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Sample records for qualitative mammographic features

  1. Mammographic features and subsequent risk of breast cancer: a comparison of qualitative and quantitative evaluations in the Guernsey prospective studies.

    PubMed

    Torres-Mejía, Gabriela; De Stavola, Bianca; Allen, Diane S; Pérez-Gavilán, Juan J; Ferreira, Jorge M; Fentiman, Ian S; Dos Santos Silva, Isabel

    2005-05-01

    Mammographic features are known to be associated with breast cancer but the magnitude of the effect differs markedly from study to study. Methods to assess mammographic features range from subjective qualitative classifications to computer-automated quantitative measures. We used data from the UK Guernsey prospective studies to examine the relative value of these methods in predicting breast cancer risk. In all, 3,211 women ages > or =35 years who had a mammogram taken in 1986 to 1989 were followed-up to the end of October 2003, with 111 developing breast cancer during this period. Mammograms were classified using the subjective qualitative Wolfe classification and several quantitative mammographic features measured using computer-based techniques. Breast cancer risk was positively associated with high-grade Wolfe classification, percent breast density and area of dense tissue, and negatively associated with area of lucent tissue, fractal dimension, and lacunarity. Inclusion of the quantitative measures in the same model identified area of dense tissue and lacunarity as the best predictors of breast cancer, with risk increasing by 59% [95% confidence interval (95% CI), 29-94%] per SD increase in total area of dense tissue but declining by 39% (95% CI, 53-22%) per SD increase in lacunarity, after adjusting for each other and for other confounders. Comparison of models that included both the qualitative Wolfe classification and these two quantitative measures to models that included either the qualitative or the two quantitative variables showed that they all made significant contributions to prediction of breast cancer risk. These findings indicate that breast cancer risk is affected not only by the amount of mammographic density but also by the degree of heterogeneity of the parenchymal pattern and, presumably, by other features captured by the Wolfe classification.

  2. Qualitative Radiogenomics: Association between Oncotype DX Test Recurrence Score and BI-RADS Mammographic and Breast MR Imaging Features.

    PubMed

    Woodard, Genevieve A; Ray, Kimberly M; Joe, Bonnie N; Price, Elissa R

    2017-09-08

    Purpose To evaluate the association between Breast Imaging Reporting and Data System (BI-RADS) mammographic and magnetic resonance (MR) imaging features and breast cancer recurrence risk in patients with estrogen receptor-positive breast cancer who underwent the Oncotype DX assay. Materials and Methods In this institutional review board-approved and HIPAA-compliant protocol, 408 patients diagnosed with invasive breast cancer between 2004 and 2013 who underwent the Oncotype DX assay were identified. Mammographic and MR imaging features were retrospectively collected according to the BI-RADS lexicon. Linear regression assessed the association between imaging features and Oncotype DX test recurrence score (ODxRS), and post hoc pairwise comparisons assessed ODxRS means by using imaging features. Results Mammographic breast density was inversely associated with ODxRS (P ≤ .05). Average ODxRS for density category A was 24.4 and that for density category D was 16.5 (P < .02). Both indistinct mass margins and fine linear branching calcifications at mammography were significantly associated with higher ODxRS (P < .01 and P < .03, respectively). Masses with indistinct margins had an average ODxRS of 31.3, which significantly differed from the ODxRS of 18.5 for all other mass margins (P < .01). The average ODxRS for fine linear branching calcifications was 29.6, whereas the ODxRS for all other suspicious calcification morphologies was 19.4 (P < .03). Average ODxRS was significantly higher for irregular mass margins at MR imaging compared with spiculated mass margins (24.0 vs 17.6; P < .02). The presence of nonmass enhancement at MR imaging was associated with lower ODxRS than was its absence (16.4 vs 19.9; P < .05). Conclusion The BI-RADS features of mammographic breast density, calcification morphology, mass margins at mammography and MR imaging, and nonmass enhancement at MR imaging have the potential to serve as imaging biomarkers of breast cancer recurrence risk

  3. Mammographic features of early breast cancer

    SciTech Connect

    Sickles, E.A.

    1984-09-01

    Mammographic detection of breast cancer at the earliest possible stage requires optimal radiographic technique and a full knowledge of the subtle features with which very small cancers can present. Although some early cancers are identified as characteristic clusters of calcifications or as spiculated or multinodular (knobby) masses, others demonstrate less typical and sometimes much less obvious mammographic signs: the single dilated duct, focal architectural distortion, asymmetry, and the developing density sign. Although these indirect signs are nonspecific, they provide mammographers with the important opportunity to discover breast cancer at a very early stage, when the likelihood for cure is great.

  4. Posterior breast cancer - mammographic and ultrasonographic features.

    PubMed

    Janković, Ana; Nadrljanski, Mirjan; Karapandzić, Vesna Plesinac; Ivanović, Nebojsa; Radojicić, Zoran; Milosević, Zorica

    2013-11-01

    Posterior breast cancers are located in the prepectoral region of the breast. Owing to this distinctive anatomical localization, physical examination and mammographic or ultrasonographic evaluation can be difficult. The purpose of the study was to assess possibilities of diagnostic mammography and breast ultrasonography in detection and differentiation of posterior breast cancers. The study included 40 women with palpable, histopathological confirmed posterior breast cancer. Mammographic and ultrasonographic features were defined according to Breast Imaging Reporting and Data System (BI-RADS) lexicon. Based on standard two-view mammography 87.5%, of the cases were classified as BI-RADS 4 and 5 categories, while after additional mammographic views all the cases were defined as BI-RADS 4 and 5 categories. Among 96 mammographic descriptors, the most frequent were: spiculated mass (24.0%), architectural distortion (16.7%), clustered micro-calcifications (12.6%) and focal asymmetric density (12.6%). The differentiation of the spiculated mass was significantly associated with the possibility to visualize the lesion at two-view mammography (p = 0.009), without the association with lesion diameter (p = 0.083) or histopathological type (p = 0.055). Mammographic signs of invasive lobular carcinoma were significantly different from other histopathological types (architectural distortion, p = 0.003; focal asymmetric density, p = 0.019; association of four or five subtle signs of malignancy, p = 0.006). All cancers were detectable by ultrasonography. Mass lesions were found in 82.0% of the cases. Among 153 ultrasonographic descriptors, the most frequent were: irregular mass (15.7%), lobulated mass (7.2%), abnormal color Doppler signals (20.3%), posterior acoustic attenuation (18.3%). Ultrasonographic BI-RADS 4 and 5 categories were defined in 72.5% of the cases, without a significant difference among various histopathological types (p = 0.109). Standard two-view mammography

  5. Mammographic feature enhancement by multiscale analysis

    SciTech Connect

    Laine, A.F.; Schuler, S.; Fan, J.; Huda, W. )

    1994-12-01

    This paper introduces a novel approach for accomplishing mammographic feature analysis by overcomplete multiresolution representations. The authors show that efficient representations may be identified within a continuum of scale-space and used to enhance features of importance to mammography. Methods of contrast enhancement are described based on three overcomplete multiscale representations: (1) the dyadic wavelet transform (separable), (2) the [var phi]-transform (nonseparable, nonorthogonal), and (3) the hexagonal wavelet transform (nonseparable). Multiscale edges identified within distinct levels of transform space provide local support for image enhancement. Mammograms are reconstructed from wavelet coefficients modified at one or more levels by local and global nonlinear operators. In each case, edges and gain parameters are identified adaptively by a measure of energy within each level of scale-space. The authors show quantitatively that transform coefficients, modified by adaptive nonlinear operators, can make more obvious unseen or barely seen features of mammography without requiring additional radiation. The results are compared with traditional image enhancement techniques by measuring the local contrast of known mammographic features. The authors demonstrate that features extracted from multiresolution representations can provide an adaptive mechanism for accomplishing local contrast enhancement. By improving the visualization of breast pathology, they can improve chances of early detection while requiring less time to evaluate mammograms for most patients.

  6. Adaptive feature enhancement for mammographic images with wavelet multiresolution analysis

    NASA Astrophysics Data System (ADS)

    Chen, Lulin; Chen, Chang W.; Parker, Kevin J.

    1997-10-01

    A novel and computationally efficient approach to an adaptive mammographic image feature enhancement using wavelet-based multiresolution analysis is presented. On wavelet decomposition applied to a given mammographic image, we integrate the information of the tree-structured zero crossings of wavelet coefficients and the information of the low-pass-filtered subimage to enhance the desired image features. A discrete wavelet transform with pyramidal structure is employed to speedup the computation for wavelet decomposition and reconstruction. The spatiofrequency localization property of the wavelet transform is exploited based on the spatial coherence of image and the principle of human psycho-visual mechanism. Preliminary results show that the proposed approach is able to adaptively enhance local edge features, suppress noise, and improve global visualization of mammographic image features. This wavelet- based multiresolution analysis is therefore promising for computerized mass screening of mammograms.

  7. Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?

    PubMed

    Bagnera, Silvia; Milanesio, Luisella; Brachet Cota, Piero B; Berrino, Carla; Cataldi, Aldo; Gatti, Giovanni; Mondini, Guido; Paino, Ovidio; Comello, Erika G; Orlassino, Renzo; Pasquino, Massimo; Cante, Domenico; La Porta, Maria R; Patania, Sebastiano; La Valle, Giovanni

    2015-01-01

    To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications. A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging. Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology-Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. "No change" was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type). No statistically significant changes in follow-up mammographies 5-9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection. The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after AWB-RT treatment (up to 5-9 years after radiotherapy) justifies large

  8. Does accelerated hypofractionated adjuvant whole-breast radiotherapy increase mammographic density or change mammographic features?

    PubMed Central

    Milanesio, Luisella; Brachet Cota, Piero B; Berrino, Carla; Cataldi, Aldo; Gatti, Giovanni; Mondini, Guido; Paino, Ovidio; Comello, Erika G; Orlassino, Renzo; Pasquino, Massimo; Cante, Domenico; La Porta, Maria R; Patania, Sebastiano; La Valle, Giovanni

    2015-01-01

    Objective: To compare mammographic features before and after accelerated hypofractionated adjuvant whole-breast radiotherapy (AWB-RT) and to evaluate possible appearance of modifications. Methods: A retrospective review of 177 females before and after an AWB-RT treatment (follow-up ranging from 5 to 9 years) was performed by four radiologists focused in breast imaging who independently evaluated diffuse mammographic density patterns and reported on possible onset of focal alterations; modifications in density and fibrosis with parenchymal distortion were deemed as indicators of AWB-RT treatment impact in breast imaging. Results: Prevalent mammographic density (D) patterns in the 177 females evaluated were according to the American College of Radiology–Breast Imaging Reporting and Data System (ACR-BIRADS): D1, fibroadipose density (score percentage from 55.9% to 43.5%); and D2, scattered fibroglandular density (from 42.9% to 32.7%). No change in diffuse mammographic density and no significant difference in mammographic breast parenchymal structure were observed. “No change” was reported with score percentage from 87% to 79.6%. Appearance of fibrosis with parenchymal distortion was reported by all radiologists in only two cases (1.1%, p = 0.3); dystrophic calcification was identified with percentage score from 2.2% to 3.3% (small type) and from 9.6% to 12.9% (coarse type). Conclusion: No statistically significant changes in follow-up mammographies 5–9 years after AWB-RT were detected, justifying large-scale selection of AWB-RT treatment with no risk of altering radiological breast parameters of common use in tumour recurrence detection. Advances in knowledge: The hypofractionated radiotherapy (AWB-RT treatment) is a new proven, safe and effective modality in post-operative patients with early breast cancer with excellent local control and survival. In our study, the absence of changes in mammographic density patterns and in breast imaging before and after

  9. Correspondence in texture features between two mammographic views

    SciTech Connect

    Gupta, Shalini; Markey, Mia K.

    2005-06-15

    It is well established that radiologists are better able to interpret mammograms when two mammographic views are available. Consequently, two mammographic projections are standard: mediolateral oblique (MLO) and craniocaudal (CC). Computer-aided diagnosis algorithms have been investigated for assisting in the detection and diagnosis of breast lesions in digitized/digital mammograms. A few previous studies suggest that computer-aided systems may also benefit from combining evidence from the two views. Intuitively, we expect that there would only be value in merging data from two views if they provide complementary information. A measure of the similarity of information is the correlation coefficient between corresponding features from the MLO and CC views. The purpose of this study was to investigate the correspondence in Haralick's texture features between the MLO and CC mammographic views of breast lesions. Features were ranked on the basis of correlation values and the two-view correlation of features for subgroups of data including masses versus calcification and benign versus malignant lesions were compared. All experiments were performed on a subset of mammography cases from the Digital Database for Screening Mammography (DDSM). It was observed that the texture features from the MLO and CC views were less strongly correlated for calcification lesions than for mass lesions. Similarly, texture features from the two views were less strongly correlated for benign lesions than for malignant lesions. These differences were statistically significant. The results suggest that the inclusion of texture features from multiple mammographic views in a CADx algorithm may impact the accuracy of diagnosis of calcification lesions and benign lesions.

  10. Characterizing mammographic images by using generic texture features

    PubMed Central

    2012-01-01

    Introduction Although mammographic density is an established risk factor for breast cancer, its use is limited in clinical practice because of a lack of automated and standardized measurement methods. The aims of this study were to evaluate a variety of automated texture features in mammograms as risk factors for breast cancer and to compare them with the percentage mammographic density (PMD) by using a case-control study design. Methods A case-control study including 864 cases and 418 controls was analyzed automatically. Four hundred seventy features were explored as possible risk factors for breast cancer. These included statistical features, moment-based features, spectral-energy features, and form-based features. An elaborate variable selection process using logistic regression analyses was performed to identify those features that were associated with case-control status. In addition, PMD was assessed and included in the regression model. Results Of the 470 image-analysis features explored, 46 remained in the final logistic regression model. An area under the curve of 0.79, with an odds ratio per standard deviation change of 2.88 (95% CI, 2.28 to 3.65), was obtained with validation data. Adding the PMD did not improve the final model. Conclusions Using texture features to predict the risk of breast cancer appears feasible. PMD did not show any additional value in this study. With regard to the features assessed, most of the analysis tools appeared to reflect mammographic density, although some features did not correlate with PMD. It remains to be investigated in larger case-control studies whether these features can contribute to increased prediction accuracy. PMID:22490545

  11. Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

    PubMed Central

    Destounis, Stamatia; Arieno, Andrea; Morgan, Renee; Roberts, Christina; Chan, Ariane

    2017-01-01

    Mammographic breast density (MBD) has been proven to be an important risk factor for breast cancer and an important determinant of mammographic screening performance. The measurement of density has changed dramatically since its inception. Initial qualitative measurement methods have been found to have limited consistency between readers, and in regards to breast cancer risk. Following the introduction of full-field digital mammography, more sophisticated measurement methodology is now possible. Automated computer-based density measurements can provide consistent, reproducible, and objective results. In this review paper, we describe various methods currently available to assess MBD, and provide a discussion on the clinical utility of such methods for breast cancer screening. PMID:28561776

  12. Prediction of occult invasive disease in ductal carcinoma in situ using computer-extracted mammographic features

    NASA Astrophysics Data System (ADS)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Predicting the risk of occult invasive disease in ductal carcinoma in situ (DCIS) is an important task to help address the overdiagnosis and overtreatment problems associated with breast cancer. In this work, we investigated the feasibility of using computer-extracted mammographic features to predict occult invasive disease in patients with biopsy proven DCIS. We proposed a computer-vision algorithm based approach to extract mammographic features from magnification views of full field digital mammography (FFDM) for patients with DCIS. After an expert breast radiologist provided a region of interest (ROI) mask for the DCIS lesion, the proposed approach is able to segment individual microcalcifications (MCs), detect the boundary of the MC cluster (MCC), and extract 113 mammographic features from MCs and MCC within the ROI. In this study, we extracted mammographic features from 99 patients with DCIS (74 pure DCIS; 25 DCIS plus invasive disease). The predictive power of the mammographic features was demonstrated through binary classifications between pure DCIS and DCIS with invasive disease using linear discriminant analysis (LDA). Before classification, the minimum redundancy Maximum Relevance (mRMR) feature selection method was first applied to choose subsets of useful features. The generalization performance was assessed using Leave-One-Out Cross-Validation and Receiver Operating Characteristic (ROC) curve analysis. Using the computer-extracted mammographic features, the proposed model was able to distinguish DCIS with invasive disease from pure DCIS, with an average classification performance of AUC = 0.61 +/- 0.05. Overall, the proposed computer-extracted mammographic features are promising for predicting occult invasive disease in DCIS.

  13. Assessment of two mammographic density related features in predicting near-term breast cancer risk

    NASA Astrophysics Data System (ADS)

    Zheng, Bin; Sumkin, Jules H.; Zuley, Margarita L.; Wang, Xingwei; Klym, Amy H.; Gur, David

    2012-02-01

    In order to establish a personalized breast cancer screening program, it is important to develop risk models that have high discriminatory power in predicting the likelihood of a woman developing an imaging detectable breast cancer in near-term (e.g., <3 years after a negative examination in question). In epidemiology-based breast cancer risk models, mammographic density is considered the second highest breast cancer risk factor (second to woman's age). In this study we explored a new feature, namely bilateral mammographic density asymmetry, and investigated the feasibility of predicting near-term screening outcome. The database consisted of 343 negative examinations, of which 187 depicted cancers that were detected during the subsequent screening examination and 155 that remained negative. We computed the average pixel value of the segmented breast areas depicted on each cranio-caudal view of the initial negative examinations. We then computed the mean and difference mammographic density for paired bilateral images. Using woman's age, subjectively rated density (BIRADS), and computed mammographic density related features we compared classification performance in estimating the likelihood of detecting cancer during the subsequent examination using areas under the ROC curves (AUC). The AUCs were 0.63+/-0.03, 0.54+/-0.04, 0.57+/-0.03, 0.68+/-0.03 when using woman's age, BIRADS rating, computed mean density and difference in computed bilateral mammographic density, respectively. Performance increased to 0.62+/-0.03 and 0.72+/-0.03 when we fused mean and difference in density with woman's age. The results suggest that, in this study, bilateral mammographic tissue density is a significantly stronger (p<0.01) risk indicator than both woman's age and mean breast density.

  14. Decision trees and integrated features for computer aided mammographic screening

    SciTech Connect

    Kegelmeyer, W.P. Jr.; Groshong, B.; Allmen, M.; Woods, K.

    1997-02-01

    Breast cancer is a serious problem, which in the United States causes 43,000 deaths a year, eventually striking 1 in 9 women. Early detection is the only effective countermeasure, and mass mammography screening is the only reliable means for early detection. Mass screening has many shortcomings which could be addressed by a computer-aided mammographic screening system. Accordingly, we have applied the pattern recognition methods developed in earlier investigations of speculated lesions in mammograms to the detection of microcalcifications and circumscribed masses, generating new, more rigorous and uniform methods for the detection of both those signs. We have also improved the pattern recognition methods themselves, through the development of a new approach to combinations of multiple classifiers.

  15. Analysis of mammographic microcalcifications using gray-level image structure features

    SciTech Connect

    Dhawan, A.P.; Chitre, Y.; Kaiser-Bonasso, C.; Moskowitz, M.

    1996-06-01

    Most of the techniques used in the computerized analysis of mammographic microcalcifications use shape features on the segmented regions of microcalcifications extracted from the digitized mammograms. Since mammographic images usually suffer from poorly defined microcalcification features, the extraction of shape features based on a segmentation process may not accurately represent microcalcifications. In this paper, the authors define a set of image structure features for classification of malignancy. Two categories of correlated gray-level image structure features are defined for classification of difficult-to-diagnose cases. The first category of features includes second-order histogram statistics-based features representing the global texture and the wavelet decomposition-based features representing the local texture of the microcalcification area of interest. The second category of features represents the first-order gray-level histogram-based statistics of the segmented microcalcification regions and the size, number, and distance features of the segmented microcalcification cluster. Various features in each category were correlated with the biopsy examination results of 191 difficult-to-diagnose cases for selection of the best set of features representing the complete gray-level image structure information. The selection of the best features was performed using the multivariate cluster analysis as well as a genetic algorithm (GA)-based search method. The selected features were used for classification using backpropagation neural network and parametric statistical classifiers. Receiver operating characteristic (ROC) analysis was performed to compare the neural network-based classification with linear and k-nearest neighbor (KNN) classifiers.

  16. Mammographic features in infertile women as a potential risk for breast cancer: a preliminary study.

    PubMed

    Meggiorini, M L; Cipolla, V; Rech, F; Labi, L; Vestri, A; de Felice, C

    2012-01-01

    The purpose of the present study was to evaluate breast mammographic features, particularly mammographic density in a selected population of infertile women and to assess if these women should be considered at higher risk for breast cancer. The prevalence of female infertility in Western countries is approximately 10-15% and since causes affecting the female are involved in 35-40%, concerns have developed about the future health of these women, specifically whether infertility could represent a risk factor for future cancer development. Moreover, infertility is now often treated with medication and procedures that could modify the hormonal environment and be cofactors in the cellular changes towards cancer development. Mammographic breast density is a useful marker for breast cancer risk and breast density is considered one of the strongest risk factors for breast cancer. Breast density is associated with known breast cancer risk factors such as reproductive and menstrual factors including serum estrogen and progesterone concentrations. In Italy the National Federation for Breast Cancer (FONCAM) guidelines suggest the usefulness of mammography from 35 years of age for women who undergo infertility hormone therapy (FONCAM Guidelines, 2005). According to this recommendation 294 women aged > or = 35, with primary infertility, sent to our breast service before joining an IVF program were recruited and then underwent clinical examination and X-ray mammography. Women were divided into two groups: dense breast (DB) and non-dense breast (NDB). Univariate analysis was employed to evaluate if there was an association between mammographic density and other risk factors. Evaluation of mammographic features showed the presence of BI-RADs C and D in the sample of 200 (68%) patients with DB and in 94 (32%) patients with NDB BI-RADS A and B. Univariate analysis showed that there were no statistically significant differences between the groups BD and NDB as regards age at

  17. Can upstaging of ductal carcinoma in situ be predicted at biopsy by histologic and mammographic features?

    NASA Astrophysics Data System (ADS)

    Shi, Bibo; Grimm, Lars J.; Mazurowski, Maciej A.; Marks, Jeffrey R.; King, Lorraine M.; Maley, Carlo C.; Hwang, E. Shelley; Lo, Joseph Y.

    2017-03-01

    Reducing the overdiagnosis and overtreatment associated with ductal carcinoma in situ (DCIS) requires accurate prediction of the invasive potential at cancer screening. In this work, we investigated the utility of pre-operative histologic and mammographic features to predict upstaging of DCIS. The goal was to provide intentionally conservative baseline performance using readily available data from radiologists and pathologists and only linear models. We conducted a retrospective analysis on 99 patients with DCIS. Of those 25 were upstaged to invasive cancer at the time of definitive surgery. Pre-operative factors including both the histologic features extracted from stereotactic core needle biopsy (SCNB) reports and the mammographic features annotated by an expert breast radiologist were investigated with statistical analysis. Furthermore, we built classification models based on those features in an attempt to predict the presence of an occult invasive component in DCIS, with generalization performance assessed by receiver operating characteristic (ROC) curve analysis. Histologic features including nuclear grade and DCIS subtype did not show statistically significant differences between cases with pure DCIS and with DCIS plus invasive disease. However, three mammographic features, i.e., the major axis length of DCIS lesion, the BI-RADS level of suspicion, and radiologist's assessment did achieve the statistical significance. Using those three statistically significant features as input, a linear discriminant model was able to distinguish patients with DCIS plus invasive disease from those with pure DCIS, with AUC-ROC equal to 0.62. Overall, mammograms used for breast screening contain useful information that can be perceived by radiologists and help predict occult invasive components in DCIS.

  18. Characterization of mammographic masses based on level set segmentation with new image features and patient information

    SciTech Connect

    Shi Jiazheng; Sahiner, Berkman; Chan Heangping; Ge Jun; Hadjiiski, Lubomir; Helvie, Mark A.; Nees, Alexis; Wu Yita; Wei Jun; Zhou Chuan; Zhang Yiheng; Cui Jing

    2008-01-15

    Computer-aided diagnosis (CAD) for characterization of mammographic masses as malignant or benign has the potential to assist radiologists in reducing the biopsy rate without increasing false negatives. The purpose of this study was to develop an automated method for mammographic mass segmentation and explore new image based features in combination with patient information in order to improve the performance of mass characterization. The authors' previous CAD system, which used the active contour segmentation, and morphological, textural, and spiculation features, has achieved promising results in mass characterization. The new CAD system is based on the level set method and includes two new types of image features related to the presence of microcalcifications with the mass and abruptness of the mass margin, and patient age. A linear discriminant analysis (LDA) classifier with stepwise feature selection was used to merge the extracted features into a classification score. The classification accuracy was evaluated using the area under the receiver operating characteristic curve. The authors' primary data set consisted of 427 biopsy-proven masses (200 malignant and 227 benign) in 909 regions of interest (ROIs) (451 malignant and 458 benign) from multiple mammographic views. Leave-one-case-out resampling was used for training and testing. The new CAD system based on the level set segmentation and the new mammographic feature space achieved a view-based A{sub z} value of 0.83{+-}0.01. The improvement compared to the previous CAD system was statistically significant (p=0.02). When patient age was included in the new CAD system, view-based and case-based A{sub z} values were 0.85{+-}0.01 and 0.87{+-}0.02, respectively. The study also demonstrated the consistency of the newly developed CAD system by evaluating the statistics of the weights of the LDA classifiers in leave-one-case-out classification. Finally, an independent test on the publicly available digital database

  19. Reduction of false-positive recalls using a computerized mammographic image feature analysis scheme

    NASA Astrophysics Data System (ADS)

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-08-01

    The high false-positive recall rate is one of the major dilemmas that significantly reduce the efficacy of screening mammography, which harms a large fraction of women and increases healthcare cost. This study aims to investigate the feasibility of helping reduce false-positive recalls by developing a new computer-aided diagnosis (CAD) scheme based on the analysis of global mammographic texture and density features computed from four-view images. Our database includes full-field digital mammography (FFDM) images acquired from 1052 recalled women (669 positive for cancer and 383 benign). Each case has four images: two craniocaudal (CC) and two mediolateral oblique (MLO) views. Our CAD scheme first computed global texture features related to the mammographic density distribution on the segmented breast regions of four images. Second, the computed features were given to two artificial neural network (ANN) classifiers that were separately trained and tested in a ten-fold cross-validation scheme on CC and MLO view images, respectively. Finally, two ANN classification scores were combined using a new adaptive scoring fusion method that automatically determined the optimal weights to assign to both views. CAD performance was tested using the area under a receiver operating characteristic curve (AUC). The AUC = 0.793  ±  0.026 was obtained for this four-view CAD scheme, which was significantly higher at the 5% significance level than the AUCs achieved when using only CC (p = 0.025) or MLO (p = 0.0004) view images, respectively. This study demonstrates that a quantitative assessment of global mammographic image texture and density features could provide useful and/or supplementary information to classify between malignant and benign cases among the recalled cases, which may eventually help reduce the false-positive recall rate in screening mammography.

  20. Risk of Breast Cancer in Women with False-Positive Results according to Mammographic Features.

    PubMed

    Castells, Xavier; Torá-Rocamora, Isabel; Posso, Margarita; Román, Marta; Vernet-Tomas, Maria; Rodríguez-Arana, Ana; Domingo, Laia; Vidal, Carmen; Baré, Marisa; Ferrer, Joana; Quintana, María Jesús; Sánchez, Mar; Natal, Carmen; Espinàs, Josep A; Saladié, Francina; Sala, María

    2016-08-01

    Purpose To assess the risk of breast cancer in women with false-positive screening results according to radiologic classification of mammographic features. Materials and Methods Review board approval was obtained, with waiver of informed consent. This retrospective cohort study included 521 200 women aged 50-69 years who underwent screening as part of the Spanish Breast Cancer Screening Program between 1994 and 2010 and who were observed until December 2012. Cox proportional hazards regression analysis was used to estimate the age-adjusted hazard ratio (HR) of breast cancer and the 95% confidence interval (CI) in women with false-positive mammograms as compared with women with negative mammograms. Separate models were adjusted for screen-detected and interval cancers and for screen-film and digital mammography. Time without a breast cancer diagnosis was plotted by using Kaplan-Meier curves. Results When compared with women with negative mammograms, the age-adjusted HR of cancer in women with false-positive results was 1.84 (95% CI: 1.73, 1.95; P < .001). The risk was higher in women who had calcifications, whether they were (HR, 2.73; 95% CI: 2.28, 3.28; P < .001) or were not (HR, 2.24; 95% CI: 2.02, 2.48; P < .001) associated with masses. Women in whom mammographic features showed changes in subsequent false-positive results were those who had the highest risk (HR, 9.13; 95% CI: 8.28, 10.07; P < .001). Conclusion Women with false-positive results had an increased risk of breast cancer, particularly women who had calcifications at mammography. Women who had more than one examination with false-positive findings and in whom the mammographic features changed over time had a highly increased risk of breast cancer. Previous mammographic features might yield useful information for further risk-prediction models and personalized follow-up screening protocols. (©) RSNA, 2016 Online supplemental material is available for this article.

  1. Association of mammographic image feature change and an increasing risk trend of developing breast cancer: an assessment

    NASA Astrophysics Data System (ADS)

    Tan, Maxine; Leader, Joseph K.; Liu, Hong; Zheng, Bin

    2015-03-01

    We recently investigated a new mammographic image feature based risk factor to predict near-term breast cancer risk after a woman has a negative mammographic screening. We hypothesized that unlike the conventional epidemiology-based long-term (or lifetime) risk factors, the mammographic image feature based risk factor value will increase as the time lag between the negative and positive mammography screening decreases. The purpose of this study is to test this hypothesis. From a large and diverse full-field digital mammography (FFDM) image database with 1278 cases, we collected all available sequential FFDM examinations for each case including the "current" and 1 to 3 most recently "prior" examinations. All "prior" examinations were interpreted negative, and "current" ones were either malignant or recalled negative/benign. We computed 92 global mammographic texture and density based features, and included three clinical risk factors (woman's age, family history and subjective breast density BIRADS ratings). On this initial feature set, we applied a fast and accurate Sequential Forward Floating Selection (SFFS) feature selection algorithm to reduce feature dimensionality. The features computed on both mammographic views were individually/ separately trained using two artificial neural network (ANN) classifiers. The classification scores of the two ANNs were then merged with a sequential ANN. The results show that the maximum adjusted odds ratios were 5.59, 7.98, and 15.77 for using the 3rd, 2nd, and 1st "prior" FFDM examinations, respectively, which demonstrates a higher association of mammographic image feature change and an increasing risk trend of developing breast cancer in the near-term after a negative screening.

