Feasibility of Portable Microwave Imaging Device for Breast Cancer Detection

Purpose: Microwave radar-based breast imaging technology utilizes the principle of radar, in which radio waves reflect at the interface between target and normal tissues, which have different permittivities. This study aims to investigate the feasibility and safety of a portable microwave breast imaging device in clinical practice. Materials and methods: We retrospectively collected the imaging data of ten breast cancers in nine women (median age: 66.0 years; range: 37–78 years) who had undergone microwave imaging examination before surgery. All were Japanese and the tumor sizes were from 4 to 10 cm. Using a five-point scale (1 = very poor; 2 = poor; 3 = fair; 4 = good; and 5 = excellent), a radiologist specialized in breast imaging evaluated the ability of microwave imaging to detect breast cancer and delineate its location and size in comparison with conventional mammography and the pathological findings. Results: Microwave imaging detected 10/10 pathologically proven breast cancers, including non-invasive ductal carcinoma in situ (DCIS) and micro-invasive carcinoma, whereas mammography failed to detect 2/10 breast cancers due to dense breast tissue. In the five-point evaluation, median score of location and size were 4.5 and 4.0, respectively. Conclusion: The results of the evaluation suggest that the microwave imaging device is a safe examination that can be used repeatedly and has the potential to be useful in detecting breast cancer.

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Microvessel Density and Mammaglobin A Expression as Prognostic Markers in Molecular Types of Breast Cancer

Revista de Chimie ◽

10.37358/rc.19.7.7403 ◽

2019 ◽

Vol 70 (7) ◽

pp. 2671-2676

Author(s):

Adriana Andreea Jitariu ◽

Amalia Raluca Ceausu ◽

Adriana Meche ◽

Cristian Nica ◽

Amelia Burlea ◽

...

Keyword(s):

Breast Cancer ◽

Tumor Cells ◽

Microvessel Density ◽

Ductal Carcinoma ◽

Hot Spot ◽

Histopathological Diagnosis ◽

Breast Cancers ◽

Breast Cancer Patients ◽

Luminal A ◽

Mean Values

Increased microvessel density (MVD) values in breast cancer correlate with tumor growth and progression while mammaglobin (MGB) expression in tumor cells is associated with a favorable prognosis. We aim to evaluate and correlate MVD values with MGB expression in molecular types of breast cancer specimens and to determine their utility as prognostic biological markers. A number of 52 breast cancer specimens were included in the study. Specimens were processed for routine histopathological diagnosis followed by the molecular classification by means of estrogen (ER), progesterone (PR) and HER2 immunohistochemical reactions. After performing immunohistochemistry for CD34 and MGB, MVD evaluation was made using the �hot spot� method for each case and MGB was scored between 0 (negative) and +3 (strong positive) depending on the intensity and distribution of the staining. MGB expression in tumor cells and MVD mean values were extremely variable. The greatest MVD mean values were obtained in luminal B followed by HER2, luminal A and triple negative breast cancer (TNBC) (95.33, 69, 62, and 40, respectively). MGB expression in the tumor cells generally ranged from mild to weak and was strong only in a few invasive ductal carcinoma cases. In cases with TNBCs the expression of MGB in tumor cells was weak and focal or negative. This variability was noticed between the molecular types of breast cancers and even within the same molecular type. In a restricted number of cases, MGB positive tumors were associated with low MVD values while the negative cases were characterized by increased MVD mean values. The variable results we obtained regarding the correlation between MVD and MGB in breast cancer specimens may indicate a rather restricted use of MVD/MGB in estimating breast cancer patients� prognosis.

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Microwave Breast Imaging Using Rotational Bistatic Impulse Radar for the Detection of Breast Cancer: Protocol for a Prospective Diagnostic Study (Preprint)

10.2196/preprints.17524 ◽

2019 ◽

Author(s):

Shinsuke Sasada ◽

Norio Masumoto ◽

Hang Song ◽

Akiko Emi ◽

Takayuki Kadoya ◽

...

