scholarly journals Mammographic Breast Density: it’s Role in Tumor Size Assessment with Imaging Techniques

2019 ◽  
Vol 4 (1) ◽  
Keyword(s):  
Linear Regression ◽  
Breast Density ◽  
Tumor Size ◽  
Breast Imaging ◽  
Imaging Techniques ◽  
Automatic Measurement ◽  
Mammographic Breast Density ◽  
Size Estimation ◽  
Imaging Data ◽  
Mean Size

Aims: To study the visual and automatic measurement of mammographic breast density (MBD) and its implications in tumor size assessment using distinct imaging techniques. Methods: Retrospective, observational study of the visual and automatic measurement of mammographic breast density according to the breast imaging data system (BI-RADS) in 212 patients with invasive unifocal breast cancer, excluding microinvasive lesions, who did not receive neoadjuvant chemotherapy. Tumor size assessment is compared using a linear regression according pathologic size with mammographic, US and MR size. The influence of MBD in each technique of pathologic size was seen by Bland-Altman plot. Results: Patient’s mean age was 55, 7±9.9 year-old. The mean size of the lesion stablished by mammography was 16.8± 10.4 (4 -70) mm, by US was 13.6±7.2 (5 – 55) mm and by MR 17.2 ±9.9 (5 – 66) mm. Mean pathologic size was 12.6 ±8.1 (0.3 – 55) mm. Automatic MBD mean was 25.2±16.78. BIRAD assessment with visual and automatic MBD measurements were correlated with a tendency of tumor size overestimation with visual method. Linear regression of tumor size according image techniques with pathologic size showed an adjusted r-square of 27.3% for mammography, 41.8% for US and 51.7% for MR. The best correlation was seen with MR although has a tendency to overestimate tumor size. Only tumor size assessed by mammography was influenced by MBD. With this technique, tumor size was best adjusted for those breasts with lower MBD. Conclusion: Visual measurement overestimates MBD versus automatic measurement according BIRADS categories. MR is the more accurate breast imaging technique for assessing tumor size independently of the BMD, which only influences in the mammographic tumor size estimation.

Contrast-enhanced spectral mammography in patients with MRI contraindications

2017 ◽  
Vol 59 (7) ◽  
pp. 798-805 ◽  
Author(s):  
Vivien Richter ◽  
Valerie Hatterman ◽  
Heike Preibsch ◽  
Sonja D Bahrs ◽  
Markus Hahn ◽  
...  
Keyword(s):  
Problem Solving ◽  
Diagnostic Accuracy ◽  
Breast Imaging ◽  
Diagnostic Yield ◽  
Therapy Response ◽  
Lesion Size ◽  
Size Estimation ◽  
Imaging Data ◽  
Technical Problems ◽  
Contrast Enhanced

Background Contrast-enhanced spectral mammography (CESM) is a novel breast imaging technique providing comparable diagnostic accuracy to breast magnetic resonance imaging (MRI). Purpose To show that CESM in patients with MRI contraindications is feasible, accurate, and useful as a problem-solving tool, and to highlight its limitations. Material and Methods A total of 118 patients with MRI contraindications were examined by CESM. Histology was obtained in 94 lesions and used as gold standard for diagnostic accuracy calculations. Imaging data were reviewed retrospectively for feasibility, accuracy, and technical problems. The diagnostic yield of CESM as a problem-solving tool and for therapy response evaluation was reviewed separately. Results CESM was more accurate than mammography (MG) for lesion categorization (r = 0.731, P < 0.0001 vs. r = 0.279, P = 0.006) and for lesion size estimation (r = 0.738 vs. r = 0.689, P < 0.0001). Negative predictive value of CESM was significantly higher than of MG (85.71% vs. 30.77%, P < 0.0001). When used for problem-solving, CESM changed patient management in 2/8 (25%) cases. Superposition artifacts and timing problems affected diagnostic utility in 3/118 (2.5%) patients. Conclusion CESM is a feasible and accurate alternative for patients with MRI contraindications, but it is necessary to be aware of the method’s technical limitations.