  2. Classification of mammographic masses: influence of regions used for feature extraction on the classification performance

    NASA Astrophysics Data System (ADS)

    Wagner, Florian; Wittenberg, Thomas; Elter, Matthias

    2010-03-01

    Computer-assisted diagnosis (CADx) for the characterization of mammographic masses as benign or malignant has a very high potential to help radiologists during the critical process of diagnostic decision making. By default, the characterization of mammographic masses is performed by extracting features from a region of interest (ROI) depicting the mass. To investigate the influence of the region on the classification performance, textural, morphological, frequency- as well as moment-based features are calculated in subregions of the ROI, which has been delineated manually by an expert. The investigated subregions are (a) the semi-automatically segmented area which includes only the core of the mass, (b) the outer border region of the mass, and (c) the combination of the outer and the inner border region, referred to as mass margin. To extract the border region and the margin of a mass an extended version of the rubber band straightening transform (RBST) was developed. Furthermore, the effectiveness of the features extracted from the RBST transformed border region and mass margin is compared to the effectiveness of the same features extracted from the untransformed regions. After the feature extraction process a preferably optimal feature subset is selected for each feature extractor. Classification is done using a k-NN classifier. The classification performance was evaluated using the area Az under the receiver operating characteristic curve. A publicly available mammography database was used as data set. Results showed that the manually drawn ROI lead to superior classification performances for the morphological feature extractors and that the transformed outer border region and the mass margin are not suitable for moment-based features but yield to promising results for textural and frequency-based features. Beyond that the mass margin, which combines the inner and the outer border region, leads to better classification performances compared to the outer border

  3. Developing a visual sensitive image features based CAD scheme to assist classification of mammographic masses

    NASA Astrophysics Data System (ADS)

    Wang, Yunzhi; Aghaei, Faranak; Tan, Maxine; Qiu, Yuchen; Liu, Hong; Zheng, Bin

    2017-03-01

    Computer-aided diagnosis (CAD) schemes of mammograms have been previously developed and tested. However, due to using "black-box" approaches with a large number of complicated features, radiologists have lower confidence to accept or consider CAD-cued results. In order to help solve this issue, this study aims to develop and evaluate a new CAD scheme that uses visual sensitive image features to classify between malignant and benign mammographic masses. A dataset of 301 masses detected on both craniocaudal (CC) and mediolateraloblique (MLO) view images was retrospectively assembled. Among them, 152 were malignant and 149 were benign. An iterative region-growing algorithm was applied to the special Gaussian-kernel filtered images to segment mass regions. Total 13 Image features were computed to mimic 5 categories of visually sensitive features that are commonly used by radiologists in classifying suspicious mammographic masses namely, mass size, shape factor, contrast, homogeneity and spiculation. We then selected one optimal feature in each of 5 feature categories by using a student t-test, and applied two logistic regression classifiers using either CC or MLO view images to distinguish between malignant and benign masses. Last, a fusion method of combining two classification scores was applied and tested. By applying a 10-fold cross-validation method, the area under receiver operating characteristic curves was 0.806+/-0.025. This study demonstrated a new approach to develop CAD scheme based on 5 visually sensitive image features. Combining with a "visual-aid" interface, CAD results are much more easily explainable to the observers and may increase their confidence to consider CAD-cued results.

  4. Feature and contrast enhancement of mammographic image based on multiscale analysis and morphology.

    PubMed

    Wu, Shibin; Yu, Shaode; Yang, Yuhan; Xie, Yaoqin

    2013-01-01

    A new algorithm for feature and contrast enhancement of mammographic images is proposed in this paper. The approach bases on multiscale transform and mathematical morphology. First of all, the Laplacian Gaussian pyramid operator is applied to transform the mammography into different scale subband images. In addition, the detail or high frequency subimages are equalized by contrast limited adaptive histogram equalization (CLAHE) and low-pass subimages are processed by mathematical morphology. Finally, the enhanced image of feature and contrast is reconstructed from the Laplacian Gaussian pyramid coefficients modified at one or more levels by contrast limited adaptive histogram equalization and mathematical morphology, respectively. The enhanced image is processed by global nonlinear operator. The experimental results show that the presented algorithm is effective for feature and contrast enhancement of mammogram. The performance evaluation of the proposed algorithm is measured by contrast evaluation criterion for image, signal-noise-ratio (SNR), and contrast improvement index (CII).

  5. Feature and Contrast Enhancement of Mammographic Image Based on Multiscale Analysis and Morphology

    PubMed Central

    Wu, Shibin; Xie, Yaoqin

    2013-01-01

    A new algorithm for feature and contrast enhancement of mammographic images is proposed in this paper. The approach bases on multiscale transform and mathematical morphology. First of all, the Laplacian Gaussian pyramid operator is applied to transform the mammography into different scale subband images. In addition, the detail or high frequency subimages are equalized by contrast limited adaptive histogram equalization (CLAHE) and low-pass subimages are processed by mathematical morphology. Finally, the enhanced image of feature and contrast is reconstructed from the Laplacian Gaussian pyramid coefficients modified at one or more levels by contrast limited adaptive histogram equalization and mathematical morphology, respectively. The enhanced image is processed by global nonlinear operator. The experimental results show that the presented algorithm is effective for feature and contrast enhancement of mammogram. The performance evaluation of the proposed algorithm is measured by contrast evaluation criterion for image, signal-noise-ratio (SNR), and contrast improvement index (CII). PMID:24416072

  6. Prediction of near-term breast cancer risk based on bilateral mammographic feature asymmetry.

    PubMed

    Tan, Maxine; Zheng, Bin; Ramalingam, Pandiyarajan; Gur, David

    2013-12-01

    The objective of this study is to investigate the feasibility of predicting near-term risk of breast cancer development in women after a negative mammography screening examination. It is based on a statistical learning model that combines computerized image features related to bilateral mammographic tissue asymmetry and other clinical factors. A database of negative digital mammograms acquired from 994 women was retrospectively collected. In the next sequential screening examination (12 to 36 months later), 283 women were diagnosed positive for cancer, 349 were recalled for additional diagnostic workups and later proved to be benign, and 362 remain negative (not recalled). From an initial pool of 183 features, we applied a Sequential Forward Floating Selection feature selection method to search for effective features. Using 10 selected features, we developed and trained a support vector machine classification model to compute a cancer risk or probability score for each case. The area under the receiver operating characteristic curve and odds ratios (ORs) were used as the two performance assessment indices. The area under the receiver operating characteristic curve = 0.725 ± 0.018 was obtained for positive and negative/benign case classification. The ORs showed an increasing risk trend with increasing model-generated risk scores (from 1.00 to 12.34, between positive and negative/benign case groups). Regression analysis of ORs also indicated a significant increase trend in slope (P = .006). This study demonstrates that the risk scores computed by a new support vector machine model involving bilateral mammographic feature asymmetry have potential to assist the prediction of near-term risk of women for developing breast cancer. Copyright © 2013 AUR. Published by Elsevier Inc. All rights reserved.

  7. Do mammographic tumor features in breast cancer relate to breast density and invasiveness, tumor size, and axillary lymph node involvement?

    PubMed

    Sartor, Hanna; Borgquist, Signe; Hartman, Linda; Olsson, Åsa; Jawdat, Faith; Zackrisson, Sophia

    2015-05-01

    Breast density and mammographic tumor features of breast cancer may carry prognostic information. The potential benefit of using the combined information obtained from breast density, mammographic tumor features, and pathological tumor characteristics has not been extensively studied. To investigate how mammographic tumor features relate to breast density and pathological tumor characteristics. This retrospective study was carried out within the Malmö Diet and Cancer Study: a population-based cohort study recruiting 17,035 women during 1991-1996. A total of 826 incident breast cancers were identified during follow-up. Mammography images were collected and analyzed according to breast density and tumor features at diagnosis. Pathological data were retrieved from medical reports. Mammographic tumor features in relation to invasiveness, tumor size, and axillary lymph node involvement were analyzed using logistic regression yielding odds ratios (OR) with 95% confidence intervals (CI) and adjusted for age at diagnosis, mode of detection, and breast density. Tumors presenting as an ill-defined mass or calcifications were more common in dense breasts than tumors presenting as a distinct mass or with spiculated appearance. Invasive cancer was more common in tumors with spiculated appearance than tumors presenting as a distinct mass (adjusted OR, 5.68 [1.81-17.84]). Among invasive tumors, an ill-defined mass was more often large (>20 mm) compared with a distinct mass, (adjusted OR, 3.16 [1.80-5.55]). Tumors presenting as an ill-defined mass or calcifications were more common in dense breasts. Spiculated appearance was related to invasiveness, and ill-defined mass to larger tumor size, regardless of mode of detection and breast density. The potential role of mammographic tumor features in clinical decision-making warrants further investigation. © The Foundation Acta Radiologica 2014 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

  8. Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?

    PubMed

    Dontchos, Brian N; Rahbar, Habib; Partridge, Savannah C; Korde, Larissa A; Lam, Diana L; Scheel, John R; Peacock, Sue; Lehman, Constance D

    2015-08-01

    To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk. In this institutional review board-approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression. Twenty-three women at high risk (mean age, 47 years ± 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively). Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study. (©) RSNA, 2015 Online supplemental material is available for

  9. A new and fast image feature selection method for developing an optimal mammographic mass detection scheme

    PubMed Central

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-01-01

    Purpose: Selecting optimal features from a large image feature pool remains a major challenge in developing computer-aided detection (CAD) schemes of medical images. The objective of this study is to investigate a new approach to significantly improve efficacy of image feature selection and classifier optimization in developing a CAD scheme of mammographic masses. Methods: An image dataset including 1600 regions of interest (ROIs) in which 800 are positive (depicting malignant masses) and 800 are negative (depicting CAD-generated false positive regions) was used in this study. After segmentation of each suspicious lesion by a multilayer topographic region growth algorithm, 271 features were computed in different feature categories including shape, texture, contrast, isodensity, spiculation, local topological features, as well as the features related to the presence and location of fat and calcifications. Besides computing features from the original images, the authors also computed new texture features from the dilated lesion segments. In order to select optimal features from this initial feature pool and build a highly performing classifier, the authors examined and compared four feature selection methods to optimize an artificial neural network (ANN) based classifier, namely: (1) Phased Searching with NEAT in a Time-Scaled Framework, (2) A sequential floating forward selection (SFFS) method, (3) A genetic algorithm (GA), and (4) A sequential forward selection (SFS) method. Performances of the four approaches were assessed using a tenfold cross validation method. Results: Among these four methods, SFFS has highest efficacy, which takes 3%–5% of computational time as compared to GA approach, and yields the highest performance level with the area under a receiver operating characteristic curve (AUC) = 0.864 ± 0.034. The results also demonstrated that except using GA, including the new texture features computed from the dilated mass segments improved the AUC

  10. A new and fast image feature selection method for developing an optimal mammographic mass detection scheme.

    PubMed

    Tan, Maxine; Pu, Jiantao; Zheng, Bin

    2014-08-01

    Selecting optimal features from a large image feature pool remains a major challenge in developing computer-aided detection (CAD) schemes of medical images. The objective of this study is to investigate a new approach to significantly improve efficacy of image feature selection and classifier optimization in developing a CAD scheme of mammographic masses. An image dataset including 1600 regions of interest (ROIs) in which 800 are positive (depicting malignant masses) and 800 are negative (depicting CAD-generated false positive regions) was used in this study. After segmentation of each suspicious lesion by a multilayer topographic region growth algorithm, 271 features were computed in different feature categories including shape, texture, contrast, isodensity, spiculation, local topological features, as well as the features related to the presence and location of fat and calcifications. Besides computing features from the original images, the authors also computed new texture features from the dilated lesion segments. In order to select optimal features from this initial feature pool and build a highly performing classifier, the authors examined and compared four feature selection methods to optimize an artificial neural network (ANN) based classifier, namely: (1) Phased Searching with NEAT in a Time-Scaled Framework, (2) A sequential floating forward selection (SFFS) method, (3) A genetic algorithm (GA), and (4) A sequential forward selection (SFS) method. Performances of the four approaches were assessed using a tenfold cross validation method. Among these four methods, SFFS has highest efficacy, which takes 3%-5% of computational time as compared to GA approach, and yields the highest performance level with the area under a receiver operating characteristic curve (AUC) = 0.864 ± 0.034. The results also demonstrated that except using GA, including the new texture features computed from the dilated mass segments improved the AUC results of the ANNs optimized

  11. Feature extraction using convolutional neural network for classifying breast density in mammographic images

    NASA Astrophysics Data System (ADS)

    Thomaz, Ricardo L.; Carneiro, Pedro C.; Patrocinio, Ana C.

    2017-03-01

    Breast cancer is the leading cause of death for women in most countries. The high levels of mortality relate mostly to late diagnosis and to the direct proportionally relationship between breast density and breast cancer development. Therefore, the correct assessment of breast density is important to provide better screening for higher risk patients. However, in modern digital mammography the discrimination among breast densities is highly complex due to increased contrast and visual information for all densities. Thus, a computational system for classifying breast density might be a useful tool for aiding medical staff. Several machine-learning algorithms are already capable of classifying small number of classes with good accuracy. However, machinelearning algorithms main constraint relates to the set of features extracted and used for classification. Although well-known feature extraction techniques might provide a good set of features, it is a complex task to select an initial set during design of a classifier. Thus, we propose feature extraction using a Convolutional Neural Network (CNN) for classifying breast density by a usual machine-learning classifier. We used 307 mammographic images downsampled to 260x200 pixels to train a CNN and extract features from a deep layer. After training, the activation of 8 neurons from a deep fully connected layer are extracted and used as features. Then, these features are feedforward to a single hidden layer neural network that is cross-validated using 10-folds to classify among four classes of breast density. The global accuracy of this method is 98.4%, presenting only 1.6% of misclassification. However, the small set of samples and memory constraints required the reuse of data in both CNN and MLP-NN, therefore overfitting might have influenced the results even though we cross-validated the network. Thus, although we presented a promising method for extracting features and classifying breast density, a greater database is

  12. Concordance of computer-extracted image features with BI-RADS descriptors for mammographic mass margin

    NASA Astrophysics Data System (ADS)

    Sahiner, Berkman; Hadjiiski, Lubomir M.; Chan, Heang-Ping; Paramagul, Chintana; Nees, Alexis; Helvie, Mark; Shi, Jiazheng

    2008-03-01

    The purpose of this study was to develop and evaluate computer-extracted features for characterizing mammographic mass margins according to BI-RADS spiculated and circumscribed categories. The mass was automatically segmented using an active contour model. A spiculation measure for a pixel on the mass boundary was defined by using the angular difference between the image gradient vector and the normal to the mass, averaged over pixels in a spiculation search region. For the circumscribed margin feature, the angular difference between the principal eigenvector of the Hessian matrix and the normal to the mass was estimated in a band of pixels centered at each point on the boundary, and the feature was extracted from the resulting profile along the boundary. Three MQSA radiologists provided BI-RADS margin ratings for a data set of 198 regions of interest containing breast masses. The features were evaluated with respect to the individual radiologists' characterization using receiver operating characteristic (ROC) analysis, as well as with respect to that from the majority rule, in which a mass was labeled as spiculated (circumscribed) if it was characterized as such by 2 or 3 radiologists, and non-spiculated (non-circumscribed) otherwise. We also investigated the performance of the features for consensus masses, defined as those labeled as spiculated (circumscribed) or nonspiculated (non-circumscribed) by all three radiologists. When masses were labeled according to radiologists R1, R2, and R3 individually, the spiculation feature had an area A z under the ROC curve of 0.90+/-0.04, 0.90+/-0.03, 0.88+/-0.03, respectively, while the circumscribed margin feature had an A z value of 0.77+/-0.04, 0.74+/-0.04, and 0.80+/-0.03, respectively. When masses were labeled according to the majority rule, the A z values for the spiculation and the circumscribed margin features were 0.92+/-0.03 and 0.80+/-+/-0.03, respectively. When only the consensus masses were considered, the A z

  13. Optimal Breast Biopsy Decision-Making Based on Mammographic Features and Demographic Factors.

    PubMed

    Chhatwal, Jagpreet; Alagoz, Oguzhan; Burnside, Elizabeth S

    2010-11-01

    Breast cancer is the most common non-skin cancer affecting women in the United States, where every year more than 20 million mammograms are performed. Breast biopsy is commonly performed on the suspicious findings on mammograms to confirm the presence of cancer. Currently, 700,000 biopsies are performed annually in the U.S.; 55%-85% of these biopsies ultimately are found to be benign breast lesions, resulting in unnecessary treatments, patient anxiety, and expenditures. This paper addresses the decision problem faced by radiologists: When should a woman be sent for biopsy based on her mammographic features and demographic factors? This problem is formulated as a finite-horizon discrete-time Markov decision process. The optimal policy of our model shows that the decision to biopsy should take the age of patient into account; particularly, an older patient's risk threshold for biopsy should be higher than that of a younger patient. When applied to the clinical data, our model outperforms radiologists in the biopsy decision-making problem. This study also derives structural properties of the model, including sufficiency conditions that ensure the existence of a control-limit type policy and nondecreasing control-limits with age.

  14. Beyond breast cancer: mammographic features and mortality risk in a population of healthy women.

    PubMed

    Murphy, Rachel A; Schairer, Catherine; Gierach, Gretchen L; Byrne, Celia; Sherman, Mark E; Register, Thomas C; Ding, Jingzhong; Kritchevsky, Stephen B; Harris, Tamara B

    2013-01-01

    Breast fibroglandular (dense) tissue is a risk factor for breast cancer. Beyond breast cancer, little is known regarding the prognostic significance of mammographic features. We evaluated relationships between nondense (fatty) breast area and dense area with all-cause mortality in 4,245 initially healthy women from the Breast Cancer Detection Demonstration Project; 1,361 died during a mean follow-up of 28.2 years. Dense area and total breast area were assessed using planimeter measurements from screening mammograms. Percent density reflects dense area relative to breast area and nondense area was calculated as the difference between total breast area and dense area. Hazard ratios (HRs) and 95% confidence intervals (CIs) were estimated by Cox proportional hazards regression. In age-adjusted models, greater nondense and total breast area were associated with increased risk of death (HR 1.17, 95% CI 1.10-1.24 and HR 1.13, 95% CI 1.06-1.19, per SD difference) while greater dense area and percent density were associated with lower risk of death (HR 0.91, 95% CI 0.86-0.95 and HR 0.87, 95% CI 0.83-0.92, per SD difference). Associations were not attenuated with adjustment for race, education, mammogram type (x-ray or xerogram), smoking status, diabetes and heart disease. With additional adjustment for body mass index, associations were diminished for all features but remained statistically significant for dense area (HR 0.94, 95% CI 0.89-0.99, per SD difference) and percent density (HR 0.93, 95% CI 0.87-0.98, per SD difference). These data indicate that dense area and percent density may relate to survival in healthy women and suggest the potential utility of mammograms beyond prediction of breast cancer risk.

  15. Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?

    PubMed Central

    Dontchos, Brian N.; Partridge, Savannah C.; Korde, Larissa A.; Lam, Diana L.; Scheel, John R.; Peacock, Sue; Lehman, Constance D.

    2015-01-01

    Purpose To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk. Materials and Methods In this institutional review board–approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression. Results Twenty-three women at high risk (mean age, 47 years ± 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively). Conclusion Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study. © RSNA

  16. Ductal Breast Carcinoma In Situ: Mammographic Features and Its Relation to Prognosis and Tumour Biology in a Population Based Cohort

    PubMed Central

    Sollie, Thomas; Blomqvist, Carl; Abdsaleh, Shahin; Liljegren, Göran

    2017-01-01

    Casting-type calcifications and a histopathological picture with cancer-filled duct-like structures have been presented as breast cancer with neoductgenesis. We correlated mammographic features and histopathological neoductgenesis with prognosis in a DCIS cohort with long follow-up. Mammographic features were classified into seven groups according to Tabár. Histopathological neoductgenesis was defined by concentration of ducts, lymphocyte infiltration, and periductal fibrosis. Endpoints were ipsilateral (IBE) in situ and invasive events. Casting-type calcifications and neoductgenesis were both related to high nuclear grade, ER- and PR-negativity, and HER2 overexpression but not to each other. Casting-type calcifications and neoductgenesis were both related to a nonsignificant lower risk of invasive IBE, HR 0.38 (0.13–1.08) and 0.82 (0.29–2.27), respectively, and the HR of an in situ IBE was 0.90 (0.41–1.95) and 1.60 (0.75–3.39), respectively. Casting-type calcifications could not be related to a worse prognosis in DCIS. We cannot explain why a more aggressive phenotype of DCIS did not correspond to a worse prognosis. Further studies on how the progression from in situ to invasive carcinoma is driven are needed. PMID:28286675

  17. Assessment of a Four-View Mammographic Image Feature Based Fusion Model to Predict Near-Term Breast Cancer Risk.

    PubMed

    Tan, Maxine; Pu, Jiantao; Cheng, Samuel; Liu, Hong; Zheng, Bin

    2015-10-01

    The purpose of this study was to develop and assess a new quantitative four-view mammographic image feature based fusion model to predict the near-term breast cancer risk of the individual women after a negative screening mammography examination of interest. The dataset included fully-anonymized mammograms acquired on 870 women with two sequential full-field digital mammography examinations. For each woman, the first "prior" examination in the series was interpreted as negative (not recalled) during the original image reading. In the second "current" examination, 430 women were diagnosed with pathology verified cancers and 440 remained negative ("cancer-free"). For each of four bilateral craniocaudal and mediolateral oblique view images of left and right breasts, we computed and analyzed eight groups of global mammographic texture and tissue density image features. A risk prediction model based on three artificial neural networks was developed to fuse image features computed from two bilateral views of four images. The risk model performance was tested using a ten-fold cross-validation method and a number of performance evaluation indices including the area under the receiver operating characteristic curve (AUC) and odds ratio (OR). The highest AUC = 0.725 ± 0.026 was obtained when the model was trained by gray-level run length statistics texture features computed on dense breast regions, which was significantly higher than the AUC values achieved using the model trained by only two bilateral one-view images (p < 0.02). The adjustable OR values monotonically increased from 1.0 to 11.8 as model-generated risk score increased. The regression analysis of OR values also showed a significant increase trend in slope (p < 0.01). As a result, this preliminary study demonstrated that a new four-view mammographic image feature based risk model could provide useful and supplementary image information to help predict the near-term breast cancer risk.

  18. Novel mammographic image features differentiate between interval and screen-detected breast cancer: a case-case study.

    PubMed

    Strand, Fredrik; Humphreys, Keith; Cheddad, Abbas; Törnberg, Sven; Azavedo, Edward; Shepherd, John; Hall, Per; Czene, Kamila

    2016-10-05

    Interval breast cancers are often diagnosed at a more advanced stage than screen-detected cancers. Our aim was to identify features in screening mammograms of the normal breast that would differentiate between future interval cancers and screen-detected cancers, and to understand how each feature affects tumor detectability. From a population-based cohort of invasive breast cancer cases in Stockholm-Gotland, Sweden, diagnosed from 2001 to 2008, we analyzed the contralateral mammogram at the preceding negative screening of 394 interval cancer cases and 1009 screen-detected cancers. We examined 32 different image features in digitized film mammograms, based on three alternative dense area identification methods, by a set of logistic regression models adjusted for percent density with interval cancer versus screen-detected cancer as the outcome. Features were forward-selected into a multiple logistic regression model adjusted for mammographic percent density, age, BMI and use of hormone replacement therapy. The associations of the identified features were assessed also in a sample from an independent cohort. Two image features, 'skewness of the intensity gradient' and 'eccentricity', were associated with the risk of interval compared with screen-detected cancer. For the first feature, the per-standard deviation odds ratios were 1.32 (95 % CI: 1.12 to 1.56) and 1.21 (95 % CI: 1.04 to 1.41) in the primary and validation cohort respectively. For the second feature, they were 1.20 (95 % CI: 1.04 to 1.39) and 1.17 (95%CI: 0.98 to 1.39) respectively. The first feature was associated with the tumor size at screen detection, while the second feature was associated with the tumor size at interval detection. We identified two novel mammographic features in screening mammograms of the normal breast that differentiated between future interval cancers and screen-detected cancers. We present a starting point for further research into features beyond percent density that might be

  19. A mammographic mass CAD system incorporating features from shape, fractal, and channelized Hotelling observer measurements: preliminary results

    NASA Astrophysics Data System (ADS)

    Catarious, David M., Jr.; Baydush, Alan H.; Abbey, Craig K.; Floyd, Carey E., Jr.

    2003-05-01

    In this paper, we present preliminary results from a highly sensitive and specific CAD system for mammographic masses. For false positive reduction, the system incorporated features derived from shape, fractal, and channelized Hotelling observer (CHO) measurements. The database for this study consisted of 80 craniocaudal mammograms randomly extracted from USF's digital database for screening mammography. The database contained 49 mass findings (24 malignant, 25 benign). To detect initial mass candidates, a difference of Gaussians (DOG) filter was applied through normalized cross correlation. Suspicious regions were localized in the filtered images via multi-level thresholding. Features extracted from the regions included shape, fractal dimension, and the output from a Laguerre-Gauss (LG) CHO. Influential features were identified via feature selection techniques. The regions were classified with a linear classifier using leave-one-out training/testing. The DOG filter achieved a sensitivity of 88% (23/24 malignant, 20/25 benign). Using the selected features, the false positives per image dropped from ~20 to ~5 with no loss in sensitivity. This preliminary investigation of combining multi-level thresholded DOG-filtered images with shape, fractal, and LG-CHO features shows great promise as a mass detector. Future work will include the addition of more texture and mass-boundary descriptive features as well as further exploration of the LG-CHO.

  20. Region based stellate features combined with variable selection using AdaBoost learning in mammographic computer-aided detection.

    PubMed

    Kim, Dae Hoe; Choi, Jae Young; Ro, Yong Man

    2015-08-01

    In this paper, a new method is developed for extracting so-called region-based stellate features to correctly differentiate spiculated malignant masses from normal tissues on mammograms. In the proposed method, a given region of interest (ROI) for feature extraction is divided into three individual subregions, namely core, inner, and outer parts. The proposed region-based stellate features are then extracted to encode the different and complementary stellate pattern information by computing the statistical characteristics for each of the three different subregions. To further maximize classification performance, a novel variable selection algorithm based on AdaBoost learning is incorporated for choosing an optimal subset of variables of region-based stellate features. In particular, we develop a new variable selection metric (criteria) that effectively determines variable importance (ranking) within the conventional AdaBoost framework. Extensive and comparative experiments have been performed on the popular benchmark mammogram database (DB). Results show that our region-based stellate features (extracted from automatically segmented ROIs) considerably outperform other state-of-the-art features developed for mammographic spiculated mass detection or classification. Our results also indicate that combining region-based stellate features with the proposed variable selection strategy has an impressive effect on improving spiculated mass classification and detection. Copyright © 2014 Elsevier Ltd. All rights reserved.

  1. Predicting error in detecting mammographic masses among radiology trainees using statistical models based on BI-RADS features

    SciTech Connect

    Grimm, Lars J. Ghate, Sujata V.; Yoon, Sora C.; Kim, Connie; Kuzmiak, Cherie M.; Mazurowski, Maciej A.

    2014-03-15

    Purpose: The purpose of this study is to explore Breast Imaging-Reporting and Data System (BI-RADS) features as predictors of individual errors made by trainees when detecting masses in mammograms. Methods: Ten radiology trainees and three expert breast imagers reviewed 100 mammograms comprised of bilateral medial lateral oblique and craniocaudal views on a research workstation. The cases consisted of normal and biopsy proven benign and malignant masses. For cases with actionable abnormalities, the experts recorded breast (density and axillary lymph nodes) and mass (shape, margin, and density) features according to the BI-RADS lexicon, as well as the abnormality location (depth and clock face). For each trainee, a user-specific multivariate model was constructed to predict the trainee's likelihood of error based on BI-RADS features. The performance of the models was assessed using area under the receive operating characteristic curves (AUC). Results: Despite the variability in errors between different trainees, the individual models were able to predict the likelihood of error for the trainees with a mean AUC of 0.611 (range: 0.502–0.739, 95% Confidence Interval: 0.543–0.680,p < 0.002). Conclusions: Patterns in detection errors for mammographic masses made by radiology trainees can be modeled using BI-RADS features. These findings may have potential implications for the development of future educational materials that are personalized to individual trainees.

  2. Modeling error in assessment of mammographic image features for improved computer-aided mammography training: initial experience

    NASA Astrophysics Data System (ADS)

    Mazurowski, Maciej A.; Tourassi, Georgia D.

    2011-03-01

    In this study we investigate the hypothesis that there exist patterns in erroneous assessment of BI-RADS image features among radiology trainees when performing diagnostic interpretation of mammograms. We also investigate whether these error making patterns can be captured by individual user models. To test our hypothesis we propose a user modeling algorithm that uses the previous readings of a trainee to identify whether certain BI-RADS feature values (e.g. "spiculated" value for "margin" feature) are associated with higher than usual likelihood that the feature will be assessed incorrectly. In our experiments we used readings of 3 radiology residents and 7 breast imaging experts for 33 breast masses for the following BI-RADS features: parenchyma density, mass margin, mass shape and mass density. The expert readings were considered as the gold standard. Rule-based individual user models were developed and tested using the leave one-one-out crossvalidation scheme. Our experimental evaluation showed that the individual user models are accurate in identifying cases for which errors are more likely to be made. The user models captured regularities in error making for all 3 residents. This finding supports our hypothesis about existence of individual error making patterns in assessment of mammographic image features using the BI-RADS lexicon. Explicit user models identifying the weaknesses of each resident could be of great use when developing and adapting a personalized training plan to meet the resident's individual needs. Such approach fits well with the framework of adaptive computer-aided educational systems in mammography we have proposed before.

  3. Computer-aided classification of mammographic masses using visually sensitive image features.

    PubMed

    Wang, Yunzhi; Aghaei, Faranak; Zarafshani, Ali; Qiu, Yuchen; Qian, Wei; Zheng, Bin

    2017-01-01

    To develop a new computer-aided diagnosis (CAD) scheme that computes visually sensitive image features routinely used by radiologists to develop a machine learning classifier and distinguish between the malignant and benign breast masses detected from digital mammograms. An image dataset including 301 breast masses was retrospectively selected. From each segmented mass region, we computed image features that mimic five categories of visually sensitive features routinely used by radiologists in reading mammograms. We then selected five optimal features in the five feature categories and applied logistic regression models for classification. A new CAD interface was also designed to show lesion segmentation, computed feature values and classification score. Areas under ROC curves (AUC) were 0.786±0.026 and 0.758±0.027 when to classify mass regions depicting on two view images, respectively. By fusing classification scores computed from two regions, AUC increased to 0.806±0.025. This study demonstrated a new approach to develop CAD scheme based on 5 visually sensitive image features. Combining with a "visual aid" interface, CAD results may be much more easily explainable to the observers and increase their confidence to consider CAD generated classification results than using other conventional CAD approaches, which involve many complicated and visually insensitive texture features.

  4. Cancers in BRCA1 and BRCA2 carriers and in women at high risk for breast cancer: MR imaging and mammographic features.