Keyword(s):

Breast Cancer ◽

Diagnostic Accuracy ◽

Breast Imaging ◽

Molecular Subtype ◽

Breast Tumors ◽

Cancer Surveillance ◽

Benign Tumors ◽

Diagnostic Study ◽

Imaging Device ◽

Microwave Breast Imaging

BACKGROUND Mammography is the standard examination for breast cancer screening; however, it is associated with pain and exposure to ionizing radiation. Microwave breast imaging is a less invasive method for breast cancer surveillance. A bistatic impulse radar–based breast cancer detector has recently been developed. OBJECTIVE This study aims to present a protocol for evaluating the diagnostic accuracy of the novel microwave breast imaging device. METHODS This is a prospective diagnostic study. A total of 120 participants were recruited before treatment administration and divided into 2 cohorts: 100 patients diagnosed with breast cancer and 20 participants with benign breast tumors. The detector will be directly placed on each breast, while the participant is in supine position, without a coupling medium. Confocal images will be created based on the analyzed data, and the presence of breast tumors will be assessed. The primary endpoint will be the diagnostic accuracy, sensitivity, and specificity of the detector for breast cancer and benign tumors. The secondary endpoint will be the safety and detectability of each molecular subtype of breast cancer. For an exploratory endpoint, the influence of breast density and tumor size on tumor detection will be investigated. RESULTS Recruitment began in November 2018 and was completed by March 2020. We anticipate the preliminary results to be available by summer 2021. CONCLUSIONS This study will provide insights on the diagnostic accuracy of microwave breast imaging using a rotational bistatic impulse radar. The collected data will improve the diagnostic algorithm of microwave imaging and lead to enhanced device performance. CLINICALTRIAL Japan Registry of Clinical Trials jRCTs062180005; https://jrct.niph.go.jp/en-latest-detail/jRCTs062180005 INTERNATIONAL REGISTERED REPORT DERR1-10.2196/17524

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Automatic detection of various patterns of calcification distribution on mammograms: a graph convolution network approach (Preprint)

10.2196/preprints.32188 ◽

2021 ◽

Author(s):

Melissa Min-Szu Yao ◽

Hao Du ◽

Mikael Hartman ◽

Wing P. Chan ◽

Mengling Feng

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Characteristic Curve ◽

Area Under The Curve ◽

Automatic Detection ◽

Ground Truth ◽

Architectural Distortion ◽

Breast Cancers ◽

Convolutional Network ◽

Mammographic Images

UNSTRUCTURED Purpose: To develop a novel artificial intelligence (AI) model algorithm focusing on automatic detection and classification of various patterns of calcification distribution in mammographic images using a unique graph convolution approach. Materials and methods: Images from 200 patients classified as Category 4 or 5 according to the American College of Radiology Breast Imaging Reporting and Database System, which showed calcifications according to the mammographic reports and diagnosed breast cancers. The calcification distributions were classified as either diffuse, segmental, regional, grouped, or linear. Excluded were mammograms with (1) breast cancer as a single or combined characterization such as a mass, asymmetry, or architectural distortion with or without calcifications; (2) hidden calcifications that were difficult to mark; or (3) incomplete medical records. Results: A graph convolutional network-based model was developed. 401 mammographic images from 200 cases of breast cancer were divided based on calcification distribution pattern: diffuse (n = 24), regional (n = 111), group (n = 201), linear (n = 8) or segmental (n = 57). The classification performances were measured using metrics including precision, recall, F1 score, accuracy and multi-class area under receiver operating characteristic curve. The proposed achieved precision of 0.483 ± 0.015, sensitivity of 0.606 (0.030), specificity of 0.862 ± 0.018, F1 score of 0.527 ± 0.035, accuracy of 60.642% ± 3.040% and area under the curve of 0.754 ± 0.019, finding method to be superior compared to all baseline models. The predicted linear and diffuse classifications were highly similar to the ground truth, and the predicted grouped and regional classifications were also superior compared to baseline models. Conclusion: The proposed deep neural network framework is an AI solution to automatically detect and classify calcification distribution patterns on mammographic images highly suspected of showing breast cancers. Further study of the AI model in an actual clinical setting and additional data collection will improve its performance.