Visual versus automatic measurement of mammographic breast density (MBD)

2020 ◽  
Vol 138 ◽  
pp. S120
Author(s):  
M. Izquierdo ◽  
J. Browne ◽  
I. Rodriguez ◽  
F. Tresserra ◽  
M. Garcia ◽  
...  
Keyword(s):  
Breast Density ◽  
Automatic Measurement ◽  
Mammographic Breast Density

scholarly journals Efficacy of contrast-enhanced ultrasonography and shear-wave elastography in conjunction with BI-RADS classification for diagnosis of small breast nodules

2020 ◽  
Author(s):  
Yan Shen ◽  
Jie He ◽  
Miao Liu ◽  
Jiaojiao Hu ◽  
Yonglin Wan ◽  
...  
Keyword(s):  
Shear Wave ◽  
Breast Imaging ◽  
Imaging Techniques ◽  
Shear Wave Elastography ◽  
Roc Curves ◽  
Imaging Data ◽  
Diagnostic Efficacy ◽  
Predictive Values ◽  
Small Breast ◽  
Contrast Enhanced

Abstract Background: Identification of malignancy in small breast nodules can be difficult using conventional methods, especially in patients with dense breast tissue. Advanced imaging techniques, including contrast-enhanced ultrasound (CEUS) and shear-wave elastography (SWE), could be used in conjunction with the Breast Imaging Reporting and Data System (BI-RADS) classification to characterize these nodules more effectively. This retrospective study aimed to evaluate the use of CEUS and SWE for the differentiation of benign from malignant small (≤ 2 cm) breast nodules.Methods: We reviewed the medical records and imaging data of 302 patients who underwent evaluation for 305 small breast nodules from November 2015 to December 2019. The BI-RADS classification values of the nodules and the results of CEUS and SWE were retrospectively analyzed; the diagnostic efficacy of these techniques was evaluated by comparison of the pathology results. Receiver operating characteristic (ROC) curves were analyzed based on the CEUS patterns and shear-wave velocity values of the nodules. The sensitivity, specificity, positive and negative predictive values, accuracies of BI-RADS, CEUS, SWE, and a combination of all three methods for identifying benign and malignant small breast nodules were investigated.Results: CEUS was effective at diagnosing malignant nodules when at least two out of nine suspicious features were present. ROC analysis revealed that the best cut-off value for SWE was at 3.7 m/s. For the diagnosis of benign breast nodules, the BI-RADS classification was reduced by one level when both, CEUS and SWE were used, and remained unchanged when either one, CEUS or SWE was used; the highest and lowest levels were of category 5 and 3, respectively. Furthermore, when using the combined method, 75.8% (91/120) of small breast nodules with a BI-RADS category 4A classification avoided the need for coarse needle biopsies.Conclusions: CEUS and SWE can be used as auxiliary methods for clarifying BI-RADS classification of the breast nodules, and a combination of these techniques may provide more diagnostic efficacy for identifying malignancy in small breast nodules.Trial registration: Retrospectively registered.

scholarly journals Whole Breast Sound Speed Measurement from US Tomography Correlates Strongly with Volumetric Breast Density from Mammography

2020 ◽  
Vol 2 (5) ◽  
pp. 443-451
Author(s):  
Mark Sak ◽  
Peter Littrup ◽  
Rachel Brem ◽  
Neb Duric
Keyword(s):  
Breast Density ◽  
Sound Speed ◽  
Three Dimensional ◽  
Correlation Coefficients ◽  
Mammographic Breast Density ◽  
Data Sets ◽  
Imaging Data ◽  
Institutional Review ◽  
Dense Tissue ◽  
Screening Mammograms

Abstract Objective To assess the feasibility of using tissue sound speed as a quantitative marker of breast density. Methods This study was carried out under an Institutional Review Board–approved protocol (written consent required). Imaging data were selected retrospectively based on the availability of US tomography (UST) exams, screening mammograms with volumetric breast density data, patient age of 18 to 80 years, and weight less than 300 lbs. Sound speed images from the UST exams were used to measure the volume of dense tissue, the volume averaged sound speed (VASS), and the percent of high sound speed tissue (PHSST). The mammographic breast density and volume of dense tissue were estimated with three-dimensional (3D) software. Differences in volumes were assessed with paired t-tests. Spearman correlation coefficients were calculated to determine the strength of the correlations between the mammographic and UST assessments of breast density. Results A total of 100 UST and 3D mammographic data sets met the selection criteria. The resulting measurements showed that UST measured a more than 2-fold larger volume of dense tissue compared to mammography. The differences were statistically significant (P &lt; 0.001). A strong correlation of rS = 0.85 (95% CI: 0.79–0.90) between 3D mammographic breast density (BD) and the VASS was noted. This correlation is significantly stronger than those reported in previous two-dimensional studies (rS = 0.85 vs rS = 0.71). A similar correlation was found for PHSST and mammographic BD with rS = 0.86 (95% CI: 0.80–0.90). Conclusion The strong correlations between UST parameters and 3D mammographic BD suggest that breast sound speed should be further studied as a potential new marker for inclusion in clinical risk models.