    PubMed

    Gilbert, Fiona J; Warren, Ruth M L; Kwan-Lim, Gek; Thompson, Deborah J; Eeles, Ros A; Evans, D Gareth; Leach, Martin O

    2009-08-01

    To review imaging features of screening-detected cancers on images from diagnostic and prior examinations to identify specific abnormalities to aid earlier detection of or facilitate differentiation of cancers in BRCA1 and BRCA2 carriers and in women with a high risk for breast cancer. Informed consent and multicenter and local research ethics committee approval were obtained. Women (mean age, 40.1 years; range, 27-55 years) who had at least a 50% risk of being a BRCA1, BRCA2, or TP53 gene mutation carrier were recruited from August 1997 to March 2003 into the United Kingdom Magnetic Resonance Imaging in Breast Screening Study Group trial and were offered annual magnetic resonance (MR) imaging and two-view mammography (total number of screenings, 2065 and 1973; mean, 2.38 and 2.36, respectively). Images in all 39 cancer cases were reread in consensus to document the morphologic and enhancement imaging features on MR and mammographic images in screening and prior examinations. Cases were grouped into genetic subtypes. With MR imaging, there was no difference in morphologic or enhancement characteristics between the genetic subgroups. Cancers on images from prior examinations were of smaller size, showed less enhancement, and were more likely to have a type 1 enhancement curve compared with those cancers in the subsequent diagnostic screening examinations. The tumor sizes detected by using MR imaging and mammography were not significantly different (P = .46). The cancers in BRCA1 carriers found by using MR imaging tended to be smaller than those detected by using mammography (median, 17 mm vs 30 mm; P = .37), whereas the opposite was true for cancers found in BRCA2 carriers (MR imaging median size = 12.5 mm vs mammographic median size = 6 mm; P = .067); the difference was not significant. Tumors with prior MR imaging abnormalities grew at an average of 5.1 mm/y. When undertaking MR imaging surveillance in high-risk women, small enhancing lesions should be regarded

  5. Mammographic density and structural features can individually and jointly contribute to breast cancer risk assessment in mammography screening: a case-control study.

    PubMed

    Winkel, Rikke Rass; von Euler-Chelpin, My; Nielsen, Mads; Petersen, Kersten; Lillholm, Martin; Nielsen, Michael Bachmann; Lynge, Elsebeth; Uldall, Wei Yao; Vejborg, Ilse

    2016-07-07

    Mammographic density is a well-established risk factor for breast cancer. We investigated the association between three different methods of measuring density or parenchymal pattern/texture on digitized film-based mammograms, and examined to what extent textural features independently and jointly with density can improve the ability to identify screening women at increased risk of breast cancer. The study included 121 cases and 259 age- and time matched controls based on a cohort of 14,736 women with negative screening mammograms from a population-based screening programme in Denmark in 2007 (followed until 31 December 2010). Mammograms were assessed using the Breast Imaging-Reporting and Data System (BI-RADS) density classification, Tabár's classification on parenchymal patterns and a fully automated texture quantification technique. The individual and combined association with breast cancer was estimated using binary logistic regression to calculate Odds Ratios (ORs) and the area under the receiver operating characteristic (ROC) curves (AUCs). Cases showed significantly higher BI-RADS and texture scores on average than controls (p < 0.001). All three methods were individually able to segregate women into different risk groups showing significant ORs for BI-RADS D3 and D4 (OR: 2.37; 1.32-4.25 and 3.93; 1.88-8.20), Tabár's PIII and PIV (OR: 3.23; 1.20-8.75 and 4.40; 2.31-8.38), and the highest quartile of the texture score (3.04; 1.63-5.67). AUCs for BI-RADS, Tabár and the texture scores (continuous) were 0.63 (0.57-0-69), 0.65 (0.59-0-71) and 0.63 (0.57-0-69), respectively. Combining two or more methods increased model fit in all combinations, demonstrating the highest AUC of 0.69 (0.63-0.74) when all three methods were combined (a significant increase from standard BI-RADS alone). Our findings suggest that the (relative) amount of fibroglandular tissue (density) and mammographic structural features (texture/parenchymal pattern) jointly can improve risk

  6. Modeling resident error-making patterns in detection of mammographic masses using computer-extracted image features: preliminary experiments

    NASA Astrophysics Data System (ADS)

    Mazurowski, Maciej A.; Zhang, Jing; Lo, Joseph Y.; Kuzmiak, Cherie M.; Ghate, Sujata V.; Yoon, Sora

    2014-03-01

    Providing high quality mammography education to radiology trainees is essential, as good interpretation skills potentially ensure the highest benefit of screening mammography for patients. We have previously proposed a computer-aided education system that utilizes trainee models, which relate human-assessed image characteristics to interpretation error. We proposed that these models be used to identify the most difficult and therefore the most educationally useful cases for each trainee. In this study, as a next step in our research, we propose to build trainee models that utilize features that are automatically extracted from images using computer vision algorithms. To predict error, we used a logistic regression which accepts imaging features as input and returns error as output. Reader data from 3 experts and 3 trainees were used. Receiver operating characteristic analysis was applied to evaluate the proposed trainee models. Our experiments showed that, for three trainees, our models were able to predict error better than chance. This is an important step in the development of adaptive computer-aided education systems since computer-extracted features will allow for faster and more extensive search of imaging databases in order to identify the most educationally beneficial cases.

  7. Using computer-extracted image features for modeling of error-making patterns in detection of mammographic masses among radiology residents

    SciTech Connect

    Zhang, Jing Ghate, Sujata V.; Yoon, Sora C.; Lo, Joseph Y.; Kuzmiak, Cherie M.; Mazurowski, Maciej A.

    2014-09-15

    Purpose: Mammography is the most widely accepted and utilized screening modality for early breast cancer detection. Providing high quality mammography education to radiology trainees is essential, since excellent interpretation skills are needed to ensure the highest benefit of screening mammography for patients. The authors have previously proposed a computer-aided education system based on trainee models. Those models relate human-assessed image characteristics to trainee error. In this study, the authors propose to build trainee models that utilize features automatically extracted from images using computer vision algorithms to predict likelihood of missing each mass by the trainee. This computer vision-based approach to trainee modeling will allow for automatically searching large databases of mammograms in order to identify challenging cases for each trainee. Methods: The authors’ algorithm for predicting the likelihood of missing a mass consists of three steps. First, a mammogram is segmented into air, pectoral muscle, fatty tissue, dense tissue, and mass using automated segmentation algorithms. Second, 43 features are extracted using computer vision algorithms for each abnormality identified by experts. Third, error-making models (classifiers) are applied to predict the likelihood of trainees missing the abnormality based on the extracted features. The models are developed individually for each trainee using his/her previous reading data. The authors evaluated the predictive performance of the proposed algorithm using data from a reader study in which 10 subjects (7 residents and 3 novices) and 3 experts read 100 mammographic cases. Receiver operating characteristic (ROC) methodology was applied for the evaluation. Results: The average area under the ROC curve (AUC) of the error-making models for the task of predicting which masses will be detected and which will be missed was 0.607 (95% CI,0.564-0.650). This value was statistically significantly different

  8. X-ray absorptiometry of the breast using mammographic exposure factors: application to units featuring automatic beam quality selection.

    PubMed

    Kotre, C J

    2010-06-01

    A number of studies have identified the relationship between the visual appearance of high breast density at mammography and an increased risk of breast cancer. Approaches to quantify the amount of glandular tissue within the breast from mammography have so far concentrated on image-based methods. Here, it is proposed that the X-ray parameters automatically selected by the mammography unit can be used to estimate the thickness of glandular tissue overlying the automatic exposure sensor area, provided that the unit can be appropriately calibrated. This is a non-trivial task for modern mammography units that feature automatic beam quality selection, as the number of tube potential and X-ray target/filter combinations used to cover the range of breast sizes and compositions can be large, leading to a potentially unworkable number of curve fits and interpolations. Using appropriate models for the attenuation of the glandular breast in conjunction with a constrained set of physical phantom measurements, it is demonstrated that calibration for X-ray absorptiometry can be achieved despite the large number of possible exposure factor combinations employed by modern mammography units. The main source of error on the estimated glandular tissue thickness using this method is shown to be uncertainty in the measured compressed breast thickness. An additional correction for this source of error is investigated and applied. Initial surveys of glandular thickness for a cohort of women undergoing breast screening are presented.

  9. Women's features and inter-/intra-rater agreement on mammographic density assessment in full-field digital mammograms (DDM-SPAIN).

    PubMed

    Pérez-Gómez, Beatriz; Ruiz, Franciso; Martínez, Inmaculada; Casals, María; Miranda, Josefa; Sánchez-Contador, Carmen; Vidal, Carmen; Llobet, Rafael; Pollán, Marina; Salas, Dolores

    2012-02-01

    Measurement of mammographic density (MD), one of the leading risk factors for breast cancer, still relies on subjective assessment. However, the consistency of MD measurement in full-digital mammograms has yet to be evaluated. We studied inter- and intra-rater agreement with respect to estimation of breast density in full-digital mammograms, and tested whether any of the women's characteristics might have some influence on them. After an initial training period, three experienced radiologists estimated MD using Boyd scale in a left breast cranio-caudal mammogram of 1,431 women, recruited at three Spanish screening centres. A subgroup of 50 randomly selected images was read twice to estimate short-term intra-rater agreement. In addition, a reading of 1,428 of the images, performed 2 years before by one rater, was used to estimate long-term intra-rater agreement. Pair-wise weighted kappas with 95% bootstrap confidence intervals were calculated. Dichotomous variables were defined to identify mammograms in which any rater disagreed with other raters or with his/her own assessment, respectively. The association between disagreement and women's characteristics was tested using multivariate mixed logistic models, including centre as a random-effects term, and taking into account repeated measures when required. All quadratic-weighted kappa values for inter- and intra-rater agreement were excellent (higher than 0.80). None of the studied women's features, i.e. body mass index, brassiere size, menopause, nulliparity, lactation or current hormonal therapy, was associated with higher risk of inter- or intra-rater disagreement. However, raters differed significantly more in images that were classified in the higher-density MD categories, and disagreement in intra-rater assessment was also lower in low-density mammograms. The reliability of MD assessment in full-field digital mammograms is comparable to that for original or digitised images. The reassuring lack of association

  10. Clinical features distinguishing grief from depressive episodes: A qualitative analysis.

    PubMed

    Parker, Gordon; McCraw, Stacey; Paterson, Amelia

    2015-05-01

    The independence or interdependence of grief and major depression has been keenly argued in relation to recent DSM definitions and encouraged the current study. We report a phenomenological study seeking to identify the experiential and phenomenological differences between depression and grief as judged qualitatively by those who had experienced clinical (n=125) or non-clinical depressive states (n=28). Analyses involving the whole sample indicated that, in contrast to grief, depression involved feelings of hopelessness and helplessness, being endless and was associated with a lack of control, having an internal self-focus impacting on self-esteem, being more severe and stressful, being marked by physical symptoms and often lacking a justifiable cause. Grief was distinguished from depression by the individual viewing their experience as natural and to be expected, a consequence of a loss, and with an external focus (i.e. the loss of the other). Some identified differences may have reflected the impact of depressive "type" (e.g. melancholia) rather than depression per se, and argue for a two-tiered model differentiating normative depressive and grief states at their base level and then "clinical" depressive and 'pathological' grief states by their associated clinical features. Comparative analyses between the clinical and non-clinical groups were limited by the latter sub-set being few in number. The provision of definitions may have shaped subjects׳ nominated differentiating features. The study identified a distinct number of phenomenological and clinical differences between grief and depression and few shared features, but more importantly, argued for the development of a two-tiered model defining both base states and clinical expressions. Copyright © 2015 Elsevier B.V. All rights reserved.

  11. Qualitative features of the evolution of some polar satellite orbits

    NASA Astrophysics Data System (ADS)

    Vashkov'yak, M. A.

    2016-01-01

    Two special cases of the problem of the secular perturbations in the orbital elements of a satellite with a negligible mass produced by the joint influence of the oblateness of the central planet and the attraction by its most massive (or main) satellites and the Sun are considered. These cases are among the integrable ones in the general nonintegrable evolution problem. The first case is realized when the plane of the satellite orbit and the rotation axis of the planet lie in its orbital plane. The second case is realized when the plane of the satellite orbit is orthogonal to the line of intersection between the equatorial and orbital planes of the planet. The corresponding particular solutions correspond to those polar satellite orbits for which the main qualitative features of the evolution of the eccentricity and pericenter argument are described here. Families of integral curves have been constructed in the phase plane of these elements for the satellite systems of Jupiter, Saturn, and Uranus.

  12. Individualized grid-enabled mammographic training system

    NASA Astrophysics Data System (ADS)

    Yap, M. H.; Gale, A. G.

    2009-02-01

    The PERFORMS self-assessment scheme measures individuals skills in identifying key mammographic features on sets of known cases. One aspect of this is that it allows radiologists' skills to be trained, based on their data from this scheme. Consequently, a new strategy is introduced to provide revision training based on mammographic features that the radiologist has had difficulty with in these sets. To do this requires a lot of random cases to provide dynamic, unique, and up-to-date training modules for each individual. We propose GIMI (Generic Infrastructure in Medical Informatics) middleware as the solution to harvest cases from distributed grid servers. The GIMI middleware enables existing and legacy data to support healthcare delivery, research, and training. It is technology-agnostic, data-agnostic, and has a security policy. The trainee examines each case, indicating the location of regions of interest, and completes an evaluation form, to determine mammographic feature labelling, diagnosis, and decisions. For feedback, the trainee can choose to have immediate feedback after examining each case or batch feedback after examining a number of cases. All the trainees' result are recorded in a database which also contains their trainee profile. A full report can be prepared for the trainee after they have completed their training. This project demonstrates the practicality of a grid-based individualised training strategy and the efficacy in generating dynamic training modules within the coverage/outreach of the GIMI middleware. The advantages and limitations of the approach are discussed together with future plans.

  13. Development of terminology for mammographic techniques for radiological technologists.

    PubMed

    Yagahara, Ayako; Yokooka, Yuki; Tsuji, Shintaro; Nishimoto, Naoki; Uesugi, Masahito; Muto, Hiroshi; Ohba, Hisateru; Kurowarabi, Kunio; Ogasawara, Katsuhiko

    2011-07-01

    We are developing a mammographic ontology to share knowledge of the mammographic domain for radiologic technologists, with the aim of improving mammographic techniques. As a first step in constructing the ontology, we used mammography reference books to establish mammographic terminology for identifying currently available knowledge. This study proceeded in three steps: (1) determination of the domain and scope of the terminology, (2) lexical extraction, and (3) construction of hierarchical structures. We extracted terms mainly from three reference books and constructed the hierarchical structures manually. We compared features of the terms extracted from the three reference books. We constructed a terminology consisting of 440 subclasses grouped into 19 top-level classes: anatomic entity, image quality factor, findings, material, risk, breast, histological classification of breast tumors, role, foreign body, mammographic technique, physics, purpose of mammography examination, explanation of mammography examination, image development, abbreviation, quality control, equipment, interpretation, and evaluation of clinical imaging. The number of terms that occurred in the subclasses varied depending on which reference book was used. We developed a terminology of mammographic techniques for radiologic technologists consisting of 440 terms.

  14. Distinguishing Features and Similarities Between Descriptive Phenomenological and Qualitative Description Research.

    PubMed

    Willis, Danny G; Sullivan-Bolyai, Susan; Knafl, Kathleen; Cohen, Marlene Z

    2016-09-01

    Scholars who research phenomena of concern to the discipline of nursing are challenged with making wise choices about different qualitative research approaches. Ultimately, they want to choose an approach that is best suited to answer their research questions. Such choices are predicated on having made distinctions between qualitative methodology, methods, and analytic frames. In this article, we distinguish two qualitative research approaches widely used for descriptive studies: descriptive phenomenological and qualitative description. Providing a clear basis that highlights the distinguishing features and similarities between descriptive phenomenological and qualitative description research will help students and researchers make more informed choices in deciding upon the most appropriate methodology in qualitative research. We orient the reader to distinguishing features and similarities associated with each approach and the kinds of research questions descriptive phenomenological and qualitative description research address. © The Author(s) 2016.

  15. Hormonal Determinants of Mammographic Density

    DTIC Science & Technology

    2005-08-01

    AD Award Number: DAMD17-02-1-0553 TITLE: Hormonal Determinants of Mammographic Density PRINCIPAL INVESTIGATOR: Jennifer K. Simpson Francemary Modugno...NUMBER Hormonal Determinants of Mammographic Density 5b. GRANT NUMBER DAMD17-02-1-0553 5c. PROGRAM ELEMENT NUMBER 6. AUTHOR(S) 5d. PROJECT NUMBER...AVAILABILITY STATEMENT Approved for Public Release; Distribution Unlimited 13. SUPPLEMENTARY NOTES 14. ABSTRACT Hormone Replacement Therapy (HRT) has

  16. Hormonal Determinants of Mammographic Density

    DTIC Science & Technology

    2004-08-01

    AD Award Number: DAMD17-02-1-0553 TITLE: Hormonal Determinants of Mammographic Density PRINCIPAL INVESTIGATOR: Jennifer K. Simpson, R.N. Francesmary...August 2004 Annual Summary (I Aug 2003 - 31 Jul 2004) 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS Hormonal Determinants of Mammographic Density DAMD17-02...proprietary or confidential information) Hormone Replacement Therapy (HRT) has been shown to increase breast cancer risk as well as to increase breast

  17. Clinicopathologic, mammographic, and sonographic features in 1187 patients with pure ductal carcinoma in situ of the breast by estrogen receptor status

    PubMed Central

    Rauch, Gaiane M.; Kuerer, Henry M.; Scoggins, Marion E.; Fox, Patricia S.; Benveniste, Ana P.; Park, Young Mi; Lari, Sara A.; Hobbs, Brian P.; Adrada, Beatriz E.; Krishnamurthy, Savitri; Yang, Wei T.

    2014-01-01

    Background The clinicopathologic, mammographic, and sonographic findings in patients with pure ductal carcinoma in situ (DCIS) were assessed by estrogen receptor (ER) expression. Methods After institutional review board approval, patients with pure DCIS evaluated from January 1996 to July 2009 with known ER status and available imaging were identified. Images were reviewed per the ACR BI-RADS® lexicon (4th edition). Clinical, pathologic, and imaging characteristics were analyzed by ER status using t-test, chi-square test, and Fisher’s exact test. Results Of 1219 patients with pure DCIS and known ER status identified, 1187 with complete data were included. Mammography was performed in all 1187 patients and sonography in 519 (44%). There were 972 (82%) patients with ER-positive and 215 (18%) with ER-negative disease. ER-negative DCIS was more likely to be high grade (93% vs 44%, p<0.0001), associated with comedonecrosis (64% vs 29%, p<0.0001), and multifocal (23% vs 15%, p=0.009). On sonography, ER-negative DCIS was more likely to be visible (61% vs 46%, p=0.004), larger (mean size, 2.3 vs 1.6 cm, p=0.006), and show posterior shadowing (53% vs 28%, p=0.006). Mastectomy was more frequently performed for ER-negative DCIS (47% vs 37%, p=0.008). Palpable DCIS was visible on sonography in 55% of cases and mammography in 81%. Compared with ER-positive palpable DCIS, ER-negative palpable DCIS was larger and more likely to be visible on sonography. Compared with ER-positive noncalcified DCIS, ER-negative noncalcified DCIS was less likely to be visible on mammography. Conclusion ER-positive and ER-negative pure DCIS have different clinicopathologic and imaging characteristics. ER-negative DCIS is associated with worse prognostic factors then ER-positive DCIS. On sonography, ER-negative DCIS is more frequently visible than ER-positive DCIS, tends to be larger, and more frequently demonstrates posterior shadowing. PMID:23774990

  18. Qualitative Features of High Lift Hovering Dynamics and Inertial Manifolds

    NASA Astrophysics Data System (ADS)

    Gustafson, K.; Leben, R.; McArthur, J.; Mundt, M.

    1996-03-01

    Hovering aerodynamics, such as that practiced by dragonflys, hummingbirds, and certain other small insects, utilizes special patterns of vorticity to generate high lift flows. Such lift as we measure it computationally on the airfoil surface is in good agreement with downstream thrust measured in the physical laboratory. In this paper we examine the qualitative signatures of this dynamical system. A connection to the theory of inertial manifolds, more specifically the instance of time-dependent slow manifolds, is initiated. Additional interest attaches to the fact that in our compact computational domain, the forcing is on the boundary. Because of its highly oscillatory nature, in this dynamics one proceeds rapidly up the bifurcation ladder at relatively low Reynolds numbers. Thus, aside from its intrinsic interest, the hover model provides an attractive vehicle for a better understanding of dynamical system attractor dynamics and inertial manifold theory.

  19. Breast image pre-processing for mammographic tissue segmentation.

    PubMed

    He, Wenda; Hogg, Peter; Juette, Arne; Denton, Erika R E; Zwiggelaar, Reyer

    2015-12-01

    During mammographic image acquisition, a compression paddle is used to even the breast thickness in order to obtain optimal image quality. Clinical observation has indicated that some mammograms may exhibit abrupt intensity change and low visibility of tissue structures in the breast peripheral areas. Such appearance discrepancies can affect image interpretation and may not be desirable for computer aided mammography, leading to incorrect diagnosis and/or detection which can have a negative impact on sensitivity and specificity of screening mammography. This paper describes a novel mammographic image pre-processing method to improve image quality for analysis. An image selection process is incorporated to better target problematic images. The processed images show improved mammographic appearances not only in the breast periphery but also across the mammograms. Mammographic segmentation and risk/density classification were performed to facilitate a quantitative and qualitative evaluation. When using the processed images, the results indicated more anatomically correct segmentation in tissue specific areas, and subsequently better classification accuracies were achieved. Visual assessments were conducted in a clinical environment to determine the quality of the processed images and the resultant segmentation. The developed method has shown promising results. It is expected to be useful in early breast cancer detection, risk-stratified screening, and aiding radiologists in the process of decision making prior to surgery and/or treatment. Copyright © 2015 Elsevier Ltd. All rights reserved.

  20. Qualitative research methods: key features and insights gained from use in infection prevention research.

    PubMed

    Forman, Jane; Creswell, John W; Damschroder, Laura; Kowalski, Christine P; Krein, Sarah L

    2008-12-01

    Infection control professionals and hospital epidemiologists are accustomed to using quantitative research. Although quantitative studies are extremely important in the field of infection control and prevention, often they cannot help us explain why certain factors affect the use of infection control practices and identify the underlying mechanisms through which they do so. Qualitative research methods, which use open-ended techniques, such as interviews, to collect data and nonstatistical techniques to analyze it, provide detailed, diverse insights of individuals, useful quotes that bring a realism to applied research, and information about how different health care settings operate. Qualitative research can illuminate the processes underlying statistical correlations, inform the development of interventions, and show how interventions work to produce observed outcomes. This article describes the key features of qualitative research and the advantages that such features add to existing quantitative research approaches in the study of infection control. We address the goal of qualitative research, the nature of the research process, sampling, data collection and analysis, validity, generalizability of findings, and presentation of findings. Health services researchers are increasingly using qualitative methods to address practical problems by uncovering interacting influences in complex health care environments. Qualitative research methods, applied with expertise and rigor, can contribute important insights to infection prevention efforts.

  1. Robust Feature Selection from Microarray Data Based on Cooperative Game Theory and Qualitative Mutual Information.

    PubMed

    Mortazavi, Atiyeh; Moattar, Mohammad Hossein

    2016-01-01

    High dimensionality of microarray data sets may lead to low efficiency and overfitting. In this paper, a multiphase cooperative game theoretic feature selection approach is proposed for microarray data classification. In the first phase, due to high dimension of microarray data sets, the features are reduced using one of the two filter-based feature selection methods, namely, mutual information and Fisher ratio. In the second phase, Shapley index is used to evaluate the power of each feature. The main innovation of the proposed approach is to employ Qualitative Mutual Information (QMI) for this purpose. The idea of Qualitative Mutual Information causes the selected features to have more stability and this stability helps to deal with the problem of data imbalance and scarcity. In the third phase, a forward selection scheme is applied which uses a scoring function to weight each feature. The performance of the proposed method is compared with other popular feature selection algorithms such as Fisher ratio, minimum redundancy maximum relevance, and previous works on cooperative game based feature selection. The average classification accuracy on eleven microarray data sets shows that the proposed method improves both average accuracy and average stability compared to other approaches.

  2. Robust Feature Selection from Microarray Data Based on Cooperative Game Theory and Qualitative Mutual Information

    PubMed Central

    Mortazavi, Atiyeh; Moattar, Mohammad Hossein

    2016-01-01

    High dimensionality of microarray data sets may lead to low efficiency and overfitting. In this paper, a multiphase cooperative game theoretic feature selection approach is proposed for microarray data classification. In the first phase, due to high dimension of microarray data sets, the features are reduced using one of the two filter-based feature selection methods, namely, mutual information and Fisher ratio. In the second phase, Shapley index is used to evaluate the power of each feature. The main innovation of the proposed approach is to employ Qualitative Mutual Information (QMI) for this purpose. The idea of Qualitative Mutual Information causes the selected features to have more stability and this stability helps to deal with the problem of data imbalance and scarcity. In the third phase, a forward selection scheme is applied which uses a scoring function to weight each feature. The performance of the proposed method is compared with other popular feature selection algorithms such as Fisher ratio, minimum redundancy maximum relevance, and previous works on cooperative game based feature selection. The average classification accuracy on eleven microarray data sets shows that the proposed method improves both average accuracy and average stability compared to other approaches. PMID:27127506

  3. Mammographic images segmentation based on chaotic map clustering algorithm

    PubMed Central

    2014-01-01

    Background This work investigates the applicability of a novel clustering approach to the segmentation of mammographic digital images. The chaotic map clustering algorithm is used to group together similar subsets of image pixels resulting in a medically meaningful partition of the mammography. Methods The image is divided into pixels subsets characterized by a set of conveniently chosen features and each of the corresponding points in the feature space is associated to a map. A mutual coupling strength between the maps depending on the associated distance between feature space points is subsequently introduced. On the system of maps, the simulated evolution through chaotic dynamics leads to its natural partitioning, which corresponds to a particular segmentation scheme of the initial mammographic image. Results The system provides a high recognition rate for small mass lesions (about 94% correctly segmented inside the breast) and the reproduction of the shape of regions with denser micro-calcifications in about 2/3 of the cases, while being less effective on identification of larger mass lesions. Conclusions We can summarize our analysis by asserting that due to the particularities of the mammographic images, the chaotic map clustering algorithm should not be used as the sole method of segmentation. It is rather the joint use of this method along with other segmentation techniques that could be successfully used for increasing the segmentation performance and for providing extra information for the subsequent analysis stages such as the classification of the segmented ROI. PMID:24666766

  4. Mammographic images segmentation based on chaotic map clustering algorithm.

    PubMed

    Iacomi, Marius; Cascio, Donato; Fauci, Francesco; Raso, Giuseppe

    2014-03-25

    This work investigates the applicability of a novel clustering approach to the segmentation of mammographic digital images. The chaotic map clustering algorithm is used to group together similar subsets of image pixels resulting in a medically meaningful partition of the mammography. The image is divided into pixels subsets characterized by a set of conveniently chosen features and each of the corresponding points in the feature space is associated to a map. A mutual coupling strength between the maps depending on the associated distance between feature space points is subsequently introduced. On the system of maps, the simulated evolution through chaotic dynamics leads to its natural partitioning, which corresponds to a particular segmentation scheme of the initial mammographic image. The system provides a high recognition rate for small mass lesions (about 94% correctly segmented inside the breast) and the reproduction of the shape of regions with denser micro-calcifications in about 2/3 of the cases, while being less effective on identification of larger mass lesions. We can summarize our analysis by asserting that due to the particularities of the mammographic images, the chaotic map clustering algorithm should not be used as the sole method of segmentation. It is rather the joint use of this method along with other segmentation techniques that could be successfully used for increasing the segmentation performance and for providing extra information for the subsequent analysis stages such as the classification of the segmented ROI.

  5. Identification of simulated microcalcifications in white noise and mammographic backgrounds

    SciTech Connect

    Reiser, Ingrid; Nishikawa, Robert M.

    2006-08-15

    This work investigates human performance in discriminating between differently shaped simulated microcalcifications embedded in white noise or mammographic backgrounds. Human performance was determined through two alternative forced-choice (2-AFC) experiments. The signals used were computer-generated simple shapes that were designed such that they had equal signal energy. This assured equal detectability. For experiments involving mammographic backgrounds, signals were blurred to account for the imaging system modulation transfer function (MTF). White noise backgrounds were computer generated; anatomic background patches were extracted from normal mammograms. We compared human performance levels as a function of signal energy in the expected difference template. In the discrimination task, the expected difference template is the difference between the two signals shown. In white noise backgrounds, human performance in the discrimination task was degraded compared to the detection task. In mammographic backgrounds, human performance in the discrimination task exceeded that of the detection task. This indicates that human observers do not follow the optimum decision strategy of correlating the expected signal template with the image. Human observer performance was qualitatively reproduced by non-prewhitening with eye filter (NPWE) model observer calculations, in which spatial uncertainty was explicitly included by shifting the locations of the expected difference templates. The results indicate that human strategy in the discrimination task may be to match individual signal templates with the image individually, rather than to perform template matching between the expected difference template and the image.

  6. Factors associated with mammographic decisions of Chinese-Australian women.

    PubMed

    Kwok, Cannas; Cant, Rosemary; Sullivan, Gerard

    2005-12-01

    BreastScreen (a free breast cancer screening service) has been implemented in Australia since 1991. Surveys conducted overseas consistently report that women of Chinese ancestry have low participation rates in breast cancer screening. Although Chinese women's use of breast cancer screening services has been investigated abroad, to date there are few studies of mammographic screening behavior among Chinese-Australian women. The purpose of this study is to explore and investigate the factors associated with mammographic decisions of Chinese-Australian women. Using a qualitative approach, in-depth interviews were conducted with 20 Chinese-Australian women. These were augmented by additional data from ethnographic observations. The findings show two facilitators: organizational factors (an invitation letter from BreastScreen and seniors' clubs arrangements) and the influence of 'significant others'. Barriers identified were fear perceptions of mammography, modesty and fear of stigmatization. This study provides a useful framework for designing and implementing mammographic screening services for Chinese-Australian women that may improve their participation rates.