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Breast Imaging During Pregnancy and Lactation

Journal of Breast Imaging ◽

10.1093/jbi/wbz065 ◽

2019 ◽

Vol 1 (4) ◽

pp. 342-351

Author(s):

Lisa Abramson ◽

Lindsey Massaro ◽

J Jaime Alberty-Oller ◽

Amy Melsaether

Keyword(s):

Breast Cancer ◽

Breast Imaging ◽

Treatment Options ◽

Nipple Discharge ◽

Cancer Staging ◽

Imaging Features ◽

Breast Cancers ◽

Bloody Nipple Discharge ◽

Breast Cancer Staging ◽

Pregnancy And Lactation

Abstract Breast imaging during pregnancy and lactation is important in order to avoid delays in the diagnosis and treatment of pregnancy-associated breast cancers. Radiologists have an opportunity to improve breast cancer detection by becoming familiar with appropriate breast imaging and providing recommendations to women and their referring physicians. Importantly, during pregnancy and lactation, both screening and diagnostic breast imaging can be safely performed. Here we describe when and how to screen, how to work up palpable masses, and evaluate bloody nipple discharge. The imaging features of common findings in the breasts of pregnant and lactating women are also reviewed. Finally, we address breast cancer staging and provide a brief primer on treatment options for pregnancy-associated breast cancers.

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Ki67 index in intrinsic breast cancer subtypes and its association with prognostic parameters

BMC Research Notes ◽

10.1186/s13104-019-4653-x ◽

2019 ◽

Vol 12 (1) ◽

Cited By ~ 5

Author(s):

Atif Ali Hashmi ◽

Kashif Ali Hashmi ◽

Muhammad Irfan ◽

Saadia Mehmood Khan ◽

Muhammad Muzzammil Edhi ◽

...

Keyword(s):

Breast Cancer ◽

Ductal Carcinoma ◽

Prognostic Significance ◽

Breast Cancer Subtypes ◽

Prognostic Parameters ◽

Ki67 Index ◽

Breast Cancers ◽

Cancer Subtypes ◽

Luminal B ◽

Cancer Management

Abstract Objectives Ki67 is the most commonly used marker to evaluate proliferative index in breast cancer, however no cutoff values have been clearly defined for high ki67 index. Cancer management should be according to loco-regional profile; therefore, we aimed to determine ki67 index in 1951 cases of intrinsic breast cancer subtypes and its association with other prognostic parameters in our set up. Results Triple negative breast cancers showed highest ki67 index (mean 50.9 ± 23.7%) followed by Her2neu (mean 42.6 ± 21.6%) and luminal B cancers (mean 34.9 ± 20.05%). Metaplastic and medullary breast cancers significantly showed higher ki67 index as compared to ductal carcinoma, NOS. No significant association of ki67 index was noted with any of the histologic parameters in different subtypes of breast cancer expect for tumor grade. Although, ki67 index is a valuable biomarker in breast cancer, however no independent prognostic significance of ki67 could be established in our study.

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Radiological review of prior screening mammograms of screen-detected breast cancer

European Radiology ◽

10.1007/s00330-020-07130-y ◽

2020 ◽

Cited By ~ 1

Author(s):

Tone Hovda ◽

Kaitlyn Tsuruda ◽

Solveig Roth Hoff ◽

Kristine Kleivi Sahlberg ◽

Solveig Hofvind

Keyword(s):