scholarly journals Increased mammographic breast density in acromegaly: quantitative and qualitative assessment

2011 ◽  
Vol 164 (3) ◽  
pp. 335-340 ◽  
Author(s):  
Alberto Tagliafico ◽  
Massimo Calabrese ◽  
Giulio Tagliafico ◽  
Eugenia Resmini ◽  
Carlo Martinoli ◽  
...  
Keyword(s):  
Mammographic Density ◽  
Breast Density ◽  
Breast Imaging ◽  
Independent Risk Factor ◽  
Disease Duration ◽  
Observer Agreement ◽  
Qualitative Assessment ◽  
Mammographic Breast Density ◽  
Computer Aided ◽  
A Prospective Study

ContextMammographic density is a strong independent risk factor for breast cancer, whose prevalence in acromegaly is still controversial.ObjectiveTo compare breast density in premenopausal acromegalic patients and controls and to determine whether density correlated with disease duration, GH, and IGF1 levels.Design, setting and participantsA prospective study involving 30 patients and 60 controls matched for age and body mass index.InterventionsA quantitative computer-aided mammographic density estimation (MDEST) and a qualitative blind evaluation by two experienced radiologists using the breast imaging reporting and data system (BI-RADS) was performed. Totally, 60 (acromegaly) and 120 (controls) craniocaudal and mediolateral oblique mammograms were evaluated in both patients and controls.Main outcome measuresBreast density.ResultsPatients showed a significantly (P<0.01) increased mammographic breast density with both methods (MDEST: 0.33±0.21% and BI-RADS category: 2.81±0.78) in comparison with controls (MDEST: 0.26±0.19% and BI-RADS category: 2.35±0.61). The agreement between the two methods and inter-observer agreement between the two radiologists were excellent (k=0.63 and k=0.85). In patients grouped according to disease activity (17 controlled and 13 uncontrolled) and medical therapy (15 treated and 15 untreated), no differences were found. All these groups had significantly increased mammographic breast density compared with controls (P<0.01).A positive correlation was found between mammographic breast density, IGF1 values and disease duration (r=0.29 and r=0.39), whereas it was not found with GH (r=−0.02).ConclusionsMammographic breast density in premenopausal acromegalic patients is significantly higher than controls and positively correlated with IGF1 and disease duration.

scholarly journals Mammographic Breast Density Profile of Jordanian Women With Normal and Breast Cancer Findings

2020 ◽  
Vol 14 ◽  
pp. 117822342092138
Author(s):  
Dana S Al-Mousa ◽  
Maram Alakhras ◽  
Kelly M Spuur ◽  
Haytham Alewaidat ◽  
Mohammad Rawashdeh ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Density ◽  
Breast Imaging ◽  
Normal Group ◽  
University Hospital ◽  
Mammographic Breast Density ◽  
Screening Guidelines ◽  
Cancer Group ◽  
Bonferroni Adjustment ◽  
Breast Cancer Group

Purpose: To document the mammographic breast density (MBD) distribution of Jordanian women and the relationship with MBD with age. Correlation between breast cancer diagnosis and density was also explored. Methods: A retrospective review of 660 screening mammograms from King Abdullah University Hospital was conducted. Mammograms were classified into 2 groups: normal (return to routine screening) and breast cancer and rated using the American College of Radiology (ACR) Breast Imaging-Reporting and Data System (BI-RADS) 5th edition for MBD. The association between MBD and age was assessed by descriptive analyses and Kruskal-Wallis test. To compare between normal and breast cancer groups, chi-square post hoc tests with Bonferroni adjustment was used. Results: Groups consisted of 73.9% (n = 488) normal group and 26.1% (n = 172) breast cancer group. A significant inverse relationship was demonstrated between age and MBD among the normal ( r = −.319, P < .01) and breast cancer group ( r = −.569, P < .01). In total, 69% (n = 336) of women in the normal group and 71% (n = 122) in the breast cancer group and 79.1% (n = 159) of the normal group and 100% (n = 48) of the breast cancer group aged 40 to 49 years reported high MBD (ACR BI-RADS c or d). Conclusions: Most of women in both the normal and breast cancer groups evidenced increased MBD. Increased MBD was inversely proportional to age. As MBD has a known link to increased breast cancer risk and the decreased sensitivity of mammography and it is vital that future screening guidelines for Jordanian women consider the unique breast density distribution of this population.

scholarly journals Tumor size estimation of the breast cancer molecular subtypes using imaging techniques

