Sensitivity of MRI Versus Mammography for Detecting Foci of Multifocal, Multicentric Breast Cancer in Fatty and Dense Breasts Using the Whole-Breast Pathologic Examination as a Gold Standard

AbstractTamoxifen is the gold standard drug for the treatment of breast cancer in pre and post-menopausal women. Its journey from a failing contraceptive to a blockbuster is an example of pharmaceutical innovation challenges. Tamoxifen has a wide range of pharmacological activities; a drug that was initially thought to work via a simple Estrogen receptor (ER) mechanism was proven to mediate its activity through several non-ER mechanisms. Here in we review the previous literature describing ER and non-ER targets of tamoxifen, we highlighted the overlooked connection between tamoxifen, tamoxifen apoptotic effects and oxidative stress.

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Dedicated Dual-Head Gamma Imaging for Breast Cancer Screening in Women with Mammographically Dense Breasts

Radiology ◽

10.1148/radiol.10100625 ◽

2011 ◽

Vol 258 (1) ◽

pp. 106-118 ◽

Cited By ~ 103

Author(s):

Deborah J. Rhodes ◽

Carrie B. Hruska ◽

Stephen W. Phillips ◽

Dana H. Whaley ◽

Michael K. O’Connor

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Gamma Imaging ◽

Dense Breasts

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Breast cancer detection in axillary sentinel lymph nodes: the impact of the method of pathologic examination

Human Pathology ◽

10.1016/j.humpath.2014.09.004 ◽

2014 ◽

Vol 45 (12) ◽

pp. 2497-2501 ◽

Cited By ~ 3

Author(s):

Benjamin C. Calhoun ◽

Karinn Chambers ◽

Teresa Flippo-Morton ◽

Chad A. Livasy ◽

Edward J. Armstrong ◽

...

Keyword(s):

Breast Cancer ◽

Lymph Nodes ◽

Cancer Detection ◽

Sentinel Lymph Nodes ◽

Breast Cancer Detection ◽

Pathologic Examination ◽

The Impact

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Breast cancer detection: Comparison of digital mammography and digital breast tomosynthesis across non-dense and dense breasts

Radiography ◽

10.1016/j.radi.2021.04.002 ◽

2021 ◽

Author(s):

I. Hadadi ◽

W. Rae ◽

J. Clarke ◽

M. McEntee ◽

E. Ekpo

Keyword(s):

Breast Cancer ◽

Cancer Detection ◽

Digital Mammography ◽

Digital Breast Tomosynthesis ◽

Breast Cancer Detection ◽

Breast Tomosynthesis ◽

Dense Breasts

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A prospective study of an AI-based breast cancer screening solution for resource-constrained settings.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.e13586 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. e13586-e13586

Author(s):

Richa Bansal ◽

Bharat Aggarwal ◽

Lakshmi Krishnan

Keyword(s):