Breast Cancer ◽

Mammographic Density ◽

Breast Imaging ◽

Screening Program ◽

Tumor Characteristics ◽

Breast Cancers ◽

Mammographic Finding ◽

Estrogen Receptor Positivity ◽

Screening Mammograms ◽

Screening And Diagnosis

Abstract Objective To perform a radiological review of mammograms from prior screening and diagnosis of screen-detected breast cancer in BreastScreen Norway, a population-based screening program. Methods We performed a consensus-based informed review of mammograms from prior screening and diagnosis for screen-detected breast cancers. Mammographic density and findings on screening and diagnostic mammograms were classified according to the Breast Imaging-Reporting and Data System®. Cases were classified based on visible findings on prior screening mammograms as true (no findings), missed (obvious findings), minimal signs (minor/non-specific findings), or occult (no findings at diagnosis). Histopathologic tumor characteristics were extracted from the Cancer Registry of Norway. The Bonferroni correction was used to adjust for multiple testing; p < 0.001 was considered statistically significant. Results The study included mammograms for 1225 women with screen-detected breast cancer. Mean age was 62 years ± 5 (SD); 46% (567/1225) were classified as true, 22% (266/1225) as missed, and 32% (392/1225) as minimal signs. No difference in mammographic density was observed between the classification categories. At diagnosis, 59% (336/567) of true and 70% (185/266) of missed cancers were classified as masses (p = 0.004). The percentage of histological grade 3 cancers was higher for true (30% (138/469)) than for missed (14% (33/234)) cancers (p < 0.001). Estrogen receptor positivity was observed in 86% (387/469) of true and 95% (215/234) of missed (p < 0.001) cancers. Conclusions We classified 22% of the screen-detected cancers as missed based on a review of prior screening mammograms with diagnostic images available. One main goal of the study was quality improvement of radiologists’ performance and the program. Visible findings on prior screening mammograms were not necessarily indicative of screening failure. Key Points • After a consensus-based informed review, 46% of screen-detected breast cancers were classified as true, 22% as missed, and 32% as minimal signs. • Less favorable prognostic and predictive tumor characteristics were observed in true screen-detected breast cancer compared with missed. • The most frequent mammographic finding for all classification categories at the time of diagnosis was mass, while the most frequent mammographic finding on prior screening mammograms was a mass for missed cancers and asymmetry for minimal signs.

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Early-stage male breast cancer: A 10-year experience

Journal of Clinical Oncology ◽

10.1200/jco.2009.27.15_suppl.e11630 ◽

2009 ◽

Vol 27 (15_suppl) ◽

pp. e11630-e11630

Author(s):

N. Gercovich ◽

E. Gil Deza ◽

M. Russo ◽

C. Garcia Gerardi ◽

C. Diaz ◽

...

Keyword(s):

Breast Cancer ◽

Cancer Patients ◽

Male Breast Cancer ◽

Ductal Carcinoma ◽

Early Stage ◽

Male Breast ◽

Stage I ◽

Stage Ii ◽

Breast Cancers ◽

Breast Cancer Patients

e11630 Introduction: Male breast cancer is very rare, representing only between 0.7% and 1% of all breast cancers, and only half of them are early stage cases. Objective: The present study has been designed with the aim of studying retrospectively the clinical onset and evolution of male invasive breast cancer patients (stages I and II) treated at IOHM between 1997 and 2008. Methods: The records of 3,000 breast cancer cases followed between 1997 and 2008 were searched, looking for male stage I and II breast cancer patients. A database was designed following the recommendations of the Directors of Surgical Pathology of the USA. The information registered encompassed: adjuvant treatments, recurrence date and date of final consultation or death. Results: Twelve pts were identified. Mean age (range)= 66 yo (50–89 yo). Tumoral type= Invasive Ductal Carcinoma 12 pt. Tumoral subtype= NOS 9 pt (75%) Apocrine 2 pt (17%) Micropapillar 1 pt (8%). Nottingham´s grade= Grade 2: 8 pt, Grade 3: 3 pt, N/A=1 pt. Stage= I= 6 pt, II=6 pt. ER (Positve= 9 pt, Negative=1 pt, N/A= 2 pt). PR (Positve= 8 pt, Negative= 2 pt, N/A=2 pt). Her2neu (0+= 3 pt, 1+= 3 pt, 2+= 2 pt, N/A= 4 pt). Surgery= Mastectomy= 11 pt, Lumpectomy 1= pt. Radiotherapy=5 pt. Adjuvance= No=2 pt, Hormonotherapy (HT)= 3 pt, Chemotherapy (CHT) = 3 pt, CHT+HT= 4 pt. Recurrence= Yes= 2 pt, No= 10 pt. Survival: Dead= 1 pt, Alive =11 pt. Mean Time To Progression= Stage I =66 months, Stage II =42 months. Global survival: Stage I =66 months, Stage II =52 months. Conclusions: 1. Twelve stage I and II male breast cancer patients were identified out of 3000 (0.4%) breast cancer cases diagnosed and followed in the past 10 years at the IOHM. 2. Mastectomy was the surgical procedure in 11 of the 12 cases 3. Ten pt underwent adjuvant treatment. 4. With a mean follow up time of 60 months, all stage I patients are alive and there were no recurrences. Two of the 6 stage II pts progressed and one died. No significant financial relationships to disclose.

