen receptor (90.5%), high progesterone receptor (71.6%), and low HER-2 (26.4%) positivity.
CONCLUSION
IMPC mammography, sonography, and MRI clinical imaging features highly suggest malignancy. Breast molecular imaging also contributed to the diagnosis. IMPC's invasiveness correlated well with regional lymph node metastasis. Radiologists and surgeons should be more attentive to these imaging findings and additional clinical and pathological IMPC features.
PubMed: 36211280
DOI: 10.3389/fsurg.2022.1011773 -
Medicine Sep 2021Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated... (Review)
Review
Plexiform fibromyxoma (PF) is a rare mesenchymal neoplasm which can be misdiagnosed as the gastrointestinal stromal tumor. This tumor almost formed a lobulated intramural/submucosal mass in the gastric antrum and prepyloric area. It was considered as a benign tumor that exhibited no recurrence, metastasis, or tumor-related mortality. In this study, we reported 2 cases of gastric PF. The first case was a PF patient coexisting with gastric adenocarcinoma. The second case occurred in the gastric upper body close to gastric fundus. They underwent distal gastrectomy and laparoscopic partial gastric resection, respectively. Both of them exhibited a plexiform growth pattern in the submucosa, muscularis propria, and subserosal adipose tissues. The nodules were composed of abundant myxoid or fibromyxoid matrix riching in small thin-walled blood vessels and bland-looking spindle cells. The first case partially showed staggered growth pattern of PF and adenocarcinoma. Immunohistochemically, the spindle cells were diffusely immunoreactive for SMA and vimentin, and focally immunoreactive for CD10. It was important to distinguish the PF from other spindle cell tumors involving the stomach.
Topics: Adenocarcinoma; Adult; Diagnosis, Differential; Female; Fibroma; Gastrectomy; Humans; Male; Middle Aged; Neoplasm Recurrence, Local; Neoplasms, Multiple Primary; Stomach Neoplasms
PubMed: 34516510
DOI: 10.1097/MD.0000000000027164 -
The Breast Journal 2023Lobular neoplasia (LN) involves proliferative changes within the breast lobules. LN is divided into lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia... (Observational Study)
Observational Study
Lobular neoplasia (LN) involves proliferative changes within the breast lobules. LN is divided into lobular carcinoma in situ (LCIS) and atypical lobular hyperplasia (ALH). LCIS can be further subdivided into three subtypes: classic LCIS, pleomorphic LCIS, and LCIS with necrosis (florid type). Because classic LCIS is now considered as a benign etiology, current guidelines recommend close follow-up with imaging versus surgical excision. The goal of our study was to determine if the diagnosis of classic LN on core needle biopsy (CNB) merits surgical excision. This is a retrospective, observational study conducted at Mount Auburn Hospital, Cambridge, MA, from May 17, 2017, through June 30, 2020. We reviewed the data of breast biopsies conducted at our hospital over this period and included patients who were diagnosed with classic LN (LCIS and/or ALH) and excluded patients having any other atypical lesions on CNB. All known cancer patients were excluded. Of the 2707 CNBs performed during the study period, we identified 68 women who were diagnosed with ALH or LCIS on CNB. CNB was performed for an abnormal mammogram in the majority of patients (60; 88%) while 7(10.3%) had an abnormal breast magnetic resonance imaging study (MRI), and 1 had an abnormal ultrasound (US). A total of 58 patients (85%) underwent excisional biopsy, of which 3 (5.2%) showed malignancy, including 2 cases of DCIS and 1 invasive carcinoma. In addition, there was 1 case (1.7%) with pleomorphic LCIS and 11 cases with ADH (15.5%). The management of LN found on core biopsy is evolving, with some advocating surgical excision and others recommending observation. Our data show a change in diagnosis with excisional biopsy in 13 (22.4%) of patients with 2 cases of DCIS, 1 invasive carcinoma, 1 pleomorphic LCIS, and 9 cases of ADH, diagnosed on excisional biopsy. While ALH and classic LCIS are considered benign, the choice of ongoing surveillance versus excisional biopsy should be made with shared decision making with the patient, with consideration of personal and family history, as well as patient preferences.
Topics: Female; Humans; Biopsy; Biopsy, Large-Core Needle; Breast Carcinoma In Situ; Breast Neoplasms; Carcinoma in Situ; Carcinoma, Intraductal, Noninfiltrating; Carcinoma, Lobular; Hyperplasia; Observational Studies as Topic; Precancerous Conditions
PubMed: 37114120
DOI: 10.1155/2023/8185446