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Asian Pacific Journal of Cancer... 2015Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization... (Comparative Study)
Comparative Study
BACKGROUND
Full-field digital mammography (FFDM) with dense breasts has a high rate of missed diagnosis, and digital breast tomosynthesis (DBT) could reduce organization overlapping and provide more reliable images for BI-RADS classification. This study aims to explore application of COMBO (FFDM+DBT) for effect and significance of BI-RADS classification of breast cancer.
MATERIALS AND METHODS
In this study, we selected 832 patients who had been treated from May 2013 to November 2013. Classify FFDM and COMBO examination according to BI-RADS separately and compare the differences for glands in the image of the same patient in judgment, mass characteristics display and indirect signs. Employ Paired Wilcoxon rank sum test was used in 79 breast cancer patients to find differences between two examine methods.
RESULTS
The results indicated that COMBO pattern is able to observe more details in distribution of glands when estimating content. Paired Wilcoxon rank sum test showed that overall classification level of COMBO is higher significantly compared to FFDM to BI-RADS diagnosis and classification of breast (P<0.05). The area under FFDM ROC curve is 0.805, while that is 0.941 in COMBO pattern. COMBO shows relation of mass with the surrounding tissues, the calcification in the mass, and multiple foci clearly in breast cancer tissues. The optimal sensitivity of cut-off value in COMBO pattern is 82.9%, which is higher than that in FFDM (60%). They share the same specificity which is both 93.2%.
CONCLUSIONS
Digital Breast Tomosynthesis (DBT) could be used for the BI-RADS classification in breast cancer in clinical.
Topics: Breast; Breast Neoplasms; Case-Control Studies; Early Detection of Cancer; Female; Follow-Up Studies; Humans; Imaging, Three-Dimensional; Mammography; Middle Aged; Neoplasm Staging; Prognosis; Prospective Studies; ROC Curve; Radiographic Image Enhancement; Tomography, X-Ray
PubMed: 25987095
DOI: 10.7314/apjcp.2015.16.9.4109 -
Breast Cancer Research : BCR Oct 2019Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify...
BACKGROUND
Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls.
METHODS
Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara™. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time.
RESULTS
Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (- 0.26% and - 2.10 cm) than the normal breast (- 0.39% and - 2.74 cm) for a difference of 0.13% (p value < 0.001) and 0.63 cm (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (- 0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV.
CONCLUSION
There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.
Topics: Aged; Automation; Breast; Breast Density; Breast Neoplasms; Case-Control Studies; Early Detection of Cancer; Female; Humans; Mammography; Middle Aged; Reproducibility of Results; Sensitivity and Specificity; Tumor Burden
PubMed: 31660981
DOI: 10.1186/s13058-019-1198-9 -
The British Journal of Radiology Jan 2020Exposure to sex hormones is important in the pathogenesis of breast cancer and inability to tolerate such exposure may be reflected in increased asymmetrical growth of...
OBJECTIVE
Exposure to sex hormones is important in the pathogenesis of breast cancer and inability to tolerate such exposure may be reflected in increased asymmetrical growth of the breasts. This study aims to characterize, for the first time, asymmetry in breast volume (BV) and radiodense volume (DV) in a large ethnically diverse population.
METHODS
Automated measurements from digital raw mammographic images of 54,591 cancer-free participants (aged 47-73) in a UK breast screening programme were used to calculate absolute (cm) and relative asymmetry in BV and DV. Logistic regression models were fitted to assess asymmetry associations with age and ethnicity.
RESULTS
BV and DV absolute asymmetry were positively correlated with the corresponding volumetric dimension (BV or DV). BV absolute asymmetry increased, whilst DV absolute asymmetry decreased, with increasing age (P-for-linear-trend <0.001 for both). Relative to Whites, Blacks had statistically significantly higher, and Chinese lower, BV and DV absolute asymmetries. However, after adjustment for the corresponding underlying volumetric dimension the age and ethnic differences were greatly attenuated. Median relative (fluctuating) BV and DV asymmetry were 2.34 and 3.28% respectively.
CONCLUSION
After adjusting for the relevant volumetric dimension (BV or DV), age and ethnic differences in absolute breast asymmetry were largely resolved.
ADVANCES IN KNOWLEDGE
Previous small studies have reported breast asymmetry-breast cancer associations. Automated measurements of asymmetry allow the conduct of large-scale studies to further investigate these associations.