Breast Cancer ◽

Cancer Screening ◽

Breast Cancer Screening ◽

Sensitivity And Specificity ◽

Breast Tissue ◽

Dense Breast ◽

Resource Constrained ◽

Dense Breast Tissue ◽

Dense Breasts ◽

Low Sensitivity

e13586 Background: Screening mammography is often found to have low sensitivity in women with high density breast tissues. Alternate modalities of breast USG and MRI require high-quality expensive equipment making the regular screening with these modalities less affordable and accessible, particularly in resource-constrained settings This study evaluates the clinical performance of an AI-based test (Thermalytix) that uses machine learning on breast thermal images which could potentially be a low-cost solution for breast screening in low- and middle-income countries (LMICs). Methods: The prospective comparative study conducted from December 2018 to January 2020 evaluated the performance of Thermalytix in women with dense and non-dense breast tissue who presented for a health check-up at a hospital. All women underwent Thermalytix and mammography. Further investigations were recommended for participants who were reported as positive on either test. Sensitivity and specificity of Thermalytix were evaluated across age-groups, menopausal status, and breast densities. Results: Among the 687 women recruited for the study, 459 women who satisfied the inclusion criteria were included in the analysis. 168 women had ACR categories ‘c’ or ‘d’ dense breasts, of which 37 women had an inconclusive mammography report (BI-RADS 0). Overall, 21 women were detected with breast cancer in the study. Thermalytix demonstrated an overall sensitivity of 95.2% (95% CI, 76.1-99·9) and a specificity of 88.6% (95% CI, 85.2-91.4). Among women with dense breast tissue (n=168), Thermalytix showed a sensitivity of 100% (95% CI, 69.2-100) and a specificity of 81.7% (95% CI, 74.7-87.4). In women with ACR categories ‘c’ and ‘d’ dense breasts, mammography reported 22% of them as inconclusive (BI-RAD 0), while in the same sub-set of the population Thermalytix demonstrated a sensitivity of 100%. Conclusions: The AI-based Thermalytix demonstrated high sensitivity and specificity in the study cohort. It also fared well in women younger than 50 years and pre-menopausal women where routine mammography screening yields low sensitivity. Overall, this study introduces Thermalytix, a promising radiation-free, automated, and privacy-aware test that can supplement mammography for routine screening of women, especially in women with dense breast tissue, and has the potential to influence the clinical practice in LMICs by making breast cancer screening portable and affordable. Performance of Thermalytix and mammography in women with high breast densities (ACR categories ‘c’ and ‘d’ breasts). Clinical trial information: NCT04688086. [Table: see text]

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Global tissue stiffness on breast MR elastography: High-risk dense breast patients have higher stiffness compared to average-risk dense breast patients.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.10541 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 10541-10541

Author(s):

Bhavika K. Patel ◽

Kay Pepin ◽

Kathy R Brandt ◽

Gina L. Mazza ◽

Barbara A. Pockaj ◽

...

Keyword(s):

Breast Cancer ◽

High Risk ◽

Cancer Risk ◽

Menopausal Status ◽

Risk Groups ◽

Average Risk ◽

Tissue Stiffness ◽

Tissue Properties ◽

Dense Breasts ◽

Risk Patients

10541 Background: Biomechanical tissue properties may vary in the breasts of patients at elevated risk for breast cancer. We aim to quantify in vivo biomechanical tissue properties in various breast densities and in both normal risk and high risk women using Magnetic Resonance Imaging (MRI)/MRE and examine the association of biomechanical properties of the breast with cancer risk. Methods: In this IRB–approved prospective single-institution study, we recruited two groups of women differing by breast cancer risk to undergo a 3.0 T dynamic contrast enhanced MRI/MRE of the breast. Low-average risk women were defined as having no personal or significant family history of breast cancer, no prior high risk breast biopsies and a negative mammography within 12 months. High-risk breast cancer patients were recruited from those patients who underwent standard of care breast MR. Within each breast density group (non-dense versus dense), two-sample t-tests were used to compare breast stiffness, elasticity, and viscosity across risk groups (low-average vs high). Results: There were 50 low-average risk and 86 high-risk patients recruited to the study. The risk groups were similar on age (mean age = 55.6 and 53.6 years), density (68% vs. 64% dense breasts) and menopausal status (66.0% vs. 69.8%). Among patients with dense breasts, mean stiffness, elasticity, and viscosity were significantly higher in high risk patients ( N = 55) compared to low-average risk patients ( N = 34; all p < 0.001). In the multivariate logistic regression model, breast stiffness remained a significant predictor of risk status (OR=4.26, 95% CI [1.96, 9.25]) even after controlling for breast density, MRI BPE, age, and menopausal status. Similar results were seen for breast elasticity (OR=4.88, 95% CI [2.08, 11.43]) and viscosity (OR=11.49, 95% CI [1.15, 114.89]). Conclusions: Structurally-based, quantitative biomarker of tissue stiffness obtained from global 3D breast MRE is associated with differences in breast cancer risk in dense breasts. As such, tissue stiffness could provide a novel prognostic marker to help identify the subset of high-risk women with dense breasts who would benefit from increased surveillance.[Table: see text]

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