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Pathologic characteristics of breast cancer with special emphasis on prevalence of triple-negative breast cancer from Kenya: A 4-year experience.

Journal of Clinical Oncology ◽

10.1200/jco.2011.29.27_suppl.35 ◽

2011 ◽

Vol 29 (27_suppl) ◽

pp. 35-35

Author(s):

S. Sayed ◽

Z. Moloo ◽

S. Mukono ◽

R. Wasike ◽

R. R. Chauhan ◽

...

Keyword(s):

Breast Cancer ◽

Triple Negative Breast Cancer ◽

Triple Negative ◽

Ductal Carcinoma ◽

Significant Proportion ◽

Small Sample ◽

University Hospital ◽

Breast Cancers ◽

Grade 3

35 Background: Previous sub classification of breast cancer in Kenya has been fraught by small sample size, non uniform staining methodology and lack of independent review. Triple Negative Breast Cancer (TNBC) is a “special interest” cancer since it represents a significant proportion of breast cancer patients and is associated with a poorer prognosis. We aimed to determine the estrogen receptor (ER), progesterone receptor (PR) and Her2/neu receptor characteristics of breast cancers and the prevalence of TNBC diagnosed at Aga Khan University Hospital, Nairobi (AKUHN) between 2007 to date. Methods: Slides and blocks of archived invasive breast cancers diagnosed at AKUHN were identified, retrieved and reviewed by two independent pathologists. Histological type, grade and pathological stage were documented. Representative sections from available blocks were stained for ER, PR, Her2 with appropriate internal controls. Scores for ER/PR were interpreted based on the ALLRED system, Her2 /neu scoring followed CAP guidelines. The initial 111 cases were validated and confirmed at Sunnybrook Health Sciences Centre, Toronto. Results: 456 cases of invasive breast cancers were diagnosed at AKUHN during the study period. 91% of cases were invasive ductal carcinomas (NOS).The rest were special types. 37% of the tumors were grade 3 and 63% were grade 2. Blocks for 318 of 456 cases were available for receptor analysis. 54% were ER and/or PR positive, with 52% of these in women < 50 yrs. 86% of the ER and/or PR positive tumors were grade 2. Only 12% were Her2/neu positive. Of the 318 cases studied, 111 (32%) were identified as TNBC. Median age was 53 yrs. 88% were grade 3. Conclusions: Invasive ductal carcinoma (NOS) was the most common breast cancer in our study. Nearly half of our cases were ER and/or PR positive and a third were TNBC. Both occurred predominantly in women less than 50 yrs. This represents the largest validated pathologic sub classification of breast cancer from a tertiary academic hospital in Kenya. Expansion of this study to encompass all breast cancers diagnosed in Kenya is underway.

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The potential benefit of trastuzumab-based therapy upon lapatinib progression in heavily preatreated patients with advanced HER2 positive breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2013.31.15_suppl.e11576 ◽

2013 ◽

Vol 31 (15_suppl) ◽

pp. e11576-e11576

Author(s):

Anastasios L. Boutis ◽

Sofia Chatzileontiadou ◽

Nikolaos Diamantopoulos ◽

Athanasios Pouptsis ◽

Chariklia Fotiou

Keyword(s):