2020 ◽  
Author(s):  
Gulten Sezgın ◽  
Melda Apaydın ◽  
Demet Etıt ◽  
Murat Kemal Atahan
Keyword(s):  
Breast Cancer ◽  
Tumor Size ◽  
Molecular Subtypes ◽  
Imaging Techniques ◽  
Breast Cancers ◽  
Size Estimation ◽  
Luminal A ◽  
Luminal B ◽  
Cancer Management ◽  
Underestimation Rate

Background and aim. In medical practice the classification of breast cancer is most commonly based on the molecular subtypes, in order to predict the disease prognosis, avoid over-treatment, and provide individualized cancer management. Tumor size is a major determiner of treatment planning, acting on the decision-making process, whether to perform breast surgery or administer neoadjuvant chemotherapy. Imaging methods play a key role in determining the tumor size in breast cancers at the time of the diagnosis. We aimed to compare the radiologically determined tumor sizes with the corresponding pathologically determined tumor sizes of breast cancer at the time of the diagnosis, in correlation with the molecular subtypes. Methods. Ninety-one patients with primary invasive breast cancer were evaluated. The main molecular subtypes were luminal A, luminal B, HER-2 positive, and triple-negative. The Bland–Altman plot was used for presenting the limits of agreement between the radiologically and the pathologically determined tumor sizes by the molecular subtypes. Results. A significantly proportional underestimation was found for the luminal A subtype, especially for large tumors. The p-values for the magnetic resonance imaging, mammography, and ultrasonography were 0.020, 0.030, and <0.001, respectively. No statistically significant differences were observed among the radiologic modalities in determining the tumor size in the remaining molecular subtypes (p > 0.05). Conclusion. The radiologically determined tumor size was significantly smaller than the pathologically determined tumor size in the luminal A subtype of breast cancers when measured with all three imaging modalities. The differences were more prominent with ultrasonography and mammography. The underestimation rate increases as the tumor gets larger.

Mammographic breast density: visual and automated measurement, its role in tumor size and prognostic factors

The Breast ◽  
2019 ◽  
Vol 44 ◽  
pp. S88
Author(s):  
M. Izquierdo ◽  
J. Browne ◽  
S. Garcia ◽  
F. Tresserra ◽  
M. Garcia ◽  
...  
Keyword(s):  
Prognostic Factors ◽  
Breast Density ◽  
Tumor Size ◽  
Mammographic Breast Density ◽  
Automated Measurement

Intraoperative margin assessment with the MarginProbe at different mammographic breast densities.

2015 ◽  
Vol 33 (28_suppl) ◽  
pp. 47-47 ◽  
Author(s):  
Alice Police ◽  
Erin Lin ◽  
Karen Lane
Keyword(s):  
Breast Density ◽  
Clinical Benefit ◽  
Breast Imaging ◽  
Assessment Tool ◽  
Univariate Analysis ◽  
Breast Conserving Surgery ◽  
Mammographic Breast Density ◽  
Margin Assessment ◽  
Positive Margins ◽  
Intraoperative Margin Assessment

47 Background: Mammographic breast density (BD) is known to affect breast imaging. MarginProbe is an RF Spectroscopy intraoperative margin assessment tool. We looked at the effect of mammographic breast density (BD) on the performance of the device. Mammographic density was assigned by Breast Imaging-Reporting and Data System (BI-RADS) classification prior to breast conserving surgery with the MarginProbe. Methods: For the current study we analyzed MarginProbe device arm data from the MarginProbe Pivotal Trial for which BD data was available. Clear margins of the main specimen, which is where the MarginProbe was applied, were defined as no tumor on ink. Clinical benefit was defined as clearing positive main specimen margins or cancer in the shaving. Analysis was performed based on logistic and linear regression, with univariate analysis. Results: The dataset for the analysis included 196 patients for which preoperative BD data was available. With higher BD, there was an increase in the rate of main lumpectomy specimen with positive margins (OR 1.65 per change in density category, p=0.025). The rate of shavings with clinical benefit showed an upward trend, with increasing BD. The number of shavings per patient increased with BD, however the overall volume of shavings did not increase. There was an increase in the per patient relative clinical benefit as BD increased (OR 1.6 per change in density category, p=0.024). Conclusions: With higher breast density patients and surgeons face an increase in risk for main specimen positive margins. With the increased BD and main specimen positivity more shavings were removed, but shavings volume did not increase as average shaving volume decreased with higher BD. Higher level of patient clinical benefit was observed with higher BD.

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