  7. Mammographic breast density in infertile and parous women.

    PubMed

    Letizia, Meggiorini Maria; Rita, Vestri Anna; Grazia, De Stefano Maria; Valentina, Cipolla; Filippo, Bellati; Diana, Maffucci; Paola, Nusiner Maria; Cesare, Aragona; Carlo, De Felice

    2016-02-09

    Mammographic breast density is a useful marker for breast cancer risk, as breast density is considered one of the strongest breast cancer risk factors. The study objective was to evaluate and compare mammographic breast density in infertile and parous women, as infertility may be associated with high breast density and cancer occurrence. This study evaluated mammographic breast density using two different systems, BIRADS and Boyd. A selected patient population of 151 women with primary infertility (case group) was compared to 154 parous women who had at least one previous pregnancy (control group). Both groups were premenopausal women aged ≥ 35. Evaluation of mammographic features showed that 66.9% of case group patients and 53.9% of control group patients were classified BIRADS-3/BIRADS-4; p < 0.05. Adjusted Odds ratio for the case group in the categories BIRADS-3/BIRADS-4 was 1.78 (95% CI: 1.10-2.89). Using the Boyd classification system, 53.6% of case group patients and 31.8% of control group patients were classified E/F; p < 0.05. Adjusted Odds ratio for case group patients in Boyd categories E/F was 2.05 (95 % CI: 1.07-3.93). Both systems yielded a higher percentage of increased breast density in the case group. Boyd and BIRADS classification systems indicate to what extend breast cancer lesions may be missed on mammography due to masking by dense tissue. Therefore, patients with a high BIRADS or Boyd score should undergo further investigation.

  8. Abnormal mammographic findings with short-interval follow-up recommendation.

    PubMed

    Chlebowski, Rowan T; Khalkhali, Iraj

    2005-08-01

    An abnormal Breast Imaging and Reporting Data System (BIRADS) category 3 mammogram with a short interval follow-up recommendation is a common finding seen in approximately 40% of women for each decade of screening. Factors associated with category 3 mammograms include mammography examination features, tendencies of the interpreting physician, and features of the country's health care system and the screened population including age, family history, previous biopsies, obesity, and menopausal hormone therapy. Recently, the degree to which a BIRADS category 3 mammographic result provides differential breast cancer risk compared with normal mammographic categories (BIRADS category 1 or 2) has been questioned. The yield of category 3 mammographic results could potentially be increased by more uniform performance of additional imaging workup (additional views and/or ultrasonography). In addition, other strategies to more accurately characterize the risk of breast cancer in women with category 3 mammographic results are under evaluation and including magnetic resonance imaging, computer-aided classification systems, and digital tomosynthesis. Given the potential psychologic impact of abnormal mammographic results, studies attempting to more accurately relate screening mammography findings to breast cancer risk are a priority.

  9. Mammographic compression in Asian women

    PubMed Central

    Lau, Susie; Abdul Aziz, Yang Faridah; Ng, Kwan Hoong

    2017-01-01

    Objectives To investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study. Methods We retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35–80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs. Results Compression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2–11.0%, and caused no significant effects on image quality (p>0.05). Conclusions Force-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD. PMID:28419125

  10. Automated detection of qualitative spatio-temporal features in electrocardiac activation maps.

    PubMed

    Ironi, Liliana; Tentoni, Stefania

    2007-02-01

    This paper describes a piece of work aiming at the realization of a tool for the automated interpretation of electrocardiac maps. Such maps can capture a number of electrical conduction pathologies, such as arrhytmia, that can be missed by the analysis of traditional electrocardiograms. But, their introduction into the clinical practice is still far away as their interpretation requires skills that belongs to very few experts. Then, an automated interpretation tool would bridge the gap between the established research outcome and clinical practice with a consequent great impact on health care. Qualitative spatial reasoning can play a crucial role in the identification of spatio-temporal patterns and salient features that characterize the heart electrical activity. We adopted the spatial aggregation (SA) conceptual framework and an interplay of numerical and qualitative information to extract features from epicardial maps, and to make them available for reasoning tasks. Our focus is on epicardial activation isochrone maps as they are a synthetic representation of spatio-temporal aspects of the propagation of the electrical excitation. We provide a computational SA-based methodology to extract, from 3D epicardial data gathered over time, (1) the excitation wavefront structure, and (2) the salient features that characterize wavefront propagation and visually correspond to specific geometric objects. The proposed methodology provides a robust and efficient way to identify salient pieces of information in activation time maps. The hierarchical structure of the abstracted geometric objects, crucial in capturing the prominent information, facilitates the definition of general rules necessary to infer the correlation between pathophysiological patterns and wavefront structure and propagation.

  11. Features of a Health-Oriented Education Program during Daily Commutes: A Qualitative Study

    PubMed Central

    Ramezankhani, Ali; Heydarabadi, Akbar Babaei; Ghaffari, Mohtasham; Mehrabi, Yadollah; Kazemi, Sadegh

    2016-01-01

    Introduction Today, despite scientific advances, many people spend more time and distance between home and their workplaces because of various economic and population reasons. The aim of this study was to identify features of an appropriate health education program during commutes for factory staff at Ardakan county (Yazd province, Iran). Methods This qualitative study was conducted via the phenomenological method in 2014. The population of this study was members of the staff of Ardakan Steel Company. Nineteen specialists and 11 members of the factory’s staff were invited to participate in the study, and data were collected using semi-structured interviews. The interviews took 20 to 40 minutes, and their content was analyzed using content analysis. Results Extraction of codes and themes and their placement in this study showed that an educational program during commutes should have nine features to have the desired effectiveness, i.e., the program must be audience-oriented, repeatable, participatory, technology-based, combinational, supportive, and motivational and interesting. Also, the program should have environmental and organizational support, and it must be evaluated for its effectiveness. Conclusion Considering appropriate features of a health education program in educational situations, especially interventions related to daily commutes, is very important because the effectiveness of such health-oriented educational programs must be ensured. PMID:27504166

  12. Features of a Health-Oriented Education Program during Daily Commutes: A Qualitative Study.

    PubMed

    Ramezankhani, Ali; Heydarabadi, Akbar Babaei; Ghaffari, Mohtasham; Mehrabi, Yadollah; Kazemi, Sadegh

    2016-06-01

    Today, despite scientific advances, many people spend more time and distance between home and their workplaces because of various economic and population reasons. The aim of this study was to identify features of an appropriate health education program during commutes for factory staff at Ardakan county (Yazd province, Iran). This qualitative study was conducted via the phenomenological method in 2014. The population of this study was members of the staff of Ardakan Steel Company. Nineteen specialists and 11 members of the factory's staff were invited to participate in the study, and data were collected using semi-structured interviews. The interviews took 20 to 40 minutes, and their content was analyzed using content analysis. Extraction of codes and themes and their placement in this study showed that an educational program during commutes should have nine features to have the desired effectiveness, i.e., the program must be audience-oriented, repeatable, participatory, technology-based, combinational, supportive, and motivational and interesting. Also, the program should have environmental and organizational support, and it must be evaluated for its effectiveness. Considering appropriate features of a health education program in educational situations, especially interventions related to daily commutes, is very important because the effectiveness of such health-oriented educational programs must be ensured.

  13. Mammographic density: intersection of science, the law, and clinical practice.

    PubMed

    Hollenbeck, Scott; Keely, Patricia; Seewaldt, Victoria

    2013-01-01

    High mammographic density is associated with a two- to sixfold increased risk of breast cancer. Mammographic density can be altered by endogenous and exogenous hormonal factors and generally declines with age. Mammographic density is affected by confounding factors such as age, parity, menopausal status, and body mass index (BMI), thus making interpretation of mammographic density challenging. None of the established means of measuring mammographic density are entirely satisfactory because they are time consuming and/or subjective. Although mammographic density has been shown to predict breast cancer risk, the role of mammographic density in precisely assessing a woman's breast cancer risk over her lifetime and evaluating response to risk-reduction strategies cannot be fully realized until we have a better understanding of the biology that links mammographic density to breast cancer risk.

  14. Computerized prediction of breast cancer risk: comparison between the global and local bilateral mammographic tissue asymmetry

    NASA Astrophysics Data System (ADS)

    Wang, Xingwei; Lederman, Dror; Tan, Jun; Wang, Xiao Hui; Zheng, Bin

    2011-03-01

    We have developed and preliminarily tested a new breast cancer risk prediction model based on computerized bilateral mammographic tissue asymmetry. In this study, we investigated and compared the performance difference of our risk prediction model when the bilateral mammographic tissue asymmetrical features were extracted in two different methods namely (1) the entire breast area and (2) the mirror-matched local strips between the left and right breast. A testing dataset including bilateral craniocaudal (CC) view images of 100 negative and 100 positive cases for developing breast abnormalities or cancer was selected from a large and diverse full-field digital mammography (FFDM) image database. To detect bilateral mammographic tissue asymmetry, a set of 20 initial "global" features were extracted from the entire breast areas of two bilateral mammograms in CC view and their differences were computed. Meanwhile, a pool of 16 local histogram-based statistic features was computed from eight mirror-matched strips between the left and right breast. Using a genetic algorithm (GA) to select optimal features, two artificial neural networks (ANN) were built to predict the risk of a test case developing cancer. Using the leave-one-case-out training and testing method, two GAoptimized ANNs yielded the areas under receiver operating characteristic (ROC) curves of 0.754+/-0.024 (using feature differences extracted from the entire breast area) and 0.726+/-0.026 (using the feature differences extracted from 8 pairs of local strips), respectively. The risk prediction model using either ANN is able to detect 58.3% (35/60) of cancer cases 6 to 18 months earlier at 80% specificity level. This study compared two methods to compute bilateral mammographic tissue asymmetry and demonstrated that bilateral mammographic tissue asymmetry was a useful breast cancer risk indicator with high discriminatory power.

  15. How does the 'rest-self overlap' mediate the qualitative and automatic features of self-reference?

    PubMed

    Northoff, Georg

    2016-01-01

    The target article points out the qualitative and automatic features of self-reference while leaving open the underlying neural mechanisms. Based on empirical evidence about rest-self overlap and rest-stimulus interaction being special for self-related stimuli, I postulate that the resting state shows self-specific organization. The resting state's self-specific organization may be encoded by activity balances between different networks which in turn predispose the qualitative features of subsequent self-related stimulus-induced activity in, for instance, SAN as well as the automatic features of self-reference effects.

  16. A new detection algorithm for microcalcification clusters in mammographic screening

    NASA Astrophysics Data System (ADS)

    Xie, Weiying; Ma, Yide; Li, Yunsong

    2015-05-01

    A novel approach for microcalcification clusters detection is proposed. At the first time, we make a short analysis of mammographic images with microcalcification lesions to confirm these lesions have much greater gray values than normal regions. After summarizing the specific feature of microcalcification clusters in mammographic screening, we make more focus on preprocessing step including eliminating the background, image enhancement and eliminating the pectoral muscle. In detail, Chan-Vese Model is used for eliminating background. Then, we do the application of combining morphology method and edge detection method. After the AND operation and Sobel filter, we use Hough Transform, it can be seen that the result have outperformed for eliminating the pectoral muscle which is approximately the gray of microcalcification. Additionally, the enhancement step is achieved by morphology. We make effort on mammographic image preprocessing to achieve lower computational complexity. As well known, it is difficult to robustly achieve mammograms analysis due to low contrast between normal and lesion tissues, there are also much noise in such images. After a serious preprocessing algorithm, a method based on blob detection is performed to microcalcification clusters according their specific features. The proposed algorithm has employed Laplace operator to improve Difference of Gaussians (DoG) function in terms of low contrast images. A preliminary evaluation of the proposed method performs on a known public database namely MIAS, rather than synthetic images. The comparison experiments and Cohen's kappa coefficients all demonstrate that our proposed approach can potentially obtain better microcalcification clusters detection results in terms of accuracy, sensitivity and specificity.

  17. Force balancing in mammographic compression

    SciTech Connect

    Branderhorst, W. Groot, J. E. de; Lier, M. G. J. T. B. van; Grimbergen, C. A.; Neeter, L. M. F. H.; Heeten, G. J. den; Neeleman, C.

    2016-01-15

    Purpose: In mammography, the height of the image receptor is adjusted to the patient before compressing the breast. An inadequate height setting can result in an imbalance between the forces applied by the image receptor and the paddle, causing the clamped breast to be pushed up or down relative to the body during compression. This leads to unnecessary stretching of the skin and other tissues around the breast, which can make the imaging procedure more painful for the patient. The goal of this study was to implement a method to measure and minimize the force imbalance, and to assess its feasibility as an objective and reproducible method of setting the image receptor height. Methods: A trial was conducted consisting of 13 craniocaudal mammographic compressions on a silicone breast phantom, each with the image receptor positioned at a different height. The image receptor height was varied over a range of 12 cm. In each compression, the force exerted by the compression paddle was increased up to 140 N in steps of 10 N. In addition to the paddle force, the authors measured the force exerted by the image receptor and the reaction force exerted on the patient body by the ground. The trial was repeated 8 times, with the phantom remounted at a slightly different orientation and position between the trials. Results: For a given paddle force, the obtained results showed that there is always exactly one image receptor height that leads to a balance of the forces on the breast. For the breast phantom, deviating from this specific height increased the force imbalance by 9.4 ± 1.9 N/cm (6.7%) for 140 N paddle force, and by 7.1 ± 1.6 N/cm (17.8%) for 40 N paddle force. The results also show that in situations where the force exerted by the image receptor is not measured, the craniocaudal force imbalance can still be determined by positioning the patient on a weighing scale and observing the changes in displayed weight during the procedure. Conclusions: In mammographic breast

  18. 21 CFR 892.1710 - Mammographic x-ray system.

    Code of Federal Regulations, 2010 CFR

    2010-04-01

    ... 21 Food and Drugs 8 2010-04-01 2010-04-01 false Mammographic x-ray system. 892.1710 Section 892...) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1710 Mammographic x-ray system. (a) Identification. A mammographic x-ray system is a device intended to be used to produce radiographs of the breast...

  19. Epidemiologic studies of isoflavones & mammographic density.

    PubMed

    Maskarinec, Gertraud; Verheus, Martijn; Tice, Jeffrey A

    2010-01-01

    Isoflavones, phytoestrogens in soy beans with estrogen-like properties, have been examined for their cancer protective effects. Mammographic density is a strong predictor of breast cancer. This review summarizes studies that have examined the association between isoflavones and breast density. Observational investigations in Hawaii and Singapore suggest slightly lower breast density among women of Asian descent with regular soy intake, but two larger studies from Japan and Singapore did not observe a protective effect. The findings from seven randomized trials with primarily Caucasian women indicate that soy or isoflavones do not modify mammographic density. Soy foods and isoflavone supplements within a nutritional range do not appear to modify breast cancer risk as assessed by mammographic density.

  20. Use of border information in the classification of mammographic masses

    NASA Astrophysics Data System (ADS)

    Varela, C.; Timp, S.; Karssemeijer, N.

    2006-01-01

    We are developing a new method to characterize the margin of a mammographic mass lesion to improve the classification of benign and malignant masses. Towards this goal, we designed features that measure the degree of sharpness and microlobulation of mass margins. We calculated these features in a border region of the mass defined as a thin band along the mass contour. The importance of these features in the classification of benign and malignant masses was studied in relation to existing features used for mammographic mass detection. Features were divided into three groups, each representing a different mass segment: the interior region of a mass, the border and the outer area. The interior and the outer area of a mass were characterized using contrast and spiculation measures. Classification was done in two steps. First, features representing each of the three mass segments were merged into a neural network classifier resulting in a single regional classification score for each segment. Secondly, a classifier combined the three single scores into a final output to discriminate between benign and malignant lesions. We compared the classification performance of each regional classifier and the combined classifier on a data set of 1076 biopsy proved masses (590 malignant and 486 benign) from 481 women included in the Digital Database for Screening Mammography. Receiver operating characteristic (ROC) analysis was used to evaluate the accuracy of the classifiers. The area under the ROC curve (Az) was 0.69 for the interior mass segment, 0.76 for the border segment and 0.75 for the outer mass segment. The performance of the combined classifier was 0.81 for image-based and 0.83 for case-based evaluation. These results show that the combination of information from different mass segments is an effective approach for computer-aided characterization of mammographic masses. An advantage of this approach is that it allows the assessment of the contribution of regions rather

  1. Mammographic equipment, technique, and quality control

    SciTech Connect

    Friedrich, M.A. )

    1991-08-01

    The most important improvements in mammographic technique were the introduction of single- or double-emulsion high-contrast film-screen combinations for mammography, the use of a specially designed low-kilovoltage Bucky grid to reduce scattered radiation, and the introduction of smaller focal spots to improve imaging geometry. Magnification techniques, especially the spot-film technique, yields clearer delineation of high-contrast microcalcifications. Dedicated mammographic equipment with specially designed x-ray tubes is necessary for modern high-quality mammography. However, in many modern mammographic units, the automatic exposure controller still fails to provide appropriate and constant optical film density over a wide range of tissue thickness and absorption. Extended-cycle processing of single-emulsion mammographic films can yield better image contrast and reduce exposure by up to 30%. Exposure times of less than 1 second are recommended to avoid the unnecessary higher doses caused by longer exposure times and reciprocity law failure. The wide dynamic range in mammography can be reduced by a beam equalization filter, and thus be better adapted to the decreased latitude of modern high-contrast mammographic screen-film systems. Mammographic film reading (detection of subtle microcalcifications) can be facilitated by modern computer evaluation of previously digitized mammograms. Standardization and assurance of image quality have been major challenges in the technical development of mammography. Different technical and anthropomorphic phantoms have been designed to measure and compare practical image quality. Detailed quality control measures have been developed. The benefit of a single or annual screening mammography, calculated in gained life expectancy, by far outweighs the relative risk for radiation-induced breast cancer. 22 references.

  2. Qualitative and Quantitative Features of Music Reported to Support Peak Mystical Experiences during Psychedelic Therapy Sessions

    PubMed Central

    Barrett, Frederick S.; Robbins, Hollis; Smooke, David; Brown, Jenine L.; Griffiths, Roland R.

    2017-01-01

    Psilocybin is a classic (serotonergic) hallucinogen (“psychedelic” drug) that may occasion mystical experiences (characterized by a profound feeling of oneness or unity) during acute effects. Such experiences may have therapeutic value. Research and clinical applications of psychedelics usually include music listening during acute drug effects, based on the expectation that music will provide psychological support during the acute effects of psychedelic drugs, and may even facilitate the occurrence of mystical experiences. However, the features of music chosen to support the different phases of drug effects are not well-specified. As a result, there is currently neither real guidance for the selection of music nor standardization of the music used to support clinical trials with psychedelic drugs across various research groups or therapists. A description of the features of music found to be supportive of mystical experience will allow for the standardization and optimization of the delivery of psychedelic drugs in both research trials and therapeutic contexts. To this end, we conducted an anonymous survey of individuals with extensive experience administering psilocybin or psilocybin-containing mushrooms under research or therapeutic conditions, in order to identify the features of commonly used musical selections that have been found by therapists and research staff to be supportive of mystical experiences within a psilocybin session. Ten respondents yielded 24 unique recommendations of musical stimuli supportive of peak effects with psilocybin, and 24 unique recommendations of musical stimuli supportive of the period leading up to a peak experience. Qualitative analysis (expert rating of musical and music-theoretic features of the recommended stimuli) and quantitative analysis (using signal processing and music-information retrieval methods) of 22 of these stimuli yielded a description of peak period music that was characterized by regular, predictable

  3. Qualitative and Quantitative Features of Music Reported to Support Peak Mystical Experiences during Psychedelic Therapy Sessions.

    PubMed

    Barrett, Frederick S; Robbins, Hollis; Smooke, David; Brown, Jenine L; Griffiths, Roland R

    2017-01-01

    Psilocybin is a classic (serotonergic) hallucinogen ("psychedelic" drug) that may occasion mystical experiences (characterized by a profound feeling of oneness or unity) during acute effects. Such experiences may have therapeutic value. Research and clinical applications of psychedelics usually include music listening during acute drug effects, based on the expectation that music will provide psychological support during the acute effects of psychedelic drugs, and may even facilitate the occurrence of mystical experiences. However, the features of music chosen to support the different phases of drug effects are not well-specified. As a result, there is currently neither real guidance for the selection of music nor standardization of the music used to support clinical trials with psychedelic drugs across various research groups or therapists. A description of the features of music found to be supportive of mystical experience will allow for the standardization and optimization of the delivery of psychedelic drugs in both research trials and therapeutic contexts. To this end, we conducted an anonymous survey of individuals with extensive experience administering psilocybin or psilocybin-containing mushrooms under research or therapeutic conditions, in order to identify the features of commonly used musical selections that have been found by therapists and research staff to be supportive of mystical experiences within a psilocybin session. Ten respondents yielded 24 unique recommendations of musical stimuli supportive of peak effects with psilocybin, and 24 unique recommendations of musical stimuli supportive of the period leading up to a peak experience. Qualitative analysis (expert rating of musical and music-theoretic features of the recommended stimuli) and quantitative analysis (using signal processing and music-information retrieval methods) of 22 of these stimuli yielded a description of peak period music that was characterized by regular, predictable

  4. Vitamin D and Mammographic Findings

    PubMed Central

    Riedel, J.; Straub, L.; Wissing, J.; Artmann, A.; Schmidmayr, M.; Kiechle, M.; Seifert-Klauss, V. R.

    2016-01-01

    Introduction: Pleiotropic immune-modulatory and anti-proliferative effects of vitamin D and hopes to stop cancerogenesis have led to an increased interest in possible reduction of breast cancer with higher vitamin D levels. Mammographic density is an established risk factor for breast cancer risk, and its association with serum vitamin D is complex, as recent studies have shown. Patients and Methods: In this cross-sectional study, 1103 participants were recruited in the breast diagnostic unit of the Klinikum rechts der Isar, TU Munich. A standardised questionnaire and blood samples for 25-OH-vitamin D were taken on the day of mammography. Histologic results of biopsies in suspicious mammographies were documented. Results: In the 1090 data-sets analysed, vitamin D-deficiency was common among women under 40. Highest vitamin D values were observed in participants aged 60–69 years, but average values for all age cohorts were below 20 ng/ml of vitamin D. 15.6 % of all participants had very low vitamin D values (< 10 ng/ml), 51.3 % were vitamin D-deficient (10–19 ng/ml) and only 5.7 % were above 30 ng/ml, i.e. showed sufficient vitamin D. Patients with malignant results had vitamin D < 10 ng/ml more often (16.9 %; p = 0.61), and only 3.4 % in this group had sufficient vitamin D supply (> 30 ng/ml). There were no significant differences in vitamin D-levels between density groups according to the American College of Radiology (ACR) criteria. Conclusion: Vitamin D values were lower than in comparable US women. Up to now, there is no direct clinical evidence for a relationship between the risk for breast cancer and a specific vitamin D value. PMID:27239067

  5. Detection of lesions in mammographic structure

    NASA Astrophysics Data System (ADS)

    Burgess, Arthur E.; Jacobson, Francine L.; Judy, Philip F.

    1999-05-01

    This paper is a report on very surprising results from recent work on detection of real lesions in digitized mammograms. The experiments were done using a novel experimental procedure with hybrid images. The lesions (signals) were real tumor masses extracted from breast tissue specimen radiographs. In the detection experiments, the tumors were added to digitized normal mammographic backgrounds. The results of this new work have been both novel and very surprising. Contrast thresholds increased with increasing lesion size for lesions larger than approximately 1 mm in diameter. Earlier work with white noise, radiographic image noise, computed tomography (CT) noise and some types of patient structure have accustomed us to a particular relationship between lesion size and contrast for constant detectability. All previous contrast/detail (CD) diagrams have been similar, the contrast threshold decreases as lesion size increases and flattens at large lesion sizes. The CD diagram for lesion detection in mammographic structure is completely different. It will be shown that this is a consequence of the power-law dependence of the projected breast tissue structure spectral density on spatial frequency. Mammographic tissue structure power spectra have the form P(f) equals B/f(beta ), with an average exponent of approximately 3 (range from 2 to 4), and are approximately isotropic (small angular dependence). Results for two-alternative forced-choice (2AFC) signal detection experiments using 4 tumor lesions and one mathematically generated signal will be presented. These results are for an unbiased selection of mammographic backgrounds. It is possible that an additional understanding of the effects of breast structure on lesion detectability can be obtained by investigating detectability in various classes of mammographic backgrounds. This will be the subject of future research.

  6. Extraction of Qualitative Features from Sensor Data Using Windowed Fourier Transform

    NASA Technical Reports Server (NTRS)

    Amini, Abolfazl M.; Figueroa, Fenando

    2003-01-01

    In this paper, we use Matlab to model the health monitoring of a system through the information gathered from sensors. This implies assessment of the condition of the system components. Once a normal mode of operation is established any deviation from the normal behavior indicates a change. This change may be due to a malfunction of an element, a qualitative change, or a change due to a problem with another element in the network. For example, if one sensor indicates that the temperature in the tank has experienced a step change then a pressure sensor associated with the process in the tank should also experience a step change. The step up and step down as well as sensor disturbances are assumed to be exponential. An RC network is used to model the main process, which is step-up (charging), drift, and step-down (discharging). The sensor disturbances and spike are added while the system is in drift. The system is allowed to run for a period equal to three time constant of the main process before changes occur. Then each point of the signal is selected with a trailing data collected previously. Two trailing lengths of data are selected, one equal to two time constants of the main process and the other equal to two time constants of the sensor disturbance. Next, the DC is removed from each set of data and then the data are passed through a window followed by calculation of spectra for each set. In order to extract features the signal power, peak, and spectrum are plotted vs time. The results indicate distinct shapes corresponding to each process. The study is also carried out for a number of Gaussian distributed noisy cases.

  7. Extraction of Qualitative Features from Sensor Data Using Windowed Fourier Transform

    NASA Technical Reports Server (NTRS)

    Amini, Abolfazl M.; Figueroa, Fenando

    2003-01-01

    In this paper, we use Matlab to model the health monitoring of a system through the information gathered from sensors. This implies assessment of the condition of the system components. Once a normal mode of operation is established any deviation from the normal behavior indicates a change. This change may be due to a malfunction of an element, a qualitative change, or a change due to a problem with another element in the network. For example, if one sensor indicates that the temperature in the tank has experienced a step change then a pressure sensor associated with the process in the tank should also experience a step change. The step up and step down as well as sensor disturbances are assumed to be exponential. An RC network is used to model the main process, which is step-up (charging), drift, and step-down (discharging). The sensor disturbances and spike are added while the system is in drift. The system is allowed to run for a period equal to three time constant of the main process before changes occur. Then each point of the signal is selected with a trailing data collected previously. Two trailing lengths of data are selected, one equal to two time constants of the main process and the other equal to two time constants of the sensor disturbance. Next, the DC is removed from each set of data and then the data are passed through a window followed by calculation of spectra for each set. In order to extract features the signal power, peak, and spectrum are plotted vs time. The results indicate distinct shapes corresponding to each process. The study is also carried out for a number of Gaussian distributed noisy cases.

  8. Autobiographical planning and the brain: Activation and its modulation by qualitative features

    PubMed Central

    Spreng, R. Nathan; Gerlach, Kathy D.; Turner, Gary R.; Schacter, Daniel L.

    2016-01-01

    In order to engage in purposeful behavior, it is important to make plans, which organize subsequent actions. Most studies of planning involve “look-ahead” puzzle tasks that are unrelated to personal goals. We developed a task to assess autobiographical planning, which involves the formulation of personal plans in response to real-world goals, and examined autobiographical planning in 63 adults during fMRI scanning. Autobiographical planning was found to engage the default network, including medial temporal lobe and midline structures, and executive control regions in lateral prefrontal and parietal cortex and caudate. To examine how specific qualitative features of autobiographical plans modulate neural activity, we performed parametric modulation analyses. Ratings of plan detail, novelty, temporal distance, ease of plan formulation, difficulty in goal completion, and confidence in goal accomplishment were used as covariates in six hierarchical linear regression models. This modeling procedure removed shared variance among the ratings, allowing us to determine the independent relationship between ratings of interest and trial-wise BOLD signal. We found that specific autobiographical planning, describing a detailed, achievable, and actionable planning process for attaining a clearly envisioned future, recruited both default and frontoparietal brain regions. In contrast, abstract autobiographical planning, plans that were constructed from more generalized semantic or affective representations of a less tangible and distant future, involved interactions among default, sensory-perceptual, and limbic brain structures. Specific qualities of autobiographical plans are important predictors of default and frontoparietal control network engagement during plan formation and reflect the contribution of mnemonic and executive control processes to autobiographical planning. PMID:26102226

  9. Autobiographical Planning and the Brain: Activation and Its Modulation by Qualitative Features.

    PubMed

    Spreng, R Nathan; Gerlach, Kathy D; Turner, Gary R; Schacter, Daniel L

    2015-11-01

    To engage in purposeful behavior, it is important to make plans, which organize subsequent actions. Most studies of planning involve "look-ahead" puzzle tasks that are unrelated to personal goals. We developed a task to assess autobiographical planning, which involves the formulation of personal plans in response to real-world goals, and examined autobiographical planning in 63 adults during fMRI scanning. Autobiographical planning was found to engage the default network, including medial-temporal lobe and midline structures, and executive control regions in lateral pFC and parietal cortex and caudate. To examine how specific qualitative features of autobiographical plans modulate neural activity, we performed parametric modulation analyses. Ratings of plan detail, novelty, temporal distance, ease of plan formulation, difficulty in goal completion, and confidence in goal accomplishment were used as covariates in six hierarchical linear regression models. This modeling procedure removed shared variance among the ratings, allowing us to determine the independent relationship between ratings of interest and trial-wise BOLD signal. We found that specific autobiographical planning, describing a detailed, achievable, and actionable planning process for attaining a clearly envisioned future, recruited both default and frontoparietal brain regions. In contrast, abstract autobiographical planning, plans that were constructed from more generalized semantic or affective representations of a less tangible and distant future, involved interactions among default, sensory perceptual, and limbic brain structures. Specific qualities of autobiographical plans are important predictors of default and frontoparietal control network engagement during plan formation and reflect the contribution of mnemonic and executive control processes to autobiographical planning.

  10. Impact of contra-lateral breast reshaping on mammographic surveillance in women undergoing breast reconstruction following mastectomy for breast cancer.

    PubMed

    Nava, Maurizio B; Rocco, Nicola; Catanuto, Giuseppe; Falco, Giuseppe; Capalbo, Emanuela; Marano, Luigi; Bordoni, Daniele; Spano, Andrea; Scaperrotta, Gianfranco

    2015-08-01

    The ultimate goal of breast reconstruction is to achieve symmetry with the contra-lateral breast. Contra-lateral procedures with wide parenchymal rearrangements are suspected to impair mammographic surveillance. This study aims to evaluate the impact on mammographic detection of mastopexies and breast reductions for contralateral adjustment in breast reconstruction. We retrospectively evaluated 105 women affected by uni-lateral breast cancer who underwent mastectomy and immediate two-stage reconstruction between 2002 and 2007. We considered three groups according to the contra-lateral reshaping technique: mastopexy or breast reduction with inferior dermoglandular flap (group 1); mastopexy or breast reduction without inferior dermoglandular flap (group 2); no contra-lateral reshaping (group 3). We assessed qualitative mammographic variations and breast density in the three groups. Statistically significant differences have been found when comparing reshaped groups with non reshaped groups regarding parenchymal distortions, skin thickening and stromal edema, but these differences did not affect cancer surveillance. The surveillance mammography diagnostic accuracy in contra-lateral cancer detection was not significantly different between the three groups (p = 0.56), such as the need for MRI for equivocal findings at mammographic contra-lateral breast (p = 0.77) and the need for core-biopsies to confirm mammographic suspect of contra-lateral breast cancer (p = 0.90). This study confirms previous reports regarding the safety of mastopexies and breast reductions when performed in the setting of contra-lateral breast reshaping after breast reconstruction. Mammographic accuracy, sensitivity and specificity are not affected by the glandular re-arrangement. These results provide a further validation of the safety of current reconstructive paradigms. Copyright © 2015 Elsevier Ltd. All rights reserved.