Breast Cancer ◽

Advanced Breast Cancer ◽

Ductal Carcinoma ◽

Advanced Breast ◽

Breast Cancers ◽

Breast Cancer Patients ◽

Her2 Positive ◽

Adjuvant Trastuzumab ◽

Metastatic Setting ◽

Increased Risk

e11576 Background: Overexpression of human epidermal growth factor receptor 2 (HER2) occurring in about 20% of breast cancers is associated with increased risk of disease recurrence and worse prognosis. Despite the advent of therapies that target HER2, particularly, trastuzumab and lapatinib, that have altered the natural course of HER2-positive advanced breast cancer, tumor progression remains inevitable. New agents are in clinical development, but up to date there are limited data to direct the treatment of patients after lapatinib progression. Methods: We retrospectively searched for HER2-positive advanced breast cancer patients treated at our clinic, who received both trastuzumab-based therapy and lapatinib upon trastuzumab-progression in the metastatic setting. Thirty patients, all female, suffering from HER2-positive advanced breast cancer were identified. HER-2 positivity was assessed by immunohistochemistry (IHC 3+) or chromogenic in situ hybridization (CISH+). Results: Of the 30 patients, 83.3% had invasive ductal carcinoma; 60% had positive hormone receptor status, and 80% grade 3 tumours. Half of the patients received adjuvant trastuzumab. Median age was 57 years, range 37-79 years. 36.6% were switched to lapatinib after a median of three (range 2-6 lines) trastuzumab-based treatment lines. In 8 pts (37.5%) trastuzumab was re-started after lapatinib progression. In 7 of these patients, trastuzumab was combined with chemotherapy. Median progression free survival and overall survival in these patients was 4.75 and 8.87 months respectively. 3 patients received bevacizumab-based therapy upon lapatinib failure. Conclusions: Trastuzumab rechallenge after lapatinib progression may be active in a subgroup of heavily pre-treated patients. Clinical benefit of this strategy has to be balanced especially in limited resource settings with unavailability of novel agents or early phase clinical trials. As of now, there is no uniform accepted standard to define the optimal treatment approach of patients upon lapatinib progression showing the real need for new therapies in this population.

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Prevalence of BRCA2 mutations and other clinical characteristics in women with triple-negative breast cancer.

Journal of Clinical Oncology ◽

10.1200/jco.2014.32.26_suppl.160 ◽

2014 ◽

Vol 32 (26_suppl) ◽

pp. 160-160

Author(s):

Jennifer Chun ◽

Freya Ruth Schnabel ◽

Shira Schwartz ◽

Jessica Billig ◽

Karen Hiotis ◽

...

Keyword(s):

Breast Cancer ◽

At Risk ◽

Genetic Testing ◽

Clinical Characteristics ◽

Triple Negative ◽

Ductal Carcinoma ◽

Personal History ◽

Breast Cancers ◽

History Of ◽

Brca2 Mutations

160 Background: Triple-negative breast cancers (TNBC) represent 10%–20% of invasive breast cancers. Current guidelines recommend genetic testing for women who are diagnosed with TNBC. Studies have shown that BRCA1 mutations are associated with TNBC, but there is little information on the relationship of BRCA2 mutations and TNBC. The purpose of this study was to look at the clinical characteristics of TNBC compared to non-TNBC in a cohort of women with newly diagnosed breast cancer. Methods: The Breast Cancer Database at our institution was queried for patients with invasive breast cancer. We included the following variables: age, race, BRCA1,2, tumor characteristics, and personal history of breast cancer (PHBC). Statistical analyses included Pearson’s Chi-Square and Fisher’s Exact Tests. Results: Out of a total of 1,332 women, 125 (9%) had TNBC. The median age for both TNBC and non-TNBC was 59 years. Majority of women had early stage breast cancer (92%) with ductal carcinoma (80%). There was a significantly higher proportion of Blacks and Asians with TNBC (p < 0.0001). Women with TNBC had higher Ki-67 (p < 0.0001). Within the TNBC group, there were 12 (29%) patients who tested positive for BRCA1,2 mutation and 23 (8%) who tested positive for BRCA 1,2 mutations in the non-TNBC group. Interestingly, BRCA1 was not associated with TNBC (p = 0.40) and BRCA2 was significantly associated with TNBC (p < 0.0001). We also found a higher proportion of TNBC in women who had a PHBC (p = 0.01). Conclusions: In our study, women with TNBC were similar in age to women who did not have TNBC. We found that the women with TNBC in our cohort had elevated rates of BRCA2 mutations. We also found that women with a personal history of breast cancer were at risk for developing TNBC. This may be related to the use of hormonal therapy that reduces the risk of ER/PR-positive tumors. Women of all ages are at risk for developing TNBC and older age at TNBC should not deter from genetic testing.

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