Topics: Age Factors; Aged; Breast; Breast Density; Ethnicity; Female; Humans; Mammography; Middle Aged; Retrospective Studies
PubMed: 31661305
DOI: 10.1259/bjr.20190328 -
Journal of Plastic Surgery and Hand... 2023There is a lack of an accurate standardised objective method to assess aesthetic outcome after breast surgery. In this methodological study, we investigated the intra-...
There is a lack of an accurate standardised objective method to assess aesthetic outcome after breast surgery. In this methodological study, we investigated the intra- and inter-observer reproducibility of breast symmetry and volume assessed using three-dimensional surface imaging (3D-SI), evaluated the reproducibility depending on imaging posture, and proposed a new combined volume-shape-symmetry () parameter. Images were acquired using the VECTRA XT 3D imaging system, and analysed by two observers using VECTRA Analysis Module. Breast symmetry was measured through the root mean square distance. All women had undergone bilateral risk-reducing mastectomy and immediate breast reconstruction. The reproducibility and correlations of breast symmetry and volume measurements were compared using Bland-Altman's plots and tested with Spearman's rank correlation coefficient. 3D surface images of 58 women were analysed (348 symmetry measurements, 696 volume measurements). The intra-observer reproducibility of breast symmetry measurements was substantial-excellent, the inter-observer reproducibility was substantial, and the inter-posture reproducibility was substantial. For measurements of breast volumes, the intra-observer reproducibility was excellent, the inter-observer reproducibility was moderate-substantial, and the inter-posture reproducibility was substantial-excellent. The intra-observer reproducibility of was excellent while the inter-observer reproducibility was substantial for both observers, independent of posture. There were no statistically strong correlations between breast symmetry and volume differences. The intra-observer reproducibility was found to be substantial-excellent for several 3D-SI measurements independent of imaging posture. However, the inter-observer reproducibility was lower than the intra-observer reproducibility, indicating that 3D-SI in its present form is not a great assessment for symmetry.
Topics: Humans; Female; Imaging, Three-Dimensional; Reproducibility of Results; Breast Neoplasms; Mastectomy; Breast
PubMed: 35034560
DOI: 10.1080/2000656X.2021.2024553 -
Radiologia 2022Interventional procedures have become a routine part of breast imaging unit's activity. Most interventional procedures in breast imaging are done under ultrasound...
Interventional procedures have become a routine part of breast imaging unit's activity. Most interventional procedures in breast imaging are done under ultrasound guidance. The list of ultrasound-guided interventional procedures performed by breast imaging units is long. This chapter will review the different techniques, placing emphasis on the most cost-effective indications.
Topics: Breast; Ultrasonography; Ultrasonography, Interventional
PubMed: 35180991
DOI: 10.1016/j.rxeng.2021.09.006 -
Skin Research and Technology : Official... Jan 2022The current study assessed the level of reliability of ultrasound to assess dermal thickness, a clinical feature of breast lymphedema. Additionally, the relationship of... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
The current study assessed the level of reliability of ultrasound to assess dermal thickness, a clinical feature of breast lymphedema. Additionally, the relationship of dermal thickness to patient-reported outcomes was investigated.
METHODS
Women (n = 82) with unilateral breast edema secondary to treatment of breast cancer were randomized to an exercise or control group. Ultrasound measurements of the unaffected and affected breasts were taken at baseline and 12 weeks later at 3-4 cm superior, medial, inferior, and lateral to the nipple. Additionally, women completed breast-related questions from the European Organization Research and Treatment Committee Quality of Life breast cancer module (EORTC-BR23) and Lymphedema Symptom Intensity and Distress Questionnaire (LSIDS). Reliability of ultrasound measurements was determined on the unaffected breast.
RESULTS
Intraclass correlation coefficients (2,1) ranged from 0.66 (95% CI: 0.52-0.77) for the lateral location to 0.84 (0.77-0.90) for the superior location. Percent close agreement (80%) on the unaffected breast ranged from 0.20 to 0.27 mm compared to 0.57 to 0.93 mm on the affected breast. The standard error of measurement (%) on the unaffected breast varied from 9% to 13% with smallest real difference 0.34-0.41 mm. Dermal thickness of the affected breast was not-to-poorly associated with EORTC BR23 and LSIDS scores.
CONCLUSION
Reliability of dermal thickness measurements of the breast was excellent for the superior, medial, and inferior locations, and fair to good for the lateral location. However, these measurements were not related to the symptom's women perceive and measured with the EORTC BR23 or LSIDS.