  11. Task-Specific Optimization of Mammographic Systems

    DTIC Science & Technology

    2005-03-01

    by the equation: SNR Actual2 = DQE(O) . SNRI, i,,,i (1) where SNRIdeal was computed using a program by Boone to generate x-ray spectra2 and DQE(0...masses and microcalcifications. We have generated four image sets using the mammographic data obtained in 1.1. The first set was obtained at full dose...resolution and noise properties of the combined display and detector system using the generalized curve-fitting algorithm. After obtaining the

  12. High Fidelity Electronic Display of Digital Mammographs

    DTIC Science & Technology

    1997-10-01

    quality of scattering processes are modeled with the Monte Carlo CRT devices has not been adequate for displaying digital method by randomly sampling the...Electronic Display of Digital Mammographs PRINCIPAL INVESTIGATOR: Michael J. Flynn, Ph.D. CONTRACTING ORGANIZATION: Henry Ford Health Systems Detroit...TYPE AND DATES COVERED October 1997 Annual (3 Sep 96 - 2 Sep 97) 4. TITLE AND SUBTITLE 5. FUNDING NUMBERS High Fidelity Electronic Display of Digital

  13. Power spectral analysis of mammographic parenchymal patterns

    NASA Astrophysics Data System (ADS)

    Li, Hui; Giger, Maryellen L.; Olopade, Olufunmilayo I.

    2006-03-01

    Mammographic density and parenchymal patterns have been shown to be associated with the risk of developing breast cancer. Two groups of women: gene-mutation carriers and low-risk women were included in this study. Power spectral analysis was performed within parenchymal regions of 172 digitized craniocaudal normal mammograms of the BRCA1/BRCA2 gene-mutation carriers and those of women at low-risk of developing breast cancer. The power law spectrum of the form, P(f)=B/f β was evaluated for the mammographic patterns. Receiver Operating Characteristic (ROC) analysis was used to assess the performance of exponent β as a decision variable in the task of distinguishing between high and low-risk subjects. Power spectral analysis of mammograms demonstrated that mammographic parenchymal patterns have a power-law spectrum of the form, P(f)=B/f β where f is radial spatial frequency, with the average β values of 2.92 and 2.47 for the gene-mutation carriers and for the low-risk women, respectively. A z values of 0.90 and 0.89 were achieved in distinguishing between the gene-mutation carriers and the low-risk women with the individual image β value as the decision variable in the entire database and the age-matched group, respectively.

  14. Are qualitative and quantitative sleep problems associated with delinquency when controlling for psychopathic features and parental supervision?

    PubMed

    Backman, Heidi; Laajasalo, Taina; Saukkonen, Suvi; Salmi, Venla; Kivivuori, Janne; Aronen, Eeva T

    2015-10-01

    The aim of this study was to explore the relationship between sleep, including both qualitative and quantitative aspects, and delinquent behaviour while controlling for psychopathic features of adolescents and parental supervision at bedtime. We analysed data from a nationally representative sample of 4855 Finnish adolescents (mean age 15.3 years, 51% females). Sleep problems, hours of sleep and delinquency were evaluated via self-report. Psychopathic features were measured with the Antisocial Process Screening Device - Self-Report. In negative binomial regressions, gender and sleep-related variables acted as predictors for both property and violent crime after controlling for psychopathic features and parental supervision at bedtime. The results suggest that both sleep problems (at least three times per week, at least for a year) and an insufficient amount of sleep (less than 7 h) are associated with property crime and violent behaviour, and the relationship is not explained by gender, degree of parental supervision at bedtime or co-occurring psychopathic features. These results suggest that sleep difficulties and insufficient amount of sleep are associated with delinquent behaviour in adolescents. The significance of addressing sleep-related problems, both qualitative and quantitative, among adolescents is thus highlighted. Implications for a prevention technique of delinquent behaviour are discussed. © 2015 European Sleep Research Society.

  15. 21 CFR 892.1710 - Mammographic x-ray system.

    Code of Federal Regulations, 2014 CFR

    2014-04-01

    ... 21 Food and Drugs 8 2014-04-01 2014-04-01 false Mammographic x-ray system. 892.1710 Section 892.1710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1710 Mammographic x-ray system....

  16. 21 CFR 892.1710 - Mammographic x-ray system.

    Code of Federal Regulations, 2013 CFR

    2013-04-01

    ... 21 Food and Drugs 8 2013-04-01 2013-04-01 false Mammographic x-ray system. 892.1710 Section 892.1710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1710 Mammographic x-ray system....

  17. 21 CFR 892.1710 - Mammographic x-ray system.

    Code of Federal Regulations, 2011 CFR

    2011-04-01

    ... 21 Food and Drugs 8 2011-04-01 2011-04-01 false Mammographic x-ray system. 892.1710 Section 892.1710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1710 Mammographic x-ray system....

  18. 21 CFR 892.1710 - Mammographic x-ray system.

    Code of Federal Regulations, 2012 CFR

    2012-04-01

    ... 21 Food and Drugs 8 2012-04-01 2012-04-01 false Mammographic x-ray system. 892.1710 Section 892.1710 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN SERVICES (CONTINUED) MEDICAL DEVICES RADIOLOGY DEVICES Diagnostic Devices § 892.1710 Mammographic x-ray system....

  19. Mammographic density, blood telomere length and lipid peroxidation.

    PubMed

    Erdmann, Natalie J; Harrington, Lea A; Martin, Lisa J

    2017-07-19

    Extensive mammographic density is a strong risk factor for breast cancer, but may also be an indicator of biological age. In this study we examined whether mammographic density is related to blood telomere length, a potential marker of susceptibility to age-related disease. We measured mammographic density by a computer assisted method and blood telomere length using a validated PCR method. Urinary malondialdehyde (MDA), a marker of lipid peroxidation, was measured in 24 hour urine collections. In the 342 women examined telomere length was negatively correlated with age, was lower in postmenopausal compared to premenopausal women and in smokers compared to non-smokers, and was positively correlated with urinary MDA. Telomere length was not associated with percent mammographic density or dense area, before or after adjustment for risk factors and MDA. However, there was a significant interaction between telomere length and MDA in their association with mammographic density. At lower levels of MDA, mammographic density and telomere length were inversely associated; while at high levels of MDA, there was evidence of a J-shaped association between mammographic density and telomere length. Further work is need to replicate these results and to examine the association of mammographic density with age-related chronic disease and mortality.

  20. Parafoveal OCT Angiography Features in Diabetic Patients without Clinical Diabetic Retinopathy: A Qualitative and Quantitative Analysis.

    PubMed

    Goudot, Mathilde M; Sikorav, Anne; Semoun, Oudy; Miere, Alexandra; Jung, Camille; Courbebaisse, Blandine; Srour, Mayer; Freiha, Joseph G; Souied, Eric H

    2017-01-01

    To evaluate the capacity of OCT angiography (OCTA) for detecting infraclinical lesions in parafoveal capillaries in diabetic patients without diabetic retinopathy (DR). This prospective observational cross-sectional case-control study analyzed the superficial and deep capillary plexuses (SCP and DCP) on macular OCTA scans (3 × 3 mm) centered on the fovea. We compared 22 diabetic patients (34 eyes included) without DR diagnosis on color fundus photographs, with 22 age- and gender-matched nondiabetic controls (40 eyes included). Qualitative analysis concerned morphological ischemic capillary alterations. Quantitative analysis measured foveal avascular zone (FAZ) size, parafoveal capillary density, and enlargement coefficient of FAZ between SCP and DCP. Neither the qualitative nor quantitative parameters were significantly different between both groups. No microaneurysms or venous tortuosity was observed in any of the analyzed images. On the SCP, the mean FAZ area was 0.322 ± 0.125 mm(2) in diabetic patients and 0.285 ± 0.150 mm(2) in controls, P = 0.31. On the DCP, the mean FAZ area was 0.444 ± 0.153 mm(2) in cases and 0.398 ± 0.138 mm(2) in controls, P = 0.20. OCTA did not detect infraclinical qualitative or quantitative differences in parafoveal capillaries of diabetic patients without DR in comparison with nondiabetic controls.

  1. [Clinical and mammographic screening in a district of Milan: organization, social influence and results].

    PubMed

    Pravettoni, A; Cescon, S; Moro, G; Verga, M; Saibene, F; Micheli, A

    1993-12-01

    A reduction in the mortality rate for breast cancer in women over 50 years undergoing mammographic screening has been reported in many studies. Since the first experience in Florence in 1970, mammographic screenings on a population from different areas of Italy began. We report the experience carried out in the 16th District of Milan among women from 50 to 60 years of age. A promotional activity with the use of local media supported the program. The screening was based on two-view conventional mammography and clinical examination. Immediate response was given to the women. The compliance was 60%. Mainly immigrants, with only primary school education, mothers of several children and freelancers seem to be the main features of the women in the non-attenders group.

  2. Stromal characteristics may hold the key to mammographic density: the evidence to date

    PubMed Central

    Ironside, Alastair J.; Jones, J. Louise

    2016-01-01

    There is strong epidemiological data indicating a role for increased mammographic density (MD) in predisposing to breast cancer, however, the biological mechanisms underlying this phenomenon are less well understood. Recently, studies of human breast tissues have started to characterise the features of mammographically dense breasts, and a number of in-vitro and in-vivo studies have explored the potential mechanisms through which dense breast tissue may exert this tumourigenic risk. This article aims to review both the pathological and biological evidence implicating a key role for the breast stromal compartment in MD, how this may be modified and the clinical significance of these findings. The epidemiological context will be briefly discussed but will not be covered in detail. PMID:26784251

  3. Stromal characteristics may hold the key to mammographic density: the evidence to date.

    PubMed

    Ironside, Alastair J; Jones, J Louise

    2016-05-24

    There is strong epidemiological data indicating a role for increased mammographic density (MD) in predisposing to breast cancer, however, the biological mechanisms underlying this phenomenon are less well understood. Recently, studies of human breast tissues have started to characterise the features of mammographically dense breasts, and a number of in-vitro and in-vivo studies have explored the potential mechanisms through which dense breast tissue may exert this tumourigenic risk. This article aims to review both the pathological and biological evidence implicating a key role for the breast stromal compartment in MD, how this may be modified and the clinical significance of these findings. The epidemiological context will be briefly discussed but will not be covered in detail.

  4. Impact of full field digital mammography on the classification and mammographic characteristics of interval breast cancers.

    PubMed

    Knox, Mark; O'Brien, Angela; Szabó, Endre; Smith, Clare S; Fenlon, Helen M; McNicholas, Michelle M; Flanagan, Fidelma L

    2015-06-01

    Full field digital mammography (FFDM) is increasingly replacing screen film mammography (SFM) in breast screening programs. Interval breast cancers are an issue in all screening programs and the purpose of our study is to assess the impact of FFDM on the classification of interval breast cancers at independent blind review and to compare the mammographic features of interval cancers at FFDM and SFM. This study included 138 cases of interval breast cancer, 76 following an FFDM screening examination and 62 following screening with SFM. The prior screening mammogram was assessed by each of five consultant breast radiologists who were blinded to the site of subsequent cancer. Subsequent review of the diagnostic mammogram was performed and cases were classified as missed, minimal signs, occult or true interval. Mammographic features of the interval cancer at diagnosis and any abnormality identified on the prior screening mammogram were recorded. The percentages of cancers classified as missed at FFDM and SFM did not differ significantly, 10.5% (8 of 76) at FFDM and 8.1% (5 of 62) at SFM (p=.77). There were significantly less interval cancers presenting as microcalcifications (alone or in association with another abnormality) following screening with FFDM, 16% (12 of 76) than following a SFM examination, 32% (20 of 62) (p=.02). Interval breast cancers continue to pose a problem at FFDM. The switch to FFDM has changed the mammographic presentation of interval breast cancer, with less interval cancers presenting in association with microcalcifications. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

  5. Qualitative features of the HIV-specific CD8+ T-cell response associated with immunologic control.

    PubMed

    Hersperger, Adam R; Migueles, Stephen A; Betts, Michael R; Connors, Mark

    2011-05-01

    Over the past 2 years, a clearer picture has emerged regarding the properties of HIV-specific CD8+ T cells associated with immunologic control of HIV replication. These properties represent a potential mechanism by which rare patients might control HIV replication in the absence of antiretroviral therapy. This review addresses the background and recent findings that have lead to our current understanding of these mechanism(s). Patients with immunologic control of HIV are not distinguished by targeted specificities, or greater numbers or breadth of their HIV-specific CD8+ T-cell response. For this reason, recent work has focused greater attention on qualitative features of this response. The qualitative features most closely associated with immunologic control of HIV are related to the granule-exocytosis-mediated elimination of HIV-infected CD4 T cells. The ability of HIV-specific CD8+ T cells to increase their contents of proteins known to mediate cytotoxicity, such as granzyme B and perforin, appears to be a critical means by which HIV-specific cytotoxic capacity is regulated. Investigation from multiple groups has now focused upon HIV-specific CD8+ T-cell granule-exocytosis-mediated cytotoxicity as a correlate of immunologic control of HIV. In the near future, a more detailed understanding of the qualities associated with immunologic control may provide critical insights regarding the necessary features of a response that should be stimulated by immunotherapies or T-cell-based vaccines.

  6. Level set-based core segmentation of mammographic masses facilitating three stage (core, periphery, spiculation) analysis.

    PubMed

    Ball, John E; Bruce, Lori Mann

    2007-01-01

    We present mammographic mass core segmentation, based on the Chan-Vese level set method. The proposed method is analyzed via resulting feature efficacies. Additionally, the core segmentation method is used to investigate the idea of a three stage segmentation approach, i.e. segment the mass core, periphery, and spiculations (if any exist) and use features from these three segmentations to classify the mass as either benign or malignant. The proposed core segmentation method and a proposed end-to-end computer aided detection (CAD) system using a three stage segmentation are implemented and experimentally tested with a set of 60 mammographic images from the Digital Database of Screening Mammography. Receiver operating characteristic (ROC) curve AZ values for morphological and texture features extracted from the core segmentation are shown to be on par, or better, than those extracted from a periphery segmentation. The efficacy of the core segmentation features when combined with the periphery and spiculation segmentation features are shown to be feature set dependent. The proposed end-to-end system uses stepwise linear discriminant analysis for feature selection and a maximum likelihood classifier. Using all three stages (core + periphery + spiculations) results in an overall accuracy (OA) of 90% with 2 false negatives (FN). Since many CAD systems only perform a periphery analysis, adding core features could be a benefit to potentially increase OA and reduce FN cases.

  7. Qualitatively Incorrect Features in the TDDFT Spectrum of Thiophene-Based Compounds

    PubMed Central

    2014-01-01

    Ab initio molecular electronic structure computations of thiophene-based compounds constitute an active field of research prompted by the growing interest in low-cost materials for organic electronic devices. In particular, the modeling of electronically excited states and other time-dependent phenomena has moved toward the description of more realistic albeit challenging systems. We demonstrate that due to its underlying approximations, time-dependent density functional theory predicts results that are qualitatively incorrect for thiophene and thienoacenes, although not for oligothiophene chains. The failure includes spurious state inversion and excitation characters, wrong distribution of oscillator strengths and erroneous potential energy surfaces. We briefly analyze possible origins of this behavior and identify alternative methods that alleviate these problems. PMID:26263085

  8. Using component technologies for web based wavelet enhanced mammographic image visualization.

    PubMed

    Sakellaropoulos, P; Costaridou, L; Panayiotakis, G

    2000-01-01

    The poor contrast detectability of mammography can be dealt with by domain specific software visualization tools. Remote desktop client access and time performance limitations of a previously reported visualization tool are addressed, aiming at more efficient visualization of mammographic image resources existing in web or PACS image servers. This effort is also motivated by the fact that at present, web browsers do not support domain-specific medical image visualization. To deal with desktop client access the tool was redesigned by exploring component technologies, enabling the integration of stand alone domain specific mammographic image functionality in a web browsing environment (web adaptation). The integration method is based on ActiveX Document Server technology. ActiveX Document is a part of Object Linking and Embedding (OLE) extensible systems object technology, offering new services in existing applications. The standard DICOM 3.0 part 10 compatible image-format specification Papyrus 3.0 is supported, in addition to standard digitization formats such as TIFF. The visualization functionality of the tool has been enhanced by including a fast wavelet transform implementation, which allows for real time wavelet based contrast enhancement and denoising operations. Initial use of the tool with mammograms of various breast structures demonstrated its potential in improving visualization of diagnostic mammographic features. Web adaptation and real time wavelet processing enhance the potential of the previously reported tool in remote diagnosis and education in mammography.

  9. Mammographic phenotypes of breast cancer risk driven by breast anatomy

    NASA Astrophysics Data System (ADS)

    Gastounioti, Aimilia; Oustimov, Andrew; Hsieh, Meng-Kang; Pantalone, Lauren; Conant, Emily F.; Kontos, Despina

    2017-03-01

    Image-derived features of breast parenchymal texture patterns have emerged as promising risk factors for breast cancer, paving the way towards personalized recommendations regarding women's cancer risk evaluation and screening. The main steps to extract texture features of the breast parenchyma are the selection of regions of interest (ROIs) where texture analysis is performed, the texture feature calculation and the texture feature summarization in case of multiple ROIs. In this study, we incorporate breast anatomy in these three key steps by (a) introducing breast anatomical sampling for the definition of ROIs, (b) texture feature calculation aligned with the structure of the breast and (c) weighted texture feature summarization considering the spatial position and the underlying tissue composition of each ROI. We systematically optimize this novel framework for parenchymal tissue characterization in a case-control study with digital mammograms from 424 women. We also compare the proposed approach with a conventional methodology, not considering breast anatomy, recently shown to enhance the case-control discriminatory capacity of parenchymal texture analysis. The case-control classification performance is assessed using elastic-net regression with 5-fold cross validation, where the evaluation measure is the area under the curve (AUC) of the receiver operating characteristic. Upon optimization, the proposed breast-anatomy-driven approach demonstrated a promising case-control classification performance (AUC=0.87). In the same dataset, the performance of conventional texture characterization was found to be significantly lower (AUC=0.80, DeLong's test p-value<0.05). Our results suggest that breast anatomy may further leverage the associations of parenchymal texture features with breast cancer, and may therefore be a valuable addition in pipelines aiming to elucidate quantitative mammographic phenotypes of breast cancer risk.

  10. Mammographic breast density and serum phytoestrogen levels.

    PubMed

    Lowry, Sarah J; Sprague, Brian L; Aiello Bowles, Erin J; Hedman, Curtis J; Hemming, Jocelyn; Hampton, John M; Burnside, Elizabeth S; Sisney, Gale A; Buist, Diana S M; Trentham-Dietz, Amy

    2012-08-01

    Some forms of estrogen are associated with breast cancer risk as well as with mammographic density (MD), a strong marker of breast cancer risk. Whether phytoestrogen intake affects breast density, however, remains unclear. We evaluated the association between serum levels of phytoestrogens and MD in postmenopausal women. We enrolled 269 women, ages 55-70 yr, who received a screening mammogram and had no history of postmenopausal hormone use. Subjects completed a survey on diet and factors related to MD and provided a blood sample for analysis of 3 phytoestrogens: genistein, daidzein, and coumestrol. We examined whether mean percent MD was related to serum level of phytoestrogens, adjusting for age and body mass index. Genistein and daidzein levels correlated with self-reported soy consumption. Mean percent MD did not differ across women with different phytoestrogen levels. For example, women with nondetectable genistein levels had mean density of 11.0% [95% confidence intervals (CI) = 9.9-12.4], compared to 10.5% (95% CI = 8.0-13.7) and 11.2% (95% CI = 8.7-14.6) for < and ≥ median detectable levels, respectively. In a population with relatively low soy intake, serum phytoestrogens were not associated with mammographic density. Additional studies are needed to determine effects of higher levels, particularly given patterns of increasing phytoestrogen intake.

  11. Tumor location and detectability in mammographic screening

    SciTech Connect

    Schmitt, E.L.; Threatt, B.

    1982-10-01

    The adequacy of a film mammogram that does not visualize the retromammary space or ribs has concerned radiologists. The 79 prevalent cancers detected in the 10,000 self-referred woman at the University of Michigan Breast Cancer Detection Demonstration Project were analyzed for number of films required to detect the cancer, relationship of the cancer to the posterior edge of the film, number of occult lesions, tumor size, histologic type, sensitivity of detection method, and number of interval carcinomas. The mammograms were obtained using a dedicated mammographic machine and the upright position, with visualization of the anterior axillary fold on the mediolateral view. The ribs were not imaged. Of the 79 cancers, 76 were detectable on the mammogram. All were visualized on the mediolateral view, while three were not imaged on the craniocaudal view. Twelve percent of the cancers were within 1 cm of the posterior edge of the film. Only six ''interval'' carcinomas were found in the 10,000 patients within the year of the initial examinations; these women had dense P2 or DY mammographic parenchymal patterns. The detected cancers were smaller and had a significantly higher percentage of noninvasive cancers than in a symptomatic clinical population. Thus, properly exposed film mammograms using vigorous breast compression examine the breast adequately without visualizing the ribs.

  12. Precursors and trajectories of sensory features: qualitative analysis of infant home videos.

    PubMed

    Freuler, Ashley; Baranek, Grace T; Watson, Linda R; Boyd, Brian A; Bulluck, John C

    2012-01-01

    OBJECTIVE. This study explored precursors and trajectories of extreme sensory patterns in children with autism spectrum disorders (ASD) compared with children with developmental delay (DD). METHOD. We conducted a retrospective analysis of home videos of 12 infants who later displayed extreme presence or absence of three sensory patterns at preschool and school age. RESULTS. In ASD, hyporesponsiveness was most evident in infancy, followed by sensory repetitions. Hyporesponsiveness appeared stable over time and also was a precursor of sensory seeking. Infants with DD had few sensory precursors. CONCLUSION. Precursors of extreme sensory features emerge early in children with ASD and appear relatively stable over time for a pattern of hyporesponsiveness but less stable for patterns of hyperresponsiveness and sensory seeking. These findings highlight the emergent nature of sensory features that may inform early identification and intervention. Copyright © 2012 by the American Occupational Therapy Association, Inc.

  13. The website-based eaTracker® 'My Goals' feature: a qualitative evaluation.

    PubMed

    Lieffers, Jessica Rl; Haresign, Helen; Mehling, Christine; Arocha, Jose F; Hanning, Rhona M

    2017-04-01

    In 2011, Dietitians of Canada added 'My Goals' to its website-based nutrition/activity tracking program (eaTracker®, http://www.eaTracker.ca/); this feature allows users to choose 'ready-made' or 'write-your-own' goals and to self-report progress. The purpose of the present study was to document experiences and perceptions of goal setting and My Goals, and report users' feedback on what is needed in future website-based goal setting/tracking tools. One-on-one semi-structured interviews were conducted with (i) My Goals users and (ii) dietitians providing a public information support service, EatRight Ontario (ERO). My Goals users from Ontario and Alberta, Canada were recruited via an eaTracker website pop-up box; ERO dietitians working in Ontario, Canada were recruited via ERO. My Goals users (n 23; age 19-70 years; 91 % female; n 5 from Alberta/n 18 from Ontario) and ERO dietitians (n 5). Dietitians and users felt goal setting for nutrition (and activity) behaviour change was both a beneficial and a challenging process. Dietitians were concerned about users setting poor-quality goals and users felt it was difficult to stick to their goals. Both users and dietitians were enthusiastic about the My Goals concept, but felt the current feature had limitations that affected use. Dietitians and users provided suggestions to improve My Goals (e.g. more prominent presence of My Goals in eaTracker; assistance with goal setting; automated personalized feedback). Dietitians and users shared similar perspectives on the My Goals feature and both felt goal use was challenging. Several suggestions were provided to enhance My Goals that are relevant to website-based goal setting/tracking tool design in general.

  14. Mammographic parenchymal texture as an imaging marker of hormonal activity: a comparative study between pre- and post-menopausal women

    NASA Astrophysics Data System (ADS)

    Daye, Dania; Bobo, Ezra; Baumann, Bethany; Ioannou, Antonios; Conant, Emily F.; Maidment, Andrew D. A.; Kontos, Despina

    2011-03-01

    Mammographic parenchymal texture patterns have been shown to be related to breast cancer risk. Yet, little is known about the biological basis underlying this association. Here, we investigate the potential of mammographic parenchymal texture patterns as an inherent phenotypic imaging marker of endogenous hormonal exposure of the breast tissue. Digital mammographic (DM) images in the cranio-caudal (CC) view of the unaffected breast from 138 women diagnosed with unilateral breast cancer were retrospectively analyzed. Menopause status was used as a surrogate marker of endogenous hormonal activity. Retroareolar 2.5cm2 ROIs were segmented from the post-processed DM images using an automated algorithm. Parenchymal texture features of skewness, coarseness, contrast, energy, homogeneity, grey-level spatial correlation, and fractal dimension were computed. Receiver operating characteristic (ROC) curve analysis was performed to evaluate feature classification performance in distinguishing between 72 pre- and 66 post-menopausal women. Logistic regression was performed to assess the independent effect of each texture feature in predicting menopause status. ROC analysis showed that texture features have inherent capacity to distinguish between pre- and post-menopausal statuses (AUC>0.5, p<0.05). Logistic regression including all texture features yielded an ROC curve with an AUC of 0.76. Addition of age at menarche, ethnicity, contraception use and hormonal replacement therapy (HRT) use lead to a modest model improvement (AUC=0.78) while texture features maintained significant contribution (p<0.05). The observed differences in parenchymal texture features between pre- and post- menopausal women suggest that mammographic texture can potentially serve as a surrogate imaging marker of endogenous hormonal activity.

  15. Qualitative Features Extraction from Sensor Data using Short-time Fourier Transform

    NASA Technical Reports Server (NTRS)

    Amini, Abolfazl M.; Figueroa, Fernando

    2004-01-01

    The information gathered from sensors is used to determine the health of a sensor. Once a normal mode of operation is established any deviation from the normal behavior indicates a change. This change may be due to a malfunction of the sensor(s) or the system (or process). The step-up and step-down features, as well as sensor disturbances are assumed to be exponential. An RC network is used to model the main process, which is defined by a step-up (charging), drift, and step-down (discharging). The sensor disturbances and spike are added while the system is in drift. The system runs for a period of at least three time-constants of the main process every time a process feature occurs (e.g. step change). The Short-Time Fourier Transform of the Signal is taken using the Hamming window. Three window widths are used. The DC value is removed from the windowed data prior to taking the FFT. The resulting three dimensional spectral plots provide good time frequency resolution. The results indicate distinct shapes corresponding to each process.

  16. Qualitative and quantitative comparison of colonic microendoscopy image features to histopathology

    NASA Astrophysics Data System (ADS)

    Prieto, Sandra P.; Powless, Amy J.; Lai, Keith; Laryea, Jonathan A.; Mizell, Jason S.; Muldoon, Timothy J.

    2015-03-01

    Colorectal cancer is the second leading cause of cancer deaths in the United States, affecting more than 130,000 Americans every year1. Determining tumor margins prior to surgical resection is essential to providing optimal treatment and reducing recurrence rates. Colorectal cancer recurrence can occur in up to 20% of cases, commonly within three years after curative treatment. Typically, when colorectal cancers are resected, a margin of normal tissue on both sides of the tumor is required. The minimum margin required for colon cancer is 5 cm and for the lower rectum 2 cm. However, usually more normal tissue is taken on both sides of the tumor because the blood supply to the entire segment is removed with the surgery and therefore the entire segment must be removed. Anastomotic recurrences may result from inadequate margins. Pathologists look at the margins to ensure that there is no residual tumor and this is usually documented in the pathology report. We have developed a portable, point-of-care fiber bundle microendoscopy imaging system for detection of abnormalities in colonic epithelial microstructure. The system comprises a laptop, a modified fiber bundle image guide with a 1mm active area diameter and custom LabVIEW interface, and is approved for imaging surgically resected colon tissue at the University of Arkansas for Medical Sciences. The microendoscopy probe provides high-resolution images of superficial epithelial histology in real-time to assist surgical guidance and to localize occult regions of dysplasia which may not be visible. Microendoscopy images of freshly resected human colonic epithelium were acquired using the microendoscopy device and subsequently mosaicked using custom post-processing software. Architectural changes in the glands were mapped to histopathology H&E slides taken from the precise location of the microendoscopy images. Qualitatively, glandular distortion and placement of image guide was used to map normal and dysplastic areas of

  17. Qualitative and quantitative comparison of colonic microendoscopy image features to histopathology

    PubMed Central

    Prieto, Sandra P.; Powless, Amy J.; Lai, Keith; Laryea, Jonathan A.; Mizell, Jason S.; Muldoon, Timothy J.