Topics: Breast; Female; Humans; Patient Reported Outcome Measures; Quality of Life; Reproducibility of Results; Ultrasonography
PubMed: 34455642
DOI: 10.1111/srt.13100 -
Annals of Internal Medicine Feb 2016Screening mammography has lower sensitivity and specificity in women with dense breasts, who experience higher breast cancer risk. (Review)
Review
BACKGROUND
Screening mammography has lower sensitivity and specificity in women with dense breasts, who experience higher breast cancer risk.
PURPOSE
To perform a systematic review of reproducibility of Breast Imaging Reporting and Data System (BI-RADS) density categorization and test performance and clinical outcomes of supplemental screening with breast ultrasonography, magnetic resonance imaging (MRI), and digital breast tomosynthesis (DBT) in women with dense breasts and negative mammography results.
DATA SOURCES
MEDLINE, PubMed, EMBASE, and Cochrane database from January 2000 to July 2015.
STUDY SELECTION
Studies reporting BI-RADS density reproducibility or supplemental screening results for women with dense breasts.
DATA EXTRACTION
Quality assessment and abstraction of 24 studies from 7 countries; 6 studies were good-quality.
DATA SYNTHESIS
Three good-quality studies reported reproducibility of BI-RADS density; 13% to 19% of women were recategorized between "dense" and "nondense" at subsequent screening. Two good-quality studies reported that sensitivity of ultrasonography for women with negative mammography results ranged from 80% to 83%; specificity, from 86% to 94%; and positive predictive value (PPV), from 3% to 8%. The sensitivity of MRI ranged from 75% to 100%; specificity, from 78% to 94%; and PPV, from 3% to 33% (3 studies). Rates of additional cancer detection with ultrasonography were 4.4 per 1000 examinations (89% to 93% invasive); recall rates were 14%. Use of MRI detected 3.5 to 28.6 additional cancer cases per 1000 examinations (34% to 86% invasive); recall rates were 12% to 24%. Rates of cancer detection with DBT increased by 1.4 to 2.5 per 1000 examinations compared with mammography alone (3 studies). Recall rates ranged from 7% to 11%, compared with 7% to 17% with mammography alone. No studies examined breast cancer outcomes.
LIMITATIONS
Good-quality evidence was sparse. Studies were small and CIs were wide. Definitions of recall were absent or inconsistent.
CONCLUSION
Density ratings may be recategorized on serial screening mammography. Supplemental screening of women with dense breasts finds additional breast cancer but increases false-positive results. Use of DBT may reduce recall rates. Effects of supplemental screening on breast cancer outcomes remain unclear.
PRIMARY FUNDING SOURCE
Agency for Healthcare Research and Quality.
Topics: Adult; Aged; Breast; Breast Density; Breast Neoplasms; Early Detection of Cancer; Female; Humans; Magnetic Resonance Imaging; Mammary Glands, Human; Mammography; Mass Screening; Middle Aged; Risk Factors; Ultrasonography, Mammary
PubMed: 26757021
DOI: 10.7326/M15-1789 -
Asian Pacific Journal of Cancer... 2015To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the...
BACKGROUND
To investigate the impact of the breast size, shape, maximum heart depth (MDH), and chest wall hypotenuse (the distance connecting middle point of the sternum and the length of lung draw on the selected transverse CT slice) on the volumetric dose to heart with whole breast irradiation (WBI) of left-sided breast cancer patients.
MATERIALS AND METHODS
Fifty-three patients with left-sided breast cancer undergoing adjuvant intensity-modulated radiotherapy (IMRT) were enrolled in the study. The primary breast size and shape, MHD and DCWH (chest wall hypotenuse) were contoured on radiotherapy (RT) planning CT slices. The dose data of hearts were obtained from the dose-volume histograms (DVHs). Data were analyzed by one-way analysis of variance (ANOVA), Student's t-test and linear regression analysis.
RESULTS
Breast size was independent of heart dose, whereas breast shape, MHD and DCWH were correlated with heart dose. The shapes of breasts were divided into four types, as the flap type, hemisphere type, cone type and pendulous type with heart mean dose being 491.8±234.6 cGy, 752.7±219.0 cGy, 620.2±275.7 cGy, and 666.1±238.0 cGy, respectively. The flap type of breasts shows a strong statistically reduction in heart dose, compared to others (p=0.008 for V30 of heart). DCWH and MHD were found to be the most important parameters correlating with heart dose in WBI.