    2015-01-01

    Colorectal cancer is the second leading cause of cancer deaths in the United States, affecting more than 130,000 Americans every year1. Determining tumor margins prior to surgical resection is essential to providing optimal treatment and reducing recurrence rates. Colorectal cancer recurrence can occur in up to 20% of cases, commonly within three years after curative treatment. Typically, when colorectal cancers are resected, a margin of normal tissue on both sides of the tumor is required. The minimum margin required for colon cancer is 5 cm and for the lower rectum 2 cm. However, usually more normal tissue is taken on both sides of the tumor because the blood supply to the entire segment is removed with the surgery and therefore the entire segment must be removed. Anastomotic recurrences may result from inadequate margins. Pathologists look at the margins to ensure that there is no residual tumor and this is usually documented in the pathology report. We have developed a portable, point-of-care fiber bundle microendoscopy imaging system for detection of abnormalities in colonic epithelial microstructure. The system comprises a laptop, a modified fiber bundle image guide with a 1mm active area diameter and custom Lab VIEW interface, and is approved for imaging surgically resected colon tissue at the University of Arkansas for Medical Sciences. The microendoscopy probe provides high-resolution images of superficial epithelial histology in real-time to assist surgical guidance and to localize occult regions of dysplasia which may not be visible. Microendoscopy images of freshly resected human colonic epithelium were acquired using the microendoscopy device and subsequently mosaicked using custom post-processing software. Architectural changes in the glands were mapped to histopathology H&E slides taken from the precise location of the microendoscopy images. Qualitatively, glandular distortion and placement of image guide was used to map normal and dysplastic areas

  18. Qualitative and quantitative comparison of colonic microendoscopy image features to histopathology.

    PubMed

    Prieto, Sandra P; Powless, Amy J; Lai, Keith; Laryea, Jonathan A; Mizell, Jason S; Muldoon, Timothy J

    2015-04-09

    Colorectal cancer is the second leading cause of cancer deaths in the United States, affecting more than 130,000 Americans every year(1). Determining tumor margins prior to surgical resection is essential to providing optimal treatment and reducing recurrence rates. Colorectal cancer recurrence can occur in up to 20% of cases, commonly within three years after curative treatment. Typically, when colorectal cancers are resected, a margin of normal tissue on both sides of the tumor is required. The minimum margin required for colon cancer is 5 cm and for the lower rectum 2 cm. However, usually more normal tissue is taken on both sides of the tumor because the blood supply to the entire segment is removed with the surgery and therefore the entire segment must be removed. Anastomotic recurrences may result from inadequate margins. Pathologists look at the margins to ensure that there is no residual tumor and this is usually documented in the pathology report. We have developed a portable, point-of-care fiber bundle microendoscopy imaging system for detection of abnormalities in colonic epithelial microstructure. The system comprises a laptop, a modified fiber bundle image guide with a 1mm active area diameter and custom Lab VIEW interface, and is approved for imaging surgically resected colon tissue at the University of Arkansas for Medical Sciences. The microendoscopy probe provides high-resolution images of superficial epithelial histology in real-time to assist surgical guidance and to localize occult regions of dysplasia which may not be visible. Microendoscopy images of freshly resected human colonic epithelium were acquired using the microendoscopy device and subsequently mosaicked using custom post-processing software. Architectural changes in the glands were mapped to histopathology H&E slides taken from the precise location of the microendoscopy images. Qualitatively, glandular distortion and placement of image guide was used to map normal and dysplastic areas

  19. Mammographic density, lobular involution, and risk of breast cancer

    PubMed Central

    Ginsburg, O M; Martin, L J; Boyd, N F

    2008-01-01

    In this review, we propose that age-related changes in mammographic density and breast tissue involution are closely related phenomena, and consider their potential relevance to the aetiology of breast cancer. We propose that the reduction in mammographic density that occurs with increasing age, parity and menopause reflects the involution of breast tissue. We further propose that age-related changes in both mammographic density and breast tissue composition are observable and measurable phenomena that resemble Pike's theoretical construct of ‘breast tissue ageing'. Extensive mammographic density and delayed breast involution are both associated with an increased risk of breast cancer and are consistent with the hypothesis of the Pike model that cumulative exposure of breast tissue to hormones and growth factors that stimulate cell division, as well as the accumulation of genetic damage in breast cells, are major determinants of breast cancer incidence. PMID:18781174

  20. Understanding Clinical Mammographic Breast Density Assessment: a Deep Learning Perspective.

    PubMed

    Mohamed, Aly A; Luo, Yahong; Peng, Hong; Jankowitz, Rachel C; Wu, Shandong

    2017-09-20

    Mammographic breast density has been established as an independent risk marker for developing breast cancer. Breast density assessment is a routine clinical need in breast cancer screening and current standard is using the Breast Imaging and Reporting Data System (BI-RADS) criteria including four qualitative categories (i.e., fatty, scattered density, heterogeneously dense, or extremely dense). In each mammogram examination, a breast is typically imaged with two different views, i.e., the mediolateral oblique (MLO) view and cranial caudal (CC) view. The BI-RADS-based breast density assessment is a qualitative process made by visual observation of both the MLO and CC views by radiologists, where there is a notable inter- and intra-reader variability. In order to maintain consistency and accuracy in BI-RADS-based breast density assessment, gaining understanding on radiologists' reading behaviors will be educational. In this study, we proposed to leverage the newly emerged deep learning approach to investigate how the MLO and CC view images of a mammogram examination may have been clinically used by radiologists in coming up with a BI-RADS density category. We implemented a convolutional neural network (CNN)-based deep learning model, aimed at distinguishing the breast density categories using a large (15,415 images) set of real-world clinical mammogram images. Our results showed that the classification of density categories (in terms of area under the receiver operating characteristic curve) using MLO view images is significantly higher than that using the CC view. This indicates that most likely it is the MLO view that the radiologists have predominately used to determine the breast density BI-RADS categories. Our study holds a potential to further interpret radiologists' reading characteristics, enhance personalized clinical training to radiologists, and ultimately reduce reader variations in breast density assessment.

  1. Influences of organizational features of healthcare settings on clinical decision making: Qualitative results from a cross-national factorial experiment*

    PubMed Central

    Lutfey, Karen E.; Campbell, Stephen M.; Marceau, Lisa D.; Roland, Martin O.; McKinlay, John B.

    2013-01-01

    A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians’ explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the US, are discussed. PMID:21177712

  2. Influences of organizational features of healthcare settings on clinical decision making: qualitative results from a cross-national factorial experiment.

    PubMed

    Lutfey, Karen E; Campbell, Stephen M; Marceau, Lisa D; Roland, Martin O; McKinlay, John B

    2012-01-01

    A proliferating literature documents cross-national variation in medical practice and seeks to explain observed differences in terms of the presence of certain kinds of healthcare systems, economic, and cultural differences between countries. Less is known about how providers themselves understand these influences and perceive them as relevant to their clinical work. Using qualitative data from a cross-national factorial experiment in the United States and United Kingdom, we analyze 244 primary care physicians' explanations of how organizational features of their respective healthcare settings influence the treatment decisions they made for a vignette patient, including affordability of care; within-system quality deficits; and constraints due to patient behavior. While many differences are attributed to financial constraints deriving from two very differently structured healthcare systems, in other ways they are reflections of cultural and historical expectations regarding medical care, or interactions between the two. Implications, including possible challenges to the implementation of universal care in the USA, are discussed.

  3. Impedance mammograph 3D phantom studies.

    PubMed

    Wtorek, J; Stelter, J; Nowakowski, A

    1999-04-20

    The results obtained using the Technical University of Gdansk Electroimpedance Mammograph (TUGEM) of a 3D phantom study are presented. The TUGEM system is briefly described. The hardware contains the measurement head and DSP-based identification modules controlled by a PC computer. A specially developed reconstruction algorithm, Regulated Correction Frequency Algebraic Reconstruction Technique (RCFART), is used to obtain 3D images. To visualize results, the Advance Visualization System (AVS) is used. It allows a powerful image processing on a fast workstation or on a high-performance computer. Results of three types of 3D conductivity perturbations used in the study (aluminum, Plexiglas, and cucumber) are shown. The relative volumes of perturbations less than 2% of the measurement chamber are easily evidenced.

  4. Determining efficacy of mammographic CAD systems.

    PubMed

    Hoffmeister, Jeffrey W; Rogers, Steven K; DeSimio, Martin P; Brem, Rachel F

    2002-01-01

    Computer-aided detection (CAD) system sensitivity estimates without a radiologist in the loop are straightforward to measure but are extremely data dependent. The only relevant performance metric is improvement in CAD-assisted radiologist sensitivity. Unfortunately, this is difficult to accurately assess. Without a large study measuring the improvement in CAD-assisted radiologist sensitivity over the same cases, it is not possible to make valid comparisons between systems. As multiple CAD systems become commercially available, comparison issues need to be explored and resolved. Data from clinical trials of 2 systems are examined. Statistical hypothesis tests are applied to these data. Additionally, sensitivities of 2 systems are compared from an experiment testing over the same 120 cases. Even with large databases, there is not sufficient evidence to conclude performance differences exist between the 2 systems. It is prohibitively expensive to show conclusive sensitivity differences between commercially available mammographic CAD systems.

  5. On the orientation of mammographic structure

    PubMed Central

    Reiser, I.; Lee, S.; Nishikawa, R. M.

    2011-01-01

    Purpose: Burgess et al. have shown that the power-spectral density of mammographic breast tissue P(f) follows a power-law, P(f) = c/fβ.1 Due to the complexity of the breast anatomy, breast phantoms often make use of power-law backgrounds to approximate the irregular texture of breast images. However, the current methodology of estimating power-law coefficients assumes that the breast structure is isotropic. The purpose of this letter is to demonstrate that breast anatomic structure is not isotropic, but in fact has a preferred orientation. Further, we present a formalism to estimate power-law coefficients β and c while accounting for tissue orientation in mammographic regions-of-interests (ROIs). We then show the effect of structure orientation on β and c, as well as on the appearance of simulated power-law backgrounds. Methods: When breast tissue exhibits a preferred orientation, the radial symmetry in the associated power spectrum is broken. The new symmetry was fit by an ellipsoidal model. Ellipse tilt angle and axis ratio were accounted for in the power-law fit. Results: On average, breast structure was found to point toward the nipple: the average orientation in MLO views was 22.5 °, while it was 5 ° for CC views, and the mean orientation for left breasts was negative while it was positive for right breasts. For both power-law magnitude and exponent, the mean difference was statistically significant (<Δβ > = −0.096, <Δlog(c) > =−0.192). Conclusions: A formalism for quantification of breast structure and structure orientation is provided. The difference in power-law coefficient estimates when accounting for orientation was found to be statistically significant. Examples of statistically defined backgrounds indicate that breast structure is mimicked more closely when structure orientation is accounted for. PMID:21992347

  6. Development and application of a segmentation routine in a mammographic mass CAD system

    NASA Astrophysics Data System (ADS)

    Catarious, David M., Jr.; Baydush, Alan H.; Floyd, Carey E., Jr.

    2004-05-01

    The purpose of this paper is to present a new segmentation routine developed for mammographic masses. We previously developed a computer-aided detection (CAD) system for mammographic masses that employed a simple but imprecise segmentation procedure. To improve the systems performance, an iterative, linear segmentation routine was developed. The routine begins by employing a linear discriminant function to determine the optimal threshold between estimates of an objects interior and exterior pixels. After applying the threshold and identifying the objects outline, two constraints are applied to minimize the influence of extraneous background structures. Each iteration further refines the outline until the stopping criterion is reached. The segmentation algorithm was tested on a database of 181 mammographic images that contained forty-nine malignant and fifty benign masses. A set of suspicious regions of interest (ROIs) was found using the previous CAD system. Twenty features were measured from the regions before and after applying the new segmentation routine. The difference in the features discriminatory ability was examined via receiver operating characteristic (ROC) analysis. A significant performance difference was observed in many features, particularly those describing the object border. Free-response ROC (FROC) curves were utilized to examine how the overall CAD system performance changed with the inclusion of the segmentation routine. The FROC performance appeared to be improved, especially for malignant masses. When detecting 90% of the malignant masses, the previous system achieved 4.4 false positives per image (FPpI) compared to the post-segmentation systems 3.7 FPpI. At 85%, the respective FPpI are 4.1 and 2.1.

  7. Computer-aided diagnosis of mammographic masses using geometric verification-based image retrieval

    NASA Astrophysics Data System (ADS)

    Li, Qingliang; Shi, Weili; Yang, Huamin; Zhang, Huimao; Li, Guoxin; Chen, Tao; Mori, Kensaku; Jiang, Zhengang

    2017-03-01

    Computer-Aided Diagnosis of masses in mammograms is an important indicator of breast cancer. The use of retrieval systems in breast examination is increasing gradually. In this respect, the method of exploiting the vocabulary tree framework and the inverted file in the mammographic masse retrieval have been proved high accuracy and excellent scalability. However it just considered the features in each image as a visual word and had ignored the spatial configurations of features. It greatly affect the retrieval performance. To overcome this drawback, we introduce the geometric verification method to retrieval in mammographic masses. First of all, we obtain corresponding match features based on the vocabulary tree framework and the inverted file. After that, we grasps the main point of local similarity characteristic of deformations in the local regions by constructing the circle regions of corresponding pairs. Meanwhile we segment the circle to express the geometric relationship of local matches in the area and generate the spatial encoding strictly. Finally we judge whether the matched features are correct or not, based on verifying the all spatial encoding are whether satisfied the geometric consistency. Experiments show the promising results of our approach.

  8. Childhood factors associated with mammographic density in adult women.

    PubMed

    Lope, Virginia; Pérez-Gómez, Beatriz; Moreno, María Pilar; Vidal, Carmen; Salas-Trejo, Dolores; Ascunce, Nieves; Román, Isabel González; Sánchez-Contador, Carmen; Santamariña, María Carmen; Carrete, Jose Antonio Vázquez; Collado-García, Francisca; Pedraz-Pingarrón, Carmen; Ederra, María; Ruiz-Perales, Francisco; Peris, Mercé; Abad, Soledad; Cabanes, Anna; Pollán, Marina

    2011-12-01

    Growth and development factors could contribute to the development of breast cancer associated with an increase in mammographic density. This study examines the influence of certain childhood-related, socio-demographic and anthropometric variables on mammographic density in adult woman. The study covered 3574 women aged 45-68 years, participating in breast cancer-screening programmes in seven Spanish cities. Based on a craniocaudal mammogram, blind, anonymous measurement of mammographic density was made by a single radiologist, using Boyd's semiquantitative scale. Data associated with the early stages of life were obtained from a direct survey. Ordinal logistic regression and generalised linear models were employed to estimate the association between mammographic density and the variables covered by the questionnaire. Screening programme was introduced as a random effects term. Age, number of children, body mass index (BMI) and other childhood-related variables were used as adjustment variables, and stratified by menopausal status. A total of 811 women (23%) presented mammographic density of over 50%, and 5% of densities exceeded 75%. Our results show a greater prevalence of high mammographic density in women with low prepubertal weight (OR: 1.18; 95% CI: 1.02-1.36); marked prepubertal height (OR: 1.25; 95% CI: 0.97-1.60) and advanced age of their mothers at their birth (>39 years: OR: 1.28; 95% CI: 1.03-1.60); and a lower prevalence of high mammographic density in women with higher prepubertal weight, low birth weight and earlier menarche. The influence of these early-life factors may be explained by greater exposure to hormones and growth factors during the development of the breast gland, when breast tissue would be particularly susceptible to proliferative and carcinogenic stimulus.

  9. Alcohol intake over the life course and mammographic density.

    PubMed

    Flom, Julie D; Ferris, Jennifer S; Tehranifar, Parisa; Terry, Mary Beth

    2009-10-01

    Alcohol intake is one of the few modifiable risk factors for breast cancer. Current alcohol intake has been associated with mammographic density, a strong intermediate marker of breast cancer risk, though few studies have examined the effect of both current and average lifetime alcohol intake. We interviewed 262 participants from a New York birth cohort (born 1959-1963) and obtained mammograms from 163 (71.5% of participants with a mammogram). We collected information on alcohol intake by beverage type separately for each decade of life. We used multivariable linear models to assess the associations between current and average lifetime alcohol intake and mammographic density using a quantitative measure of density from digitized images. Overall, current alcohol intake was more strongly associated with mammographic density than average lifetime alcohol intake; compared with nondrinkers, those with current intake of seven or more servings per week had on average 12.3% (95% CI: 4.3, 20.4) higher density, adjusted for average lifetime alcohol intake, age, and body mass index. We observed a consistent inverse association for red wine intake and mammographic density, suggesting that the positive association between mammographic density and overall alcohol intake was driven by other types of alcoholic beverages. Our findings support an association between current alcohol intake and increased mammographic density independent of the effect of average lifetime alcohol intake. If replicated, our study suggests that reducing current alcohol consumption, particularly beer and white wine intake, may be a means of reducing mammographic density regardless of intake earlier in life.

  10. Influence of lifestyle factors on mammographic density in postmenopausal women.

    PubMed

    Brand, Judith S; Czene, Kamila; Eriksson, Louise; Trinh, Thang; Bhoo-Pathy, Nirmala; Hall, Per; Celebioglu, Fuat

    2013-01-01

    Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density. We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied. Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07). This association was modified by HRT use (P interaction  = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01) but not in non-current users (P trend  = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk.

  11. Influence of Lifestyle Factors on Mammographic Density in Postmenopausal Women

    PubMed Central

    Brand, Judith S.; Czene, Kamila; Eriksson, Louise; Trinh, Thang; Bhoo-Pathy, Nirmala; Hall, Per; Celebioglu, Fuat

    2013-01-01

    Background Mammographic density is a strong risk factor for breast cancer. Apart from hormone replacement therapy (HRT), little is known about lifestyle factors that influence breast density. Methods We examined the effect of smoking, alcohol and physical activity on mammographic density in a population-based sample of postmenopausal women without breast cancer. Lifestyle factors were assessed by a questionnaire and percentage and area measures of mammographic density were measured using computer-assisted software. General linear models were used to assess the association between lifestyle factors and mammographic density and effect modification by body mass index (BMI) and HRT was studied. Results Overall, alcohol intake was positively associated with percent mammographic density (P trend  = 0.07). This association was modified by HRT use (P interaction  = 0.06): increasing alcohol intake was associated with increasing percent density in current HRT users (P trend  = 0.01) but not in non-current users (P trend  = 0.82). A similar interaction between alcohol and HRT was found for the absolute dense area, with a positive association being present in current HRT users only (P interaction  = 0.04). No differences in mammographic density were observed across categories of smoking and physical activity, neither overall nor in stratified analyses by BMI and HRT use. Conclusions Increasing alcohol intake is associated with an increase in mammography density, whereas smoking and physical activity do not seem to influence density. The observed interaction between alcohol and HRT may pose an opportunity for HRT users to lower their mammographic density and breast cancer risk. PMID:24349146

  12. Characterization of difference of Gaussian filters in the detection of mammographic regions

    SciTech Connect

    Catarious, David M. Jr.; Baydush, Alan H.; Floyd, Carey E. Jr.

    2006-11-15

    In this article, we present a characterization of the effect of difference of Gaussians (DoG) filters in the detection of mammographic regions. DoG filters have been used previously in mammographic mass computer-aided detection (CAD) systems. As DoG filters are constructed from the subtraction of two bivariate Gaussian distributions, they require the specification of three parameters: the size of the filter template and the standard deviations of the constituent Gaussians. The influence of these three parameters in the detection of mammographic masses has not been characterized. In this work, we aim to determine how the parameters affect (1) the physical descriptors of the detected regions (2) the true and false positive rates, and (3) the classification performance of the individual descriptors. To this end, 30 DoG filters are created from the combination of three template sizes and four values for each of the Gaussians' standard deviations. The filters are used to detect regions in a study database of 181 craniocaudal-view mammograms extracted from the Digital Database for Screening Mammography. To describe the physical characteristics of the identified regions, morphological and textural features are extracted from each of the detected regions. Differences in the mean values of the features caused by altering the DoG parameters are examined through statistical and empirical comparisons. The parameters' effects on the true and false positive rate are determined by examining the mean malignant sensitivities and false positives per image (FPpI). Finally, the effect on the classification performance is described by examining the variation in FPpI at the point where 81% of the malignant masses in the study database are detected. Overall, the findings of the study indicate that increasing the standard deviations of the Gaussians used to construct a DoG filter results in a dramatic decrease in the number of regions identified at the expense of missing a small number of

  13. Characterization of difference of Gaussian filters in the detection of mammographic regions.

    PubMed

    Catarious, David M; Baydush, Alan H; Floyd, Carey E

    2006-11-01

    In this article, we present a characterization of the effect of difference of Gaussians (DoG) filters in the detection of mammographic regions. DoG filters have been used previously in mammographic mass computer-aided detection (CAD) systems. As DoG filters are constructed from the subtraction of two bivariate Gaussian distributions, they require the specification of three parameters: the size of the filter template and the standard deviations of the constituent Gaussians. The influence of these three parameters in the detection of mammographic masses has not been characterized. In this work, we aim to determine how the parameters affect (1) the physical descriptors of the detected regions, (2) the true and false positive rates, and (3) the classification performance of the individual descriptors. To this end, 30 DoG filters are created from the combination of three template sizes and four values for each of the Gaussians' standard deviations. The filters are used to detect regions in a study database of 181 craniocaudal-view mammograms extracted from the Digital Database for Screening Mammography. To describe the physical characteristics of the identified regions, morphological and textural features are extracted from each of the detected regions. Differences in the mean values of the features caused by altering the DoG parameters are examined through statistical and empirical comparisons. The parameters' effects on the true and false positive rate are determined by examining the mean malignant sensitivities and false positives per image (FPpI). Finally, the effect on the classification performance is described by examining the variation in FPpI at the point where 81% of the malignant masses in the study database are detected. Overall, the findings of the study indicate that increasing the standard deviations of the Gaussians used to construct a DoG filter results in a dramatic decrease in the number of regions identified at the expense of missing a small number

  14. Volume of Mammographic Density and Risk of Breast Cancer

    PubMed Central

    Shepherd, John A.; Kerlikowske, Karla; Ma, Lin; Duewer, Frederick; Fan, Bo; Wang, Jeff; Malkov, Sergei; Vittinghoff, Eric; Cummings, Steven R.

    2011-01-01

    Background Assessing the volume of mammographic density might more accurately reflect the amount of breast volume at risk of malignant transformation and provide a stronger indication of risk of breast cancer than methods based on qualitative scores or dense breast area. Methods We prospectively collected mammograms for women undergoing screening mammography. We determined the diagnosis of subsequent invasive or ductal carcinoma in situ (DCIS) for 275 cases, selected 825 controls matched for age, ethnicity, and mammography system, and assessed three measures of breast density: percent dense area, fibroglandular volume, and percent fibroglandular volume. Results After adjustment for familial breast cancer history, body mass index, history of breast biopsy, and age at first live birth, the odds ratios for breast cancer risk in the highest versus lowest measurement quintiles were 2.5 (95% CI: 1.5, 4.3) for percent dense area, 2.9 (95% CI: 1.7, 4.9) for fibroglandular volume, and 4.1 (95% CI: 2.3, 7.2) for percent fibroglandular volume. Net reclassification indexes for density measures plus risk factors versus risk factors alone were 9.6% (P=0.07) for percent dense area, 21.1% (P=0.0001) for fibroglandular volume, and 14.8% (P=0.004) for percent fibroglandular volume. Fibroglandular volume improved the categorical risk classification of 1 in 5 women for both women with and without breast cancer. Conclusion Volumetric measures of breast density are more accurate predictors of breast cancer risk than risk factors alone and than percent dense area. Impact Risk models including dense fibroglandular volume may more accurately predict breast cancer risk than current risk models. PMID:21610220

  15. Roles of biologic breast tissue composition and quantitative image analysis of mammographic images in breast tumor characterization

    NASA Astrophysics Data System (ADS)

    Drukker, Karen; Giger, Maryellen L.; Duewer, Fred; Malkov, Serghei; Flowers, Christopher I.; Joe, Bonnie; Kerlikowske, Karla; Drukteinis, Jennifer S.; Shepherd, John

    2014-03-01

    Purpose. Investigate whether knowledge of the biologic image composition of mammographic lesions provides imagebased biomarkers above and beyond those obtainable from quantitative image analysis (QIA) of X-ray mammography. Methods. The dataset consisted of 45 in vivo breast lesions imaged with the novel 3-component breast (3CB) imaging technique based on dual-energy mammography (15 malignant, 30 benign diagnoses). The 3CB composition measures of water, lipid, and protein thicknesses were assessed and mathematical descriptors, `3CB features', were obtained for the lesions and their periphery. The raw low-energy mammographic images were analyzed with an established in-house QIA method obtaining `QIA features' describing morphology and texture. We investigated the correlation within the `3CB features', within the `QIA features', and between the two. In addition, the merit of individual features in the distinction between malignant and benign lesions was assessed. Results. Whereas many descriptors within the `3CB features' and `QIA features' were, often by design, highly correlated, correlation between descriptors of the two feature groups was much weaker (maximum absolute correlation coefficient 0.58, p<0.001) indicating that 3CB and QIA-based biomarkers provided potentially complementary information. Single descriptors from 3CB and QIA appeared equally well-suited for the distinction between malignant and benign lesions, with maximum area under the ROC curve 0.71 for a protein feature (3CB) and 0.71 for a texture feature (QIA). Conclusions. In this pilot study analyzing the new 3CB imaging modality, knowledge of breast tissue composition appeared additive in combination with existing mammographic QIA methods for the distinction between benign and malignant lesions.

  16. Circulating serum xenoestrogens and mammographic breast density

    PubMed Central

    2013-01-01

    Introduction Humans are widely exposed to estrogenically active phthalates, parabens, and phenols, raising concerns about potential effects on breast tissue and breast cancer risk. We sought to determine the association of circulating serum levels of these chemicals (reflecting recent exposure) with mammographic breast density (a marker of breast cancer risk). Methods We recruited postmenopausal women aged 55 to 70 years from mammography clinics in Madison, Wisconsin (N = 264). Subjects completed a questionnaire and provided a blood sample that was analyzed for mono-ethyl phthalate, mono-butyl phthalate, mono-benzyl phthalate, butyl paraben, propyl paraben, octylphenol, nonylphenol, and bisphenol A (BPA). Percentage breast density was measured from mammograms by using a computer-assisted thresholding method. Results Serum BPA was positively associated with mammographic breast density after adjusting for age, body mass index, and other potentially confounding factors. Mean percentage density was 12.6% (95% confidence interval (CI), 11.4 to 14.0) among the 193 women with nondetectable BPA levels, 13.7% (95% CI, 10.7 to 17.1) among the 35 women with detectable levels below the median (<0.55 ng/ml), and 17.6% (95% CI, 14.1 to 21.5) among the 34 women with detectable levels above the median (>0.55 ng/ml; Ptrend = 0.01). Percentage breast density was also elevated (18.2%; 95% CI, 13.4 to 23.7) among the 18 women with serum mono-ethyl phthalate above the median detected level (>3.77 ng/ml) compared with women with nondetectable BPA levels (13.1%; 95% CI, 11.9 to 14.3; Ptrend = 0.07). No other chemicals demonstrated associations with percentage breast density. Conclusions Postmenopausal women with high serum levels of BPA and mono-ethyl phthalate had elevated breast density. Further investigation of the impact of BPA and mono-ethyl phthalate on breast cancer risk by using repeated serum measurements or other markers of xenoestrogen exposure are needed. PMID:23710608

  17. Volumetric mammographic density: heritability and association with breast cancer susceptibility loci.

    PubMed

    Brand, Judith S; Humphreys, Keith; Thompson, Deborah J; Li, Jingmei; Eriksson, Mikael; Hall, Per; Czene, Kamila

    2014-12-01

    Mammographic density is a strong heritable trait, but data on its genetic component are limited to area-based and qualitative measures. We studied the heritability of volumetric mammographic density ascertained by a fully-automated method and the association with breast cancer susceptibility loci. Heritability of volumetric mammographic density was estimated with a variance component model in a sib-pair sample (N pairs = 955) of a Swedish screening based cohort. Associations with 82 established breast cancer loci were assessed in an independent sample of the same cohort (N = 4025 unrelated women) using linear models, adjusting for age, body mass index, and menopausal status. All tests were two-sided, except for heritability analyses where one-sided tests were used. After multivariable adjustment, heritability estimates (standard error) for percent dense volume, absolute dense volume, and absolute nondense volume were 0.63 (0.06) and 0.43 (0.06) and 0.61 (0.06), respectively (all P < .001). Percent and absolute dense volume were associated with rs10995190 (ZNF365; P = 9.0 × 10(-6) and 8.9 × 10(-7), respectively) and rs9485372 (TAB2; P = 1.8 × 10(-5) and 1.8 × 10(-3), respectively). We also observed associations of rs9383938 (ESR1) and rs2046210 (ESR1) with the absolute dense volume (P = 2.6 × 10(-4) and 4.6 × 10(-4), respectively), and rs6001930 (MLK1) and rs17356907 (NTN4) with the absolute nondense volume (P = 6.7 × 10(-6) and 8.4 × 10(-5), respectively). Our results support the high heritability of mammographic density, though estimates are weaker for absolute than percent dense volume. We also demonstrate that the shared genetic component with breast cancer is not restricted to dense tissues only. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please e-mail: journals.permissions@oup.com.

  18. No association between 25-hydroxyvitamin D and mammographic density.

    PubMed

    Knight, Julia A; Vachon, Celine M; Vierkant, Robert A; Vieth, Reinhold; Cerhan, James R; Sellers, Thomas A

    2006-10-01

    There is increasing evidence that vitamin D may protect against breast cancer. Some studies have suggested that dietary and supplemental vitamin D is associated with reduced mammographic density, which is highly associated with breast cancer risk, although this evidence is not entirely consistent. We investigated a possible association between circulating 25-hydroxyvitamin D (25OHD), the best indicator of vitamin D status, and quantitative mammographic density in the Minnesota Breast Cancer Family Study. Mean values of mammographic density (both percent and area densities) and circulating levels of 25OHD were compared across categories of covariates using ANOVA. Models were adjusted for age and body mass index, as well as other covariates, and also stratified by dietary calcium intake, menopause, and season. Serum, mammographic density, and questionnaire data were available from 487 women [133 premenopausal and 354 postmenopausal; mean age, 56.4 years (range, 27-85 years)] without breast cancer, and for 73%, the blood was drawn within 1 year of their mammogram. No evidence was found for an association between 25OHD and either percent density or total dense area. There was also no evidence for any association when the data were stratified by season of sample (winter and summer) or menopause. However, both percent density and dense area were lowest among those in the highest vitamin D quartile with calcium intake above the median. Unlike some previous reports, vitamin D does not seem to be related to mammographic density in this cohort.

  19. A Review on Automatic Mammographic Density and Parenchymal Segmentation

    PubMed Central

    He, Wenda; Juette, Arne; Denton, Erika R. E.; Oliver, Arnau

    2015-01-01

    Breast cancer is the most frequently diagnosed cancer in women. However, the exact cause(s) of breast cancer still remains unknown. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective way to tackle breast cancer. There are more than 70 common genetic susceptibility factors included in the current non-image-based risk prediction models (e.g., the Gail and the Tyrer-Cuzick models). Image-based risk factors, such as mammographic densities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction models used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer aided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue composition to facilitate mammographic risk assessment. This paper presents a comprehensive review of automatic mammographic tissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification using segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic mammographic tissue segmentation has in a clinical environment, as well as to understand the current research gaps with respect to the incorporation of image-based risk factors in non-image-based risk prediction models. PMID:26171249

  20. What features do Dutch university students prefer in a smartphone application for promotion of physical activity? A qualitative approach.