CONCLUSIONS
More attention should be paid to the heart dose of non-flap type patients. The MHD was found to be the most important parameter to correlate with heart dose in tangential WBI, closely followed by the DCWH, which could help radiation oncologists and physicsts evaluate heart dose and design RT plan in advance.
Topics: Adult; Aged; Breast; Female; Heart; Humans; Middle Aged; Radiation; Radiotherapy Dosage; Radiotherapy, Intensity-Modulated; Thorax; Unilateral Breast Neoplasms
PubMed: 25854378
DOI: 10.7314/apjcp.2015.16.7.2889 -
Breast Cancer Research : BCR Feb 2019Breast density is strongly related to breast cancer. Identifying associations between environmental exposures and density may elucidate relationships with breast cancer....
BACKGROUND
Breast density is strongly related to breast cancer. Identifying associations between environmental exposures and density may elucidate relationships with breast cancer. Metals and polycyclic aromatic hydrocarbons (PAHs) may influence breast density via oxidative stress or endocrine disruption.
METHODS
Study participants (n = 222,581) underwent a screening mammogram in 2011 at a radiology facility in the Breast Cancer Surveillance Consortium. Zip code residential levels of airborne PAHs and metals (arsenic, cadmium, chromium, cobalt, lead, manganese, mercury, nickel, and selenium) were assessed using the 2011 EPA National Air Toxics Assessment. Breast density was measured using the Breast Imaging-Reporting and Data System (BI-RADS) lexicon. Logistic regression was used to estimate adjusted odds ratios (ORs) and 95% confidence intervals (CI) for the individual air toxics and dense breasts (BI-RADS 3 or 4). Weighted quantile sum (WQS) regression was used to model the association between the air toxic mixture and density.
RESULTS
Higher residential levels of arsenic, cobalt, lead, manganese, nickel, or PAHs were individually associated with breast density. Comparing the highest to the lowest quartile, higher odds of having dense breasts were observed for cobalt (OR = 1.60, 95% CI 1.56-1.64) and lead (OR = 1.56, 95% CI 1.52-1.64). Associations were stronger for premenopausal women. The WQS index was associated with density overall (OR = 1.22, 95% CI 1.20-1.24); the most heavily weighted air toxics were lead and cobalt.
CONCLUSIONS
In this first study to evaluate the association between air toxics and breast density, women living in areas with higher concentrations of lead and cobalt were more likely to have dense breasts.
Topics: Adult; Aged; Air Pollutants; Breast; Breast Density; Breast Neoplasms; Cross-Sectional Studies; Early Detection of Cancer; Environmental Exposure; Female; Humans; Mammography; Metals; Middle Aged; Oxidative Stress; Polycyclic Aromatic Hydrocarbons; Registries
PubMed: 30760301
DOI: 10.1186/s13058-019-1110-7 -
Computational and Mathematical Methods... 2020Breast segmentation and mass detection in medical images are important for diagnosis and treatment follow-up. Automation of these challenging tasks can assist...
Breast segmentation and mass detection in medical images are important for diagnosis and treatment follow-up. Automation of these challenging tasks can assist radiologists by reducing the high manual workload of breast cancer analysis. In this paper, deep convolutional neural networks (DCNN) were employed for breast segmentation and mass detection in dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI). First, the region of the breasts was segmented from the remaining body parts by building a fully convolutional neural network based on U-Net++. Using the method of deep learning to extract the target area can help to reduce the interference external to the breast. Second, a faster region with convolutional neural network (Faster RCNN) was used for mass detection on segmented breast images. The dataset of DCE-MRI used in this study was obtained from 75 patients, and a 5-fold cross validation method was adopted. The statistical analysis of breast region segmentation was carried out by computing the Dice similarity coefficient (DSC), Jaccard coefficient, and segmentation sensitivity. For validation of breast mass detection, the sensitivity with the number of false positives per case was computed and analyzed. The Dice and Jaccard coefficients and the segmentation sensitivity value for breast region segmentation were 0.951, 0.908, and 0.948, respectively, which were better than those of the original U-Net algorithm, and the average sensitivity for mass detection achieved 0.874 with 3.4 false positives per case.
Topics: Adult; Aged; Breast; Breast Neoplasms; Computational Biology; Contrast Media; Databases, Factual; Female; Humans; Image Interpretation, Computer-Assisted; Magnetic Resonance Imaging; Middle Aged; Neural Networks, Computer; Young Adult
PubMed: 32454879
DOI: 10.1155/2020/2413706