    PubMed

    Middelweerd, Anouk; van der Laan, Danielle M; van Stralen, Maartje M; Mollee, Julia S; Stuij, Mirjam; te Velde, Saskia J; Brug, Johannes

    2015-03-01

    The transition from adolescence to early adulthood is a critical period in which there is a decline in physical activity (PA). College and university students make up a large segment of this age group. Smartphones may be used to promote and support PA. The purpose of this qualitative study was to explore Dutch students' preferences regarding a PA application (PA app) for smartphones. Thirty Dutch students (aged 18-25 years) used a PA app for three weeks and subsequently attended a focus group discussion (k = 5). To streamline the discussion, a discussion guide was developed covering seven main topics, including general app usage, usage and appreciation of the PA app, appreciation of and preferences for its features and the sharing of PA accomplishments through social media. The discussions were audio and video recorded, transcribed and analysed according to conventional content analysis. The participants, aged 21 ± 2 years, were primarily female (67%). Several themes emerged: app usage, technical aspects, PA assessment, coaching aspects and sharing through social media. Participants most often used social networking apps (e.g., Facebook or Twitter), communication apps (e.g., WhatsApp) and content apps (e.g., news reports or weather forecasts). They preferred a simple and structured layout without unnecessary features. Ideally, the PA app should enable users to tailor it to their personal preferences by including the ability to hide features. Participants preferred a companion website for detailed information about their accomplishments and progress, and they liked tracking their workout using GPS. They preferred PA apps that coached and motivated them and provided tailored feedback toward personally set goals. They appreciated PA apps that enabled competition with friends by ranking or earning rewards, but only if the reward system was transparent. They were not willing to share their regular PA accomplishments through social media unless they were

  1. Natural enamel caries in polarized light microscopy: differences in histopathological features derived from a qualitative versus a quantitative approach to interpret enamel birefringence.

    PubMed

    De Medeiros, R C G; Soares, J D; De Sousa, F B

    2012-05-01

    Lesion area measurement of enamel caries using polarized light microscopy (PLM) is currently performed in a large number of studies, but measurements are based mainly on a mislead qualitative interpretation of enamel birefringence in a single immersion medium. Here, five natural enamel caries lesions are analysed by microradiography and in PLM, and the differences in their histopathological features derived from a qualitative versus a quantitative interpretation of enamel birefringence are described. Enamel birefringence in different immersion media (air, water and quinoline) is interpreted by both qualitative and quantitative approaches, the former leading to an underestimation of the depth of enamel caries mainly when the criterion of validating sound enamel as a negatively birefringent area in immersion in water is used (a current common practice in dental research). Procedures to avoid the shortcomings of a qualitative interpretation of enamel birefringence are presented and discussed. © 2012 The Authors Journal of Microscopy © 2012 Royal Microscopical Society.

  2. Physical activity and mammographic parenchymal patterns among Greek postmenopausal women.

    PubMed

    Marmara, Eleni A; Papacharalambous, Xenofon N; Kouloulias, Vassilios E; Maridaki, D Maria; Baltopoulos, J Panayiotis

    2011-05-01

    To examine whether physical activity during the last five years is related to later breast mammographic density in postmenopausal Greek women. We designed a cross-sectional study in 724 women, of ages 45-67 years. An interview-administered questionnaire was used to obtain information on duration and intensity of recreational physical activity during five years preceding study recruitment. Mammograms were evaluated according to BIRADS classification and BIRADS score was also estimated. Multivariate ordinal logistic regression analysis was used to assess associations between physical activity index and breast density according to the BIRADS classification methods. We observed a statistically significant inverse association of mammographic breast density measured by the BIRADS classification method and recreational exercise (OR=-0.10; 95% CI -0.018, -0.001; p=0.022). For one unit increase in physical activity as expressed by the MET-h/week score, the odds of lower versus higher breast density categories are 1.105 greater, given that all of the other variables in the model are held constant. A modifying effect by age at recruitment was evident among participants, with a stronger inverse association between recreational activity and mammographic breast density among older women (OR=-0.036; 95% CI -0.063, -0.009; p=0.009). An inverse association between physical activity and BIRADS score was evident, not reaching statistical significance (OR=0.00; 95% CI -0.009, 0.008; p=0.887). Mammographic breast area was lower in postmenopausal women who participated in sports/recreational physical activity compared to inactive controls. Increasing physical activity levels among postmenopausal women might be a reasonable approach to reduce mammographic density. However, until more physical activity and mammographic breast density studies are conducted that confirm our findings, they have to be interpreted with caution, due to the retrospective nature of our data and the possibility of

  3. Mammographic Breast Density Response to Aromatase Inhibition

    PubMed Central

    Vachon, Celine M.; Suman, Vera J.; Brandt, Kathleen R.; Kosel, Matthew L.; Buzdar, Aman U.; Olson, Janet E.; Wu, Fang-Fang; Flickinger, Lynn M.; Ursin, Giske; Elliott, Catherine R.; Shepherd, Lois; Weinshilboum, Richard M.; Goss, Paul E.; Ingle, James N.

    2013-01-01

    Purpose Mammographic breast density (MBD) is decreased by tamoxifen, but the effect of aromatase inhibitors (AI) is less clear. Experimental Design We enrolled early stage postmenopausal breast cancer patients initiating adjuvant AI therapy and ascertained mammograms before and at an average 10 months of AI therapy. We matched cases to healthy postmenopausal women (controls) from a large mammography screening cohort on age, baseline body mass index, baseline MBD and interval between mammograms. We estimated change in MBD using a computer-assisted thresholding program (Cumulus) and compared differences between cases and matched controls. Results In predominantly white women (96%), we found 14% of the 387 eligible cases had a MBD reduction of at least 5% after an average of 10 months of AI therapy. MBD reductions were associated with higher baseline MBD, AI use for more than 12 months and prior postmenopausal hormone use. Comparing each case to her matched control, there was no evidence of an association of change in MBD with AI therapy (median case-control difference among 369 pairs was −0.1% (10th and 90th percentile: −5.9%, 5.2%) p=0.51). Case-control differences were similar by type of AI (p’s 0.41 and 0.56); prior use of postmenopausal hormones (p=0.85); baseline MBD (p=0.55); or length of AI therapy (p=0.08). Conclusions In postmenopausal women treated with AIs, 14% of cases had a MBD reduction of >5%, but these decreases did not differ from matched controls. These data suggest that MBD is not a clinically useful biomarker for predicting the value of AI therapy in white postmenopausal women. PMID:23468058

  4. Effect on biopsy technique of the breast imaging reporting and data system (BI-RADS) for nonpalpable mammographic abnormalities

    PubMed Central

    Ball, Chad G.; Butchart, Michael; MacFarlane, John K.

    2002-01-01

    Objective To determine if the breast imaging reporting and data system (BI-RADS) defines a group of patients with mammographic abnormalities in whom stereotactic core needle biopsy (SCNB) is appropriate. Design A blinded retrospective validation sample. Setting A university-affiliated hospital. Patients One hundred and nine consecutive patients who underwent fine-wire localization breast biopsy (FWLB) between Jan. 1, 1994, and June 1, 1999, with a known final pathological diagnosis. Intervention Blinded mammographic review and classification using the BI-RADS; review of corresponding pathological findings from FWLBs. Outcome measures Correlation of pathological findings with each BI-RADS category and analysis of the predictive value of clinical and radiologic features. Results BI-RADS findings were as follows: 0 malignant lesions in 10 category 3 cases, 18 malignant lesions (3 in situ, 15 invasive) in 68 category 4 cases and 24 malignant lesions (8 in situ and 16 invasive) in 31 category 5 cases. There was 1 malignant lesion in 22 category 4 cases in women younger than 50 years. Conclusions SCNB should be applied to BI-RADS categories 3 and 4 (< 50 yr of age). FWLB should be reserved for category 4 (> 50 yr of age) and category 5 cases. This algorithm will reduce the morbidity and cost of breast biopsies in patients with nonpalpable mammographic abnormalities. PMID:12174979

  5. Mammographic density measured as changes in tissue structure caused by HRT

    NASA Astrophysics Data System (ADS)

    Raundahl, Jakob; Loog, Marco; Nielsen, Mads

    2006-03-01

    Numerous studies have investigated the relation between mammographic density and breast cancer risk. These studies indicate that women with high breast density have a four to six fold risk increase. An investigation of whether or not this relation is causal is important for, e.g., hormone replacement therapy (HRT), which has been shown to actually increase the density. No gold standard for automatic assessment of mammographic density exists. Manual methods such as Wolfe patterns and BI-RADS are helpful for communication of diagnostic sensitivity, but they are both time consuming and crude. They may be sufficient in certain cases and for single measurements, but for serial, temporal analysis it is necessary to be able to detect more subtle changes and, in addition, to be more reproducible. In this work an automated method for measuring the effect of HRT w.r.t. changes in biological density in the breast is presented. This measure is a novel measure, which provides structural information orthogonal to intensity-based methods. Hessian eigenvalues at different scales are used as features and a clustering of these is employed to divide a mammogram into four structurally different areas. Subsequently, based on the relative size of the areas, a density score is determined. In the experiments, two sets of mammograms of 50 patients from a double blind, placebo controlled HRT experiment were used. The change in density for the HRT group, measured with the new method, was significantly higher (p = 0.0002) than the change in the control group.

  6. A novel approach to computer-aided diagnosis of mammographic images

    SciTech Connect

    Sari-Sarraf, H.; Gleason, S.S.; Hudson, K.T.; Hubner, K.F.

    1996-08-01

    This is a work-in-progress report of a research endeavor that deals with the design and development of a novel approach to computer-aided diagnosis (CAD) of mammographic images. With the initial emphasis being on the analysis of microcalcifications, the proposed approach defines a synergistic paradigm that utilizes new methodologies together with previously developed techniques. The new paradigm is intended to promote a higher degree of accuracy in CAD of mammograms with an increased overall throughput. The process of accomplishing these goals is initiated by the fractal encoding of the input image, which gives rise to the generation of focus-of-attention regions (FARs), that is, regions that contain anomalies. The primary thrust of this work is to demonstrate that by considering FARs, rather than the entire input image, the performances of the ensuing processes (i.e., segmentation, feature extraction, and classification) are enhanced in terms of accuracy and speed. After presenting the proposed approach to CAD of mammographic images, the paper describes the generation of FARs. Furthermore, an experimental study is included that demonstrates the impact of this front-end procedure on the process of microcalcification segmentation. Specifically, the experimentation reveals a dramatic decrease (increase) in the amount of input data (throughput), as well as a reduction in the number of false detections.

  7. Prenatal smoke exposure and mammographic density in mid-life

    PubMed Central

    Terry, M. B.; Schaefer, C. A.; Flom, J. D.; Wei, Y.; Tehranifar, P.; Liao, Y.; Buka, S.; Michels, K. B.

    2012-01-01

    Tobacco smoke has both carcinogenic effects and anti-estrogenic properties and its inconsistent association with breast cancer risk in observational studies may be because of these competing effects across the lifecourse. We conducted a prospective study of prenatal smoke exposure, childhood household smoke exposure, and adult active smoke exposure and mammographic density, a strong intermediate marker of breast cancer risk, in an adult follow-up of existing US birth cohorts. Specifically, we followed up women who were born between 1959 and 1967 and whose mothers participated in either the Collaborative Perinatal Project (Boston and Providence sites) or the Childhood Health and Development Study in California. Of the 1134 women interviewed in adulthood (ranging in age from 39 to 49 years at interview), 79% had a screening mammogram. Cigarette smoking was reported by mothers at the time of their pregnancy; 40% of mothers smoked while pregnant. Women whose mothers smoked during pregnancy had a 3.1% (95% confidence interval (CI) = −6.0%, −0.2%) lower mammographic density than women whose mothers did not smoke during pregnancy. When we further accounted for adult body mass index and adult smoking status, the association remained (β = −2.7, 95% CI = −5.0, −0.3).When we examined patterns of smoking, prenatal smoke exposure without adult smoke exposure was associated with a 5.6% decrease in mammographic density (β = −5.6, 95% CI = −9.6, −1.6). Given the strength of mammographic density as an intermediate marker for breast cancer, the inverse associations between mammographic density and smoking patterns across the lifecourse may help explain the complex association between cigarette smoking and breast cancer risk. PMID:23378890

  8. Time course of perception and decision making during mammographic interpretation.

    PubMed

    Nodine, Calvin F; Mello-Thoms, Claudia; Kundel, Harold L; Weinstein, Susan P

    2002-10-01

    This article describes the time course of lesion detection on digital mammograms using data about both eye position and decision time to compare performance between experienced mammographers and trainees. Research indicates that a longer decision time works against performance in the interpretation of chest radiographs because the likelihood of error is increased, particularly for trainees. Is this relation between decision time and performance also true for interpreting mammograms? Is there an optimal decision time-performance trade-off for detecting breast lesions? Six radiology trainees (experience, 302-976 cases) and three mammographers (experience, 3000-5000 cases per year) reviewed 40 test cases. Each test case was represented by two mammograms that showed different views of the same breast. Twenty breasts contained suspicious lesions, and 20 were lesion-free. An interactive computer display system with an eye-head tracker measured the timing of decisions, where visual attention was directed, and how much time was spent fixating on a region of interest for each decision. Eye position was monitored during an initial-decision phase, and decision times were measured throughout a final-decision phase during which suspicious lesions recognized initially were interpreted and localized. Performance was analyzed using localization receiver operating characteristic curves. The time course of interpreting mammograms is similar to that for interpreting chest radiographs. Mammographers detected 71% of the true lesions within 25 sec, and trainees detected 46% within 40 sec. Both a fixation dwell time of 1000 msec and a high level of confidence in the decision were associated with the detection of true lesions for the mammographers but not for the trainees. Mammographers detected most breast lesions by global recognition within 25 sec, but trainees took more time. Prolonging one's search beyond the global recognition phase yielded few new lesions and increased the risk of

  9. The relationship between education level and mammographic density.

    PubMed

    Sung, Joohon; Song, Yun-Mi

    2015-11-01

    To further understand the factors that contribute to interindividual variation in mammographic density, we evaluated the relationship between education level and each component of the mammographic density measures. Study participants included 535 women between 40 and 65 years of age who received a mammogram for a population-based twin and family study. Mammographic density was measured from digital mammograms using a computer-assisted thresholding method. To avoid negative confounding by obesity level, we calculated BMI-adjusted mammographic measures. Thereafter, each of the mammographic density measures was t-transformed using its mean value and SD for each age strata. The level of education was chosen as a marker representing socioeconomic status at the individual level. A linear mixed model considering familial correlations was used for analyses. In the unadjusted analysis for all women, the BMI-adjusted nondense area gradually decreased with an increase in education level (P for trend=0.017). This association persisted after adjusting for menstrual and reproductive factors. When we repeated the analysis according to menopausal status, an inverse association between education level and nondense area was evident in premenopausal women, whereas the inverse association attenuated to a statistically insignificant level after adjusting for menstrual and reproductive factors in postmenopausal women. Absolute dense area and percentage dense area were not associated with education level. The significant association between nondense area and education level after eliminating the effect of age and BMI suggests that socioeconomic factors may have an influential role in determining the amount of fat tissue in the breast.

  10. Combining semiquantitative measures of fibrosis and qualitative features of parenchymal remodelling to identify fibrosis regression in hepatitis C: a multiple biopsy study.

    PubMed

    Pattullo, Venessa; Thein, Hla-Hla; Heathcote, Elizabeth Jenny; Guindi, Maha

    2012-09-01

    A fall in hepatic fibrosis stage may be observed in patients with chronic hepatitis C (CHC); however, parenchymal architectural changes may also signify hepatic remodelling associated with fibrosis regression. The aim of this study was to utilize semiquantitative and qualitative methods to report the prevalence and factors associated with fibrosis regression in CHC. Paired liver biopsies were scored for fibrosis (Ishak), and for the presence of eight qualitative features of parenchymal remodelling, to derive a qualitative regression score (QR score). Combined fibrosis regression was defined as ≥2-stage fall in Ishak stage (Reg-I) or <2-stage fall in Ishak stage with a rise in QR score (Reg-Qual). Among 159 patients (biopsy interval 5.4 ± 3.1 years), Reg-I was observed in 12 (7.5%) and Reg-Qual in 26 (16.4%) patients. The combined diagnostic criteria increased the diagnosis rate for fibrosis regression (38 patients, 23.9%) compared with use of Reg-I alone (P < 0.001). Combined fibrosis regression was observed in nine patients (50%) who achieved sustained virological response (SVR), and in 29 of 141 (21%) patients despite persistent viraemia. SVR was the only clinical factor associated independently with combined fibrosis regression (odds ratio 3.05). The combination of semiquantitative measures and qualitative features aids the identification of fibrosis regression in CHC. © 2012 Blackwell Publishing Ltd.

  11. A completely automated CAD system for mass detection in a large mammographic database

    SciTech Connect

    Bellotti, R.; De Carlo, F.; Tangaro, S.

    2006-08-15

    Mass localization plays a crucial role in computer-aided detection (CAD) systems for the classification of suspicious regions in mammograms. In this article we present a completely automated classification system for the detection of masses in digitized mammographic images. The tool system we discuss consists in three processing levels: (a) Image segmentation for the localization of regions of interest (ROIs). This step relies on an iterative dynamical threshold algorithm able to select iso-intensity closed contours around gray level maxima of the mammogram. (b) ROI characterization by means of textural features computed from the gray tone spatial dependence matrix (GTSDM), containing second-order spatial statistics information on the pixel gray level intensity. As the images under study were recorded in different centers and with different machine settings, eight GTSDM features were selected so as to be invariant under monotonic transformation. In this way, the images do not need to be normalized, as the adopted features depend on the texture only, rather than on the gray tone levels, too. (c) ROI classification by means of a neural network, with supervision provided by the radiologist's diagnosis. The CAD system was evaluated on a large database of 3369 mammographic images [2307 negative, 1062 pathological (or positive), containing at least one confirmed mass, as diagnosed by an expert radiologist]. To assess the performance of the system, receiver operating characteristic (ROC) and free-response ROC analysis were employed. The area under the ROC curve was found to be A{sub z}=0.783{+-}0.008 for the ROI-based classification. When evaluating the accuracy of the CAD against the radiologist-drawn boundaries, 4.23 false positives per image are found at 80% of mass sensitivity.

  12. Classification of mammographic microcalcifications using wavelets

    NASA Astrophysics Data System (ADS)

    Chitre, Yateen S.; Dhawan, Atam P.; Moskowitz, Myron; Sarwal, Alok; Bonasso, Christine; Narayan, Suresh B.

    1995-05-01

    Breast cancer is the leading cause of death among women. Breast cancer can be detected earlier by mammography than any other non-invasive examination. About 30% to 50% of breast cancers demonstrate tiny granulelike deposits of calcium called microcalcifications. It is difficult to distinguish between benign and malignant cases based on an examination of calcification regions, especially in hard-to-diagnose cases. We investigate the potential of using energy and entropy features computed from wavelet packets for their correlation with malignancy. Two types of Daubechies discrete filters were used as prototype wavelets. The energy and entropy features were computed for 128 benign and 63 malignant cases and analyzed using a multivariate cluster analysis and a univariate statistical analysis to reduce the feature set to a `five best set of features.' The efficacy of the reduced feature set to discriminate between the malignant and benign categories was evaluated using different multilayer perceptron architectures. The multilayer perceptron was trained using the backpropagation algorithm for various training and test set sizes. For each case 40 partitions of the data set were used to set up the training and test sets. The performance of the features was evaluated by computing the best area under the relative operating characteristic (ROC) curve and the average area under the ROC curve. The performance of the features computed from the wavelet packets was compared to a second set of features consisting of the wavelet packet features, image structure features and cluster features. The classification results are encouraging and indicate the potential of using features derived from wavelet packets in discriminating microcalcification regions into benign and malignant categories.

  13. Mammographic screening in asymptomatic women aged 40 years and older

    SciTech Connect

    Not Available

    1989-05-05

    Currently, age-specific recommendations for screening mammograms in asymptomatic women that have been developed by professional, voluntary, and governmental organizations differ. While there is strong epidemiologic evidence that mammographic screening in asymptomatic women aged 50 years or older reduces breast cancer mortality, the evidence for mortality reduction is not as clear for women aged 40 to 49 years. However, as described in this report, findings of further mortality and survival follow-up of subjects in earlier studies, as well as observations from more recent studies, suggest reductions in mortality and better survival in younger women as well. While mammography is currently the most effective method for detecting early breast cancers, some breast cancers may develop during the intervals between screening mammograms. The costs of mammographic screening also require consideration in the process of making national screening recommendations.

  14. Study of digital mammographic equipments by phantom image quality.

    PubMed

    Mayo, P; Rodenas, F; Verdú, G; Campayo, J M; Villaescusa, J I

    2006-01-01

    Nowadays, the digital radiographic equipments are replacing the traditional film-screen equipments and it is necessary to update the parameters to guarantee the quality of the process. Contrast-detail phantoms are applied to digital radiography to study the threshold contrast-detail sensitivity at operation conditions of the equipment. The phantom that is studied in this work is CDMAM 3.4. One of the most extended indexes to measure the image quality in an objective way is the image quality figure (IQF). The aim of this work is to study the image quality of different images contrast-detail phantom CDMAM 3.4, carrying out the automatic detection of the contrast-detail combination and to establish a parameter which characterize in an objective way the mammographic image quality. This is useful to compare images obtained at different digital mammographic equipments to study the functioning of the equipments that facilitates the evaluation of image contrast and detail resolution.

  15. Biological and Computational Modeling of Mammographic Density and Stromal Patterning

    DTIC Science & Technology

    2010-07-01

    will be completed. Mammographic Density: Over 559 serial screen-film mammograms were digitized from the 150 women described in Task 1: 75 high... mammograms were digitized from 75 women taking tam oxifen prevention an d 75 controls using a new Howtek MultiRad 860 digitizer. The anonymized...en taking tamoxifen chemoprevention and 75 high-risk women who elected not to tak e tamoxifen using pattern analy sis of 1) serial m ammograms, 2

  16. Enhancement of Mammographic Density Measures in Breast Cancer Risk Prediction

    PubMed Central

    Cheddad, Abbas; Czene, Kamila; Shepherd, John A.; Li, Jingmei; Hall, Per; Humphreys, Keith

    2016-01-01

    Background Mammographic density is a strong risk factor for breast cancer. Methods We present a novel approach to enhance area density measures that takes advantage of the relative density of the pectoral muscle that appears in lateral mammographic views. We hypothesized that the grey scale of film mammograms is normalized to volume breast density but not pectoral density and thus pectoral density becomes an independent marker of volumetric density. Results From analysis of data from a Swedish case–control study (1,286 breast cancer cases and 1,391 control subjects, ages 50–75 years), we found that the mean intensity of the pectoral muscle (MIP) was highly associated with breast cancer risk [per SD: OR = 0.82; 95% confidence interval (CI), 0.75–0.88; P = 6 × 10−7] after adjusting for a validated computer-assisted measure of percent density (PD), Cumulus. The area under curve (AUC) changed from 0.600 to 0.618 due to using PD with the pectoral muscle as reference instead of a standard area-based PD measure. We showed that MIP is associated with a genetic variant known to be associated with mammographic density and breast cancer risk, rs10995190, in a subset of women with genetic data. We further replicated the association between MIP and rs10995190 in an additional cohort of 2,655 breast cancer cases (combined P = 0.0002). Conclusions MIP is a marker of volumetric density that can be used to complement area PD in mammographic density studies and breast cancer risk assessment. Impact Inclusion of MIP in risk models should be considered for studies using area PD from analog films. PMID:24722754

  17. The impact of mammographic density and lesion location on detection

    NASA Astrophysics Data System (ADS)

    Al Mousa, Dana; Ryan, Elaine; Lee, Warwick; Nickson, Carolyn; Pietrzyk, Mariusz; Reed, Warren; Poulos, Ann; Li, Yanpeng; Brennan, Patrick

    2013-03-01

    The aim of this study is to examine the impact of breast density and lesion location on detection. A set of 55 mammographic images (23 abnormal images with 26 lesions and 32 normal images) were examined by 22 expert radiologists. The images were classified by an expert radiologist according to the Synoptic Breast Imaging Report of the National Breast Cancer Centre (NBCC) as having low mammographic density (D1<25% glandular and D2> 25-50% glandular) or high density (D3 51-75% glandular and D4> 75-glandular). The observers freely examined the images and located any malignancy using a 5-point confidence. Performance was defined using the following metrics: sensitivity, location sensitivity, specificity, receiver operating characteristic (ROC Az) curves and jackknife free-response receiver operator characteristics (JAFROC) figures of merit. Significant increases in sensitivity (p= 0.0174) and ROC (p=0.0001) values were noted for the higher density compared with lower density images according to NBCC classification. No differences were seen in radiologists' performance between lesions within or outside the fibroglandular region. In conclusion, analysis of our data suggests that radiologists scored higher using traditional metrics in higher mammographic density images without any improvement in lesion localisation. Lesion location whether within or outside the fibroglandular region appeared to have no impact on detection abilities suggesting that if a masking effect is present the impact is minimal. Eye-tracking analyses are ongoing.

  18. Physical activity and mammographic breast density: a systematic review

    PubMed Central

    Colditz, Graham A.; Wolin, Kathleen

    2013-01-01

    Studies show a protective relationship between physical activity and breast cancer risk across the life course from menarche to postmenopausal years. Mammographic breast density is a known and strong breast cancer risk factor. Whether the association of physical activity with breast cancer risk is mediated through mammographic breast density is poorly understood. This systematic review summarizes published studies that investigated the association between physical activity and mammographic breast density and discusses the methodological issues that need to be addressed. We included in this review studies that were published before October 31, 2011 that were accessible in full-text format and were published in English. We identified 20 studies through the PubMed Central, BioMed Central, Embase, and Scopus and using the search terms “physical activity and breast density” and “exercise and breast density” as well as through manual searches of the bibliographies of the articles identified in electronic searches. We found no evidence of association between physical activity and breast density across the studies by grouping them first by the timing of physical activity assessment (in adolescence, current/recent, past, and lifetime) and then by women’s menopausal status (premenopausal and postmenopausal). Given the strength of the relationship between physical activity and breast cancer and the null findings of this review, it is unlikely that the effect of physical activity is mediated through an effect on breast density. PMID:22814722

  19. Mammographic density measurements are not affected by mammography system.

    PubMed

    Damases, Christine N; Brennan, Patrick C; McEntee, Mark F

    2015-01-01

    Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman's density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists' visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer's equipment affects a woman's MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation ([Formula: see text]; [Formula: see text]), while the VDG ([Formula: see text]; [Formula: see text]) and AvBD% ([Formula: see text]; [Formula: see text]) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS ([Formula: see text]; [Formula: see text]), however, the systems demonstrated an almost perfect agreement for VDG ([Formula: see text]; [Formula: see text]).

  20. Digital mammographic tumor classification using transfer learning from deep convolutional neural networks.

    PubMed

    Huynh, Benjamin Q; Li, Hui; Giger, Maryellen L

    2016-07-01

    Convolutional neural networks (CNNs) show potential for computer-aided diagnosis (CADx) by learning features directly from the image data instead of using analytically extracted features. However, CNNs are difficult to train from scratch for medical images due to small sample sizes and variations in tumor presentations. Instead, transfer learning can be used to extract tumor information from medical images via CNNs originally pretrained for nonmedical tasks, alleviating the need for large datasets. Our database includes 219 breast lesions (607 full-field digital mammographic images). We compared support vector machine classifiers based on the CNN-extracted image features and our prior computer-extracted tumor features in the task of distinguishing between benign and malignant breast lesions. Five-fold cross validation (by lesion) was conducted with the area under the receiver operating characteristic (ROC) curve as the performance metric. Results show that classifiers based on CNN-extracted features (with transfer learning) perform comparably to those using analytically extracted features [area under the ROC curve [Formula: see text

  1. Digital mammographic tumor classification using transfer learning from deep convolutional neural networks

    PubMed Central

    Huynh, Benjamin Q.; Li, Hui; Giger, Maryellen L.

    2016-01-01

    Abstract. Convolutional neural networks (CNNs) show potential for computer-aided diagnosis (CADx) by learning features directly from the image data instead of using analytically extracted features. However, CNNs are difficult to train from scratch for medical images due to small sample sizes and variations in tumor presentations. Instead, transfer learning can be used to extract tumor information from medical images via CNNs originally pretrained for nonmedical tasks, alleviating the need for large datasets. Our database includes 219 breast lesions (607 full-field digital mammographic images). We compared support vector machine classifiers based on the CNN-extracted image features and our prior computer-extracted tumor features in the task of distinguishing between benign and malignant breast lesions. Five-fold cross validation (by lesion) was conducted with the area under the receiver operating characteristic (ROC) curve as the performance metric. Results show that classifiers based on CNN-extracted features (with transfer learning) perform comparably to those using analytically extracted features [area under the ROC curve (AUC)=0.81]. Further, the performance of ensemble classifiers based on both types was significantly better than that of either classifier type alone (AUC=0.86 versus 0.81, p=0.022). We conclude that transfer learning can improve current CADx methods while also providing standalone classifiers without large datasets, facilitating machine-learning methods in radiomics and precision medicine. PMID:27610399

  2. Progestogen levels, Progesterone Receptor Gene polymorphisms, and mammographic density changes: results from the Postmenopausal Estrogen/Progestin Interventions Mammographic Density Study (PEPI-MDS)

    PubMed Central

    Lee, Eunjung; Ingles, Sue A.; Van Den Berg, David; Wang, Wei; LaVallee, Chris; Huang, Mei-Hua; Crandall, Carolyn J.; Stanczyk, Frank Z.; Greendale, Gail A.; Ursin, Giske

    2015-01-01

    Objective Estrogen plus progestin therapy (EPT) in postmenopausal women increases breast cancer risk and mammographic density to a higher extent than does estrogen therapy (ET) alone. Data from the randomized placebo-controlled Postmenopausal Estrogen/Progestin Interventions (PEPI) trial showed that EPT-induced increases in serum estrone and estrone sulfate levels were positively correlated with increases in mammographic density. Here, after adjusting for serum estrone and estrone sulfate levels, we investigated the roles of post-treatment serum progestogen increase and of progesterone receptor gene (PGR) genetic variations on changes in mammographic density. Methods We measured percent mammographic density and serum progestogen levels in 280 PEPI participants randomized to EPT treatment. Analyses of genetic variations in PGR were limited to 260 white women for whom we successfully obtained PGR genotypes. We used linear regression analyses to determine how increase in progestogen levels and PGR genetic variations influenced mammographic density change following EPT. Results The increase in post-treatment serum progestogen level was positively associated with greater increases in mammographic density after adjustment for covariates (P-trend=0.044). Compared to women in the lowest quartile of serum progestogen, women in the highest quartile experienced a 3.5% greater increase in mammographic density (P=0.046). We did not find a strong indication that genetic variations in PGR were associated with mammographic density increase, or modified the association with serum progestogen, however confidence in these null findings is constrained by our small sample size. Conclusions Our results suggest that higher serum progestogen levels resulting from EPT treatment lead to greater increases in mammographic density. PMID:22105149

  3. Quantitative and qualitative features of heterologous virus-vector-induced antigen-specific CD8+ T cells against Trypanosoma cruzi infection.

    PubMed

    Takayama, Eiji; Ono, Takeshi; Carnero, Elena; Umemoto, Saori; Yamaguchi, Yoko; Kanayama, Atsuhiro; Oguma, Takemi; Takashima, Yasuhiro; Tadakuma, Takushi; García-Sastre, Adolfo; Miyahira, Yasushi

    2010-11-01

    We studied some aspects of the quantitative and qualitative features of heterologous recombinant (re) virus-vector-induced, antigen-specific CD8(+) T cells against Trypanosoma cruzi. We used three different, highly attenuated re-viruses, i.e., influenza virus, adenovirus and vaccinia virus, which all expressed a single, T. cruzi antigen-derived CD8(+) T-cell epitope. The use of two out of three vectors or the triple virus-vector vaccination regimen not only confirmed that the re-vaccinia virus, which was placed last in order for sequential immunisation, was an effective booster for the CD8(+) T-cell immunity in terms of the number of antigen-specific CD8(+) T cells, but also demonstrated that (i) the majority of cells exhibit the effector memory (T(EM)) phenotype, (ii) robustly secrete IFN-γ, (iii) express higher intensity of the CD122 molecule and (iv) present protective activity against T. cruzi infection. In contrast, placing the re-influenza virus last in sequential immunisation had a detrimental effect on the quantitative and qualitative features of CD8(+) T cells. The triple virus-vector vaccination was more effective at inducing a stronger CD8(+) T-cell immunity than using two re-viruses. The different quantitative and qualitative features of CD8(+) T cells induced by different immunisation regimens support the notion that the refinement of the best choice of multiple virus-vector combinations is indispensable for the induction of a maximum number of CD8(+) T cells of high quality. Copyright © 2010 Australian Society for Parasitology Inc. All rights reserved.

  4. A Qualitative Inquiry into the Complex Features of Strained Interactions: Analysis and Implications for Health Care Personnel

    PubMed Central

    Thunborg, Charlotta; Salzmann-Erikson, Martin

    2017-01-01

    Background Communication skills are vital for successful relationships between patients and health care professionals. Failure to communicate may lead to a lack of understanding and may result in strained interactions. Our theoretical point of departure was to make use of chaos and complexity theories. Objective To examine the features of strained interactions and to discuss their relevance for health care settings. Methods A netnography study design was applied. Data were purposefully sampled, and video clips (122 minutes from 30 video clips) from public online venues were used. Results The results are presented in four categories: 1) unpredictability, 2) sensitivity dependence, 3) resistibility, and 4) iteration. They are all features of strained interactions. Conclusion Strained interactions are a complex phenomenon that exists in health care settings. The findings provide health care professionals guidance to understand the complexity and the features of strained interactions. PMID:28368786

  5. A Qualitative Inquiry into the Complex Features of Strained Interactions: Analysis and Implications for Health Care Personnel.

    PubMed

    Thunborg, Charlotta; Salzmann-Erikson, Martin

    2017-01-01

    Communication skills are vital for successful relationships between patients and health care professionals. Failure to communicate may lead to a lack of understanding and may result in strained interactions. Our theoretical point of departure was to make use of chaos and complexity theories. To examine the features of strained interactions and to discuss their relevance for health care settings. A netnography study design was applied. Data were purposefully sampled, and video clips (122 minutes from 30 video clips) from public online venues were used. The results are presented in four categories: 1) unpredictability, 2) sensitivity dependence, 3) resistibility, and 4) iteration. They are all features of strained interactions. Strained interactions are a complex phenomenon that exists in health care settings. The findings provide health care professionals guidance to understand the complexity and the features of strained interactions.

  6. Is There an Association Between Bone Mineral Density and Mammographic Density? A Systematic Review.

    PubMed

    Lee, Jong Min; Holley, Susan; Appleton, Catherine; Toriola, Adetunji T

    2017-04-01

    Both bone mineral density (BMD) and breast density are related to reproductive hormone levels. This suggests that BMD and breast density could be meaningfully associated, and serve as surrogate markers for breast cancer risk. However, few studies have investigated the association of BMD with percent mammographic density, making it difficult to draw meaningful conclusions. We conducted a systematic review of studies published in electronic databases till April 2016 using the following search terms: "bone density," "bone mineral density," "mammographic breast density," "breast density," and "mammographic density." We identified 203 articles, of which 8 met the inclusion criteria for this review. BMD does not appear to be associated with percent mammographic density. BMD at the spine was weakly positively associated with percent mammographic density among postmenopausal women who were not hormone users, while BMD at the hip and legs was positively associated with percent mammographic density among premenopausal women. On the other hand, one study reported an inverse association of BMD at the spine and hip with percent mammographic density among perimenopausal women. In this review, we found no evidence of an association between BMD and percent mammographic density.

  7. Application of shape analysis to mammographic calcifications

    SciTech Connect

    Shen, L.; Rangayyan, R.M. . Dept. of Electrical and Computer Engineering); Desautels, J.E.L. . Dept. of Radiology)

    1994-06-01

    The authors have developed a set of shape factors to measure the roughness of contours of calcifications in mammograms and for use in their classification as malignant or benign. The analysis of mammograms is performed in three stages. First, a region growing technique is used to obtain the contours of calcifications. Then, three measures of shape features, including compactness, moments, and Fourier descriptors are computed for each region. Finally, their applicability for classification is studied by using the three shape measures to form feature vectors. Classification of 143 calcifications from 18 biopsy-proven cases as benign or malignant using the three measures with the nearest-neighbor method was 100% accurate.

  8. Clinical and mammographic profile of patients with breast cancer surgically treated.

    PubMed

    Muradas, Raquel Rodrigues; Velho, Maria Teresa Aquino de Campos; Riesgo, Itamar dos Santos; Brum, Alexandre Duarte; Rossi, Raquel Montagner; Piovezan, Julia Mottecy; Lacerda, Melania

    2015-01-01

    to analyze the epidemiological, clinical and mammographic profile of women with breast cancer who were treated at the mastology clinic of the University Hospital of Santa Maria and who underwent breast surgery between January 2007 and December 2012. this was a cross-sectional study, approved by the Ethics in Research Committee. A review of the patients' medical records was performed. The data were then exported to a software program for statistical analysis, namely Minitab 14.1. the patients' profile indicated that they were mostly born and raised in Santa Maria (respectively 11.1%, n=16, and 26.3%, n=68). They were about 55.6 years old (SD ± 12.3), white (90.2%, n=213), had already given birth and breastfed their children, were nonsmokers, but also overweight (average BMI of 27 kg/m2). On physical examination of the first medical consultation, these patients, as described in the records: had a palpable mass (81.1%, n=184) measuring over three centimeters, located in the left breast, precisely in the upper outer quadrant (41.4%, n=81). Mammography (39%, n=109) showed that this lump was classified as BIRADS ® 5 (40%, n=81). On histopathological examination, the lump was diagnosed as an invasive ductal cancer (71.1%, n=191). Surgery was generally a radical mastectomy (84.7%, n=236) with axillary dissection (92.5%, n=222). some of the epidemiological, clinical and mammographic features mentioned above resembled those found in the literature reviewed. However, these patients had advanced disease and underwent non conservative surgical procedures.

  9. Sex steroid metabolism polymorphisms and mammographic density in pre- and early perimenopausal women

    PubMed Central

    Crandall, Carolyn J; Sehl, Mary E; Crawford, Sybil L; Gold, Ellen B; Habel, Laurel A; Butler, Lesley M; Sowers, MaryFran R; Greendale, Gail A; Sinsheimer, Janet S

    2009-01-01

    Introduction We examined the association between mammographic density and single-nucleotide polymorphisms (SNPs) in genes encoding CYP1A1, CYP1B1, aromatase, 17β-HSD, ESR1, and ESR2 in pre- and early perimenopausal white, African-American, Chinese, and Japanese women. Methods The Study of Women's Health Across the Nation is a longitudinal community-based cohort study. We analyzed data from 451 pre- and early perimenopausal participants of the ancillary SWAN Mammographic Density study for whom we had complete information regarding mammographic density, genotypes, and covariates. With multivariate linear regression, we examined the relation between percentage mammographic breast density (outcome) and each SNP (primary predictor), adjusting for age, race/ethnicity, parity, cigarette smoking, and body mass index (BMI). Results After multivariate adjustment, the CYP1B1 rs162555 CC genotype was associated with a 9.4% higher mammographic density than the TC/TT genotype (P = 0.04). The CYP19A1 rs936306 TT genotype was associated with 6.2% lower mammographic density than the TC/CC genotype (P = 0.02). The positive association between CYP1A1 rs2606345 and mammographic density was significantly stronger among participants with BMI greater than 30 kg/m2 than among those with BMI less than 25 kg/m2 (Pinteraction = 0.05). Among white participants, the ESR1 rs2234693 CC genotype was associated with a 7.0% higher mammographic density than the CT/TT genotype (P = 0.01). Conclusions SNPs in certain genes encoding sex steroid metabolism enzymes and ESRs were associated with mammographic density. Because the encoded enzymes and ESR1 are expressed in breast tissue, these SNPs may influence breast cancer risk by altering mammographic density. PMID:19630952

  10. Correlating mammographic and pathologic findings in clinical decision support using natural language processing and data mining methods.

    PubMed

    Patel, Tejal A; Puppala, Mamta; Ogunti, Richard O; Ensor, Joe E; He, Tiancheng; Shewale, Jitesh B; Ankerst, Donna P; Kaklamani, Virginia G; Rodriguez, Angel A; Wong, Stephen T C; Chang, Jenny C

    2017-01-01

    A key challenge to mining electronic health records for mammography research is the preponderance of unstructured narrative text, which strikingly limits usable output. The imaging characteristics of breast cancer subtypes have been described previously, but without standardization of parameters for data mining. The authors searched the enterprise-wide data warehouse at the Houston Methodist Hospital, the Methodist Environment for Translational Enhancement and Outcomes Research (METEOR), for patients with Breast Imaging Reporting and Data System (BI-RADS) category 5 mammogram readings performed between January 2006 and May 2015 and an available pathology report. The authors developed natural language processing (NLP) software algorithms to automatically extract mammographic and pathologic findings from free text mammogram and pathology reports. The correlation between mammographic imaging features and breast cancer subtype was analyzed using one-way analysis of variance and the Fisher exact test. The NLP algorithm was able to obtain key characteristics for 543 patients who met the inclusion criteria. Patients with estrogen receptor-positive tumors were more likely to have spiculated margins (P = .0008), and those with tumors that overexpressed human epidermal growth factor receptor 2 (HER2) were more likely to have heterogeneous and pleomorphic calcifications (P = .0078 and P = .0002, respectively). Mammographic imaging characteristics, obtained from an automated text search and the extraction of mammogram reports using NLP techniques, correlated with pathologic breast cancer subtype. The results of the current study validate previously reported trends assessed by manual data collection. Furthermore, NLP provides an automated means with which to scale up data extraction and analysis for clinical decision support. Cancer 2017;114-121. © 2016 American Cancer Society. © 2016 American Cancer Society.

  11. Correlation between mammographic and sonographic findings and prognostic factors in patients with node-negative invasive breast cancer.

    PubMed

    Shin, H J; Kim, H H; Huh, M O; Kim, M J; Yi, A; Kim, H; Son, B H; Ahn, S H

    2011-01-01

    The purpose of this study was to correlate sonographic and mammographic findings with prognostic factors in patients with node-negative invasive breast cancer. Sonographic and mammographic findings in 710 consecutive patients (age range 21-81 years; mean age 49 years) with 715 node-negative invasive breast cancers were retrospectively evaluated. Pathology reports relating to tumour size, histological grade, lymphovascular invasion (LVI), extensive intraductal component (EIC), oestrogen receptor (ER) status and HER-2/neu status were reviewed and correlated with the imaging findings. Statistical analysis was performed using logistic regression analysis and intraclass correlation coefficient (ICC). On mammography, non-spiculated masses with calcifications were associated with all poor prognostic factors: high histological grade, positive LVI, EIC, HER-2/neu status and negative ER. Other lesions were associated with none of these poor prognostic factors. Hyperdense masses on mammography, the presence of mixed echogenicity, posterior enhancement, calcifications in-or-out of masses and diffusely increased vascularity on sonography were associated with high histological grade and negative ER. Associated calcifications on both mammograms and sonograms were correlated with EIC and HER-2/neu overexpression. The ICC value for the disease extent was 0.60 on mammography and 0.70 on sonography. Several sonographic and mammographic features can have a prognostic value in the subsequent treatment of patients with node-negative invasive breast cancer. Radiologists should pay more attention to masses that are associated with calcifications because on both mammography and sonography associated calcifications were predictors of positive EIC and HER-2/neu overexpression.

  12. Early recovery of immunity after cord-blood transplantation in children: qualitative features and impact of cytomegalovirus infection.

    PubMed

    Farnault, Laure; Chambost, Hervé; Zandotti, Christine; Mallet, Françoise; Barlogis, Vincent; Galambrun, Claire; Michel, Gerard; Olive, Daniel

    2012-01-01

    This study investigated immune recovery and the effect of cytomegalovirus (CMV) infection on the early stages of T-lymphocyte recovery after cord-blood transplantation (CBT) from unrelated donors to 24 children. In addition, 15 children who were recipients of a bone-marrow transplant (BMT) were studied concomitantly. The main objectives of the study were whether lymphocytes from CBT recipients were capable of rapid qualitative differentiation in the effector memory (EM) stage, of regenerating de novo naïve cells and of responding to CMV infection. Results showed that CB lymphocytes were mainly differentiated into the EM stage at 3 months and into the naïve stage at 6 months. CMV infection induced a dramatic increase in CD8 but not CD4 T-cell counts, and differentiation into the EM stage with high perforin contents. Our data suggest that CB lymphocytes are capable of rapid differentiation in children, but stabilization of lymphocyte counts in children is associated with effective naïve subset regeneration at 6 months. Moreover, the T-cell repertoire is capable of rapid adjustment when CMV infection occurs. Copyright © 2012 S. Karger AG, Basel.

  13. Grid-enabled mammographic auditing and training system

    NASA Astrophysics Data System (ADS)

    Yap, M. H.; Gale, A. G.

    2008-03-01

    Effective use of new technologies to support healthcare initiatives is important and current research is moving towards implementing secure grid-enabled healthcare provision. In the UK, a large-scale collaborative research project (GIMI: Generic Infrastructures for Medical Informatics), which is concerned with the development of a secure IT infrastructure to support very widespread medical research across the country, is underway. In the UK, there are some 109 breast screening centers and a growing number of individuals (circa 650) nationally performing approximately 1.5 million screening examinations per year. At the same, there is a serious, and ongoing, national workforce issue in screening which has seen a loss of consultant mammographers and a growth in specially trained technologists and other non-radiologists. Thus there is a need to offer effective and efficient mammographic training so as to maintain high levels of screening skills. Consequently, a grid based system has been proposed which has the benefit of offering very large volumes of training cases that the mammographers can access anytime and anywhere. A database, spread geographically across three university systems, of screening cases is used as a test set of known cases. The GIMI mammography training system first audits these cases to ensure that they are appropriately described and annotated. Subsequently, the cases are utilized for training in a grid-based system which has been developed. This paper briefly reviews the background to the project and then details the ongoing research. In conclusion, we discuss the contributions, limitations, and future plans of such a grid based approach.

  14. Mammographic density and urbanization: a population-based screening study.

    PubMed

    Viel, Jean-François; Rymzhanova, Raouchan

    2012-03-01

    The high incidence of female breast cancer that has been consistently reported in urban areas could be mediated by breast density, which is considered to reflect the cumulative exposure of breast tissues to hormones. The aim of this study was to assess how mammographic density varies by the degree of urbanization. The population consisted of 55,597 cancer-free women, aged 50-59 years, who participated in a French breast cancer screening programme (Franche-Comté region) between 2005 and 2009. Ordered logistic regression was run with mammographic density as the outcome, and degree of urbanization as the independent variable, while adjusting for some known confounding factors. Multiple imputation was used to deal with missing data. A significant positive linear trend with urbanization was found in a univariate approach (P trend <10(-3)), and after adjusting for risk factors (P trend = 10(-3)). A negative and highly significant association with mammographic density was highlighted both for age at the time of mammography (odds ratio (OR) 0.41, 95% confidence interval (CI) 0.39-0.43, per 10 years), and for low socioeconomic status (OR 0.71, 95% CI 0.67-0.75). The OR for hormone replacement therapy use was 1.51 (95% CI 1.43-1.58). Knowledge of this urbanization gradient in density (whatever its mechanism) may help to identify women who may require full-field digital mammography for the early detection of breast cancer, and could assist primary care providers in recommending the best screening strategy in a risk factor-based approach.

  15. Mammographic density measurements are not affected by mammography system

    PubMed Central

    Damases, Christine N.; Brennan, Patrick C.; McEntee, Mark F.

    2015-01-01

    Abstract. Mammographic density (MD) is a significant risk factor for breast cancer and has been shown to reduce the sensitivity of mammography screening. Knowledge of a woman’s density can be used to predict her risk of developing breast cancer and personalize her imaging pathway. However, measurement of breast density has proven to be troublesome with wide variations in density recorded using radiologists’ visual Breast Imaging Reporting and Data System (BIRADS). Several automated methods for assessing breast density have been proposed, each with their own source of measurement error. The use of differing mammographic imaging systems further complicates MD measurement, especially for the same women imaged over time. The purpose of this study was to investigate whether having a mammogram on differing manufacturer’s equipment affects a woman’s MD measurement. Raw mammographic images were acquired on two mammography imaging systems (General Electric and Hologic) one year apart and processed using VolparaDensity™ to obtain the Volpara Density Grade (VDG) and average volumetric breast density percentage (AvBD%). Visual BIRADS scores were also obtained from 20 expert readers. BIRADS scores for both systems showed strong positive correlation (ρ=0.904; p<0.001), while the VDG (ρ=0.978; p<0.001) and AvBD% (ρ=0.973; p<0.001) showed stronger positive correlations. Substantial agreement was shown between the systems for BIRADS (κ=0.692; p<0.001), however, the systems demonstrated an almost perfect agreement for VDG (κ=0.933; p<0.001). PMID:26158085

  16. 900 MHz electromagnetic field exposure affects qualitative and quantitative features of hippocampal pyramidal cells in the adult female rat.

    PubMed

    Bas, Orhan; Odaci, Ersan; Kaplan, Suleyman; Acer, Niyazi; Ucok, Kagan; Colakoglu, Serdar

    2009-04-10

    The effects of electromagnetic fields (EMFs) emitted by mobile phones on humans hold special interest due to their use in close proximity to the brain. The current study investigated the number of pyramidal cells in the cornu ammonis (CA) of the 16-week-old female rat hippocampus following postnatal exposure to a 900 megahertz (MHz) EMF. In this study were three groups of 6 rats: control (Cont), sham exposed (Sham), and EMF exposed (EMF). EMF group rats were exposed to 900 MHz EMF (1 h/day for 28 days) in an exposure tube. Sham group was placed in the exposure tube but not exposed to EMF (1 h/day for 28 days). Cont group was not placed into the exposure tube nor were they exposed to EMF during the study period. In EMF group rats, the specific energy absorption rate (SAR) varied between 0.016 (whole body) and 2 W/kg (locally in the head). All of the rats were sacrificed at the end of the experiment and the number of pyramidal cells in the CA was estimated using the optical fractionator technique. Histopathological evaluations were made on sections of the CA region of the hippocampus. Results showed that postnatal EMF exposure caused a significant decrease of the pyramidal cell number in the CA of the EMF group (P<0.05). Additionally, cell loss can be seen in the CA region of EMF group even at qualitative observation. These results may encourage researchers to evaluate the chronic effects of 900 MHz EMF on teenagers' brains.

  17. Mammographic Breast Density in a Cohort of Medically Underserved Women

    DTIC Science & Technology

    2015-12-01

    the mean percent breast density among premenopausal women with type 2 diabetes ( ̂ 13.8%, 95% confidence interval [CI] 11.6-15.9) was non ...confidence interval [CI] 11.6-15.9) was non -significantly lower than that of women without type 2 diabetes ( ̂ 15.9%, 95% CI 15.0- 16.8) (p=0.07... insulin signaling breast cancer pathway in women with high breast density. Keywords: mammographic breast density, type 2 diabetes , cross-sectional

  18. Mammographic Breast Density in a Cohort of Medically Underserved Women

    DTIC Science & Technology

    2014-10-01

    and percent breast density relation was present in white women ( non - diabetic µ 16.4, SE 2.05; diabetic µ 13.3, SE 2.16; p=0.05), but not in black...women ( non - diabetic µ 16.6, SE 0.84; diabetic µ 15.8, SE 1.34; p=0.55). We were unable to examine a potential effect of metformin on decreasing breast...the insulin signaling pathway in women with high breast density. Keywords: mammographic breast density, type 2 diabetes , cross-sectional study

  19. Accuracy of the mammographic report category according to BIRADS.

    PubMed

    Hirunpat, Siriporn; Tanomkiat, Wiwatana; Khojarern, Rungrat; Arpakupakul, Nualta

    2005-01-01

    To determine the accuracy and predictive value of the mammographic report according to the BIRADS categories in Songklanagarind University Hospital. Mammograms of 1000 women who came to Songklanagarind University Hospital from June 1998 to September 1999 were reported and placed in category 1 for negative results, category 2 for benign lesions, category 3 for probably benign lesions, category 4 for suspicious lesions and category 5 for highly suspicious lesions. Accuracy was determined by either histology or by unchanged follow-up mammography within 24 months. The total accuracy was 97.8%, sensitivity 62.5% and specificity 98.1%.

  20. Triphasic and epithelioid minimal fat renal angiomyolipoma and clear cell renal cell carcinoma: qualitative and quantitative CEUS characteristics and distinguishing features.

    PubMed

    Lu, Qing; Li, Cui-xian; Huang, Bei-jian; Xue, Li-yun; Wang, Wen-ping

    2015-02-01

    To determine the contrast-enhanced ultrasonography (CEUS) characteristics of minimal fat renal angiomyolipoma (AML) (triphasic and epithelioid) and compare them to each other and to clear cell renal cell carcinoma (ccRCC) to explore their differential diagnostic clue. Qualitative and quantitative CEUS analyses were retrospectively conducted for epithelioid renal AMLs (EAMLs) (n = 15), triphasic minimal fat AMLs (TAMLs) (n = 25), and ccRCCs (n = 113). Enhancement patterns and features with CEUS were qualitatively evaluated. As for the quantitative parameters, rise times (RT), time to peak (TTP), and tumor-to-cortex enhancement ratio (TOC ratio) were compared among these renal tumor histotypes. No significant differences were detected on conventional ultrasound in the three histotypes of renal tumor. On qualitative CEUS analysis, centripetal enhancement in cortical phase (73.3% in EAMLs, 84.0% in TAMLs vs. 18.6% in ccRCCs, p < 0.001 for both), homogeneous peak enhancement (100.0% in both EAMLs and TAMLs vs. 43.4% in ccRCCs, p < 0.001 for both), and iso-enhancement in parenchyma phase (53.3% in AMLs, 52.0% in TAMLs vs. 26.5% in ccRCCs, p = 0.034 and 0.013, respectively) were valuable traits for differentiating EAMLs and TAMLs from ccRCCs. Furthermore, with quantitative analysis, RT and TTP were much shorter in ccRCCs than those in EAMLs and TAMLs. However, all these qualitative and quantitative characteristics made no significant difference between EAMLs and TAMLs. In the differential diagnosis of EAMLs from TAMLs, pseudocapsule sign was valuable (40.0% in EAMLs vs. 0.0% in TAMLs, p < 0.001), and TOC ratio was much higher in EAMLs (166.01 ± 64.47%) than that in TAMLs (93.74 ± 46.56%)(p < 0.001), though they did make overlaps with ccRCCs. With either heterogeneous peak enhancement or the presence of pseudocapsule or TOC ratio >97.34% as the criteria to differentiate ccRCCs and EAMLs from TAMLs, the sensitivity and specificity were 80.0% and 87.5%, respectively

  1. When fear of cancer recurrence becomes a clinical issue: a qualitative analysis of features associated with clinical fear of cancer recurrence.

    PubMed

    Mutsaers, Brittany; Jones, Georden; Rutkowski, Nicole; Tomei, Christina; Séguin Leclair, Caroline; Petricone-Westwood, Danielle; Simard, Sébastien; Lebel, Sophie

    2016-10-01

    Fear of cancer recurrence (FCR) is a common experience for cancer survivors. However, it remains unclear what characteristics differentiate non-clinical from clinical levels of FCR. The goal of this study was to investigate the potential hallmarks of clinical FCR. A convenience sample of 40 participants (n = 19 female) was drawn from another study (Lebel et al. in Qual Life Res 25:311-321. doi: 10.1007/s11136-015-1088-2 , 2016). The semi-structured interview for fear of cancer recurrence (Simard and Savard in J Cancer Surviv 9:481-491. doi: 10.1007/s11764-015-0424-4 , 2015) was used to identify participants with non-clinical and clinical FCR and qualitative analysis of these interviews was performed. Individuals with clinical FCR reported the following features: death-related thoughts, feeling alone, belief that the cancer would return, experiencing intolerance of uncertainty, having cancer-related thoughts and imagery that were difficult to control, daily and recurrent, lasted 30 minutes or more, increased over time, caused distress and impacted their daily life. Triggers of FCR and coping strategies did not appear to be features of clinical FCR as they were reported by participants with a range of FCR scores. While features of clinical FCR found in this analysis such as intrusive thoughts, distress and impact on functioning confirmed previous FCR research, other features spontaneously emerged from the interviews including "death-related thoughts," "feeling alone," and "belief that the cancer will return." The participants' descriptions of cancer-specific fear and worry suggest that FCR is a distinct phenomenon related to cancer survivorship, despite similarities with psychological disorders (e.g., Anxiety Disorders). Future research investigating the construct of FCR, and the distinguishing features of clinical FCR across a range of cancer types and gender is required.

  2. Classification of mammographic masses: comparison between Backpropagation Neural Network (BNN) and human readers

    NASA Astrophysics Data System (ADS)

    Arbach, Lina; Bennett, Darus L.; Reinhardt, Joseph M.; Fallouh, Ghassan

    2003-05-01

    PURPOSE: We compare mammographic mass classification performance between a backpropagation neural network (BNN), expert radiologists, and residents. Our goal is to reduce false negatives during routine reading of mammograms. METHODS: 160 cases from 3 different institutions were used. Each case contained at least one mass and had an accompanying biopsy result. Masses were extracted using region growing with seed locations identified by an expert radiologist. 10 texture and shape based features (area, perimeter, compactness, radial length, spiculation, mean/standard deviation of radial length, minimum/maximum axis, and boundary roughness) were used as inputs to a three-layer BNN. Shape features were computed on the boundary of the mass region; texture features were computed from the pixel values inside the mass. 140 cases were used for training the BNN and the remaining 20 cases were used for testing. The testing set was diagnosed by three expert radiologists, three residents, and the BNN. We evaluated the human readers and the BNN by computing the area under the ROC curve (AUC). RESULTS: The AUC was 0.923 for the BNN, 0.846 for the expert radiologists, and 0.648 for the residents. These results illustrate the promise of using BNN as a physician"s assistant for breast mass classification.

  3. Adaptation and visual search in mammographic images

    PubMed Central

    Kompaniez-Dunigan, Elysse; Abbey, Craig K.; Boone, John M.; Webster, Michael A.

    2015-01-01

    Radiologists face the visually challenging task of detecting suspicious features within the complex and noisy backgrounds characteristic of medical images. We used a search task to examine whether salience of target features in x-ray mammograms could be enhanced by prior adaptation to the spatial structure of the images. Observers were not radiologists and thus had no diagnostic training with the images. Stimuli were randomly selected sections from normal mammograms previously classified with BIRADS Density scores of “fatty” vs. “dense,” corresponding to differences in the relative quantities of fat vs. fibroglandular tissue. These categories reflect conspicuous differences in visual texture, with dense tissue being more likely to obscure lesion detection. Targets were simulated masses corresponding to bright Gaussian spots (sd = .18 deg), superimposed by adding the luminance to the background. A single target was added to each image at random locations, with contrast varied over 5 levels so that they varied from difficult to easy to detect. Reaction times were measured for detecting the target location (left or right side), before or after adapting to a gray field or random sequences of a different set of dense or fatty images. Observers were faster at detecting the targets in either dense or fatty images after adapting to the specific background type (dense or fatty) they were searching within. Thus the adaptation led to a facilitation of search performance that was selective for the background texture. Our results are consistent with the hypothesis that adaptation allows observers to more effectively suppress the specific structure of the background, thereby heightening visual salience and search efficiency. PMID:25720760

  4. Adaptation and visual search in mammographic images.

    PubMed

    Kompaniez-Dunigan, Elysse; Abbey, Craig K; Boone, John M; Webster, Michael A

    2015-05-01

    Radiologists face the visually challenging task of detecting suspicious features within the complex and noisy backgrounds characteristic of medical images. We used a search task to examine whether the salience of target features in x-ray mammograms could be enhanced by prior adaptation to the spatial structure of the images. The observers were not radiologists, and thus had no diagnostic training with the images. The stimuli were randomly selected sections from normal mammograms previously classified with BIRADS Density scores of "fatty" versus "dense," corresponding to differences in the relative quantities of fat versus fibroglandular tissue. These categories reflect conspicuous differences in visual texture, with dense tissue being more likely to obscure lesion detection. The targets were simulated masses corresponding to bright Gaussian spots, superimposed by adding the luminance to the background. A single target was randomly added to each image, with contrast varied over five levels so that they varied from difficult to easy to detect. Reaction times were measured for detecting the target location, before or after adapting to a gray field or to random sequences of a different set of dense or fatty images. Observers were faster at detecting the targets in either dense or fatty images after adapting to the specific background type (dense or fatty) that they were searching within. Thus, the adaptation led to a facilitation of search performance that was selective for the background texture. Our results are consistent with the hypothesis that adaptation allows observers to more effectively suppress the specific structure of the background, thereby heightening visual salience and search efficiency.

  5. Adolescent intake of animal fat and red meat in relation to premenopausal mammographic density.

    PubMed

    Bertrand, Kimberly A; Burian, Rosemarie A; Eliassen, A Heather; Willett, Walter C; Tamimi, Rulla M

    2016-01-01

    Adolescence is hypothesized to be a time period of particular susceptibility to breast cancer risk factors. Red meat and fat intake during high school was positively associated with risk of breast cancer among premenopausal women in the Nurses' Health Study II (NHSII). High mammographic density is a strong predictor of breast cancer risk but there is limited research on dietary factors associated with breast density. To test the hypothesis that high intake of animal fat or red meat during adolescence is associated with mammographic density, we analyzed data from premenopausal women in the NHSII. Participants recalled adolescent diet on a high school food frequency questionnaire. We assessed absolute and percent mammographic density on digitized analog film mammograms for 687 premenopausal women with no history of cancer. We used generalized linear regression to quantify associations of adolescent animal fat and red meat intake with mammographic density, adjusting for age, body mass index, and other predictors of mammographic density. Adolescent animal fat intake was significantly positively associated with premenopausal mammographic density, with a mean percent density of 39.2 % in the lowest quartile of adolescent animal fat intake versus 43.1 % in the highest quartile (p trend: 0.03). A non-significant positive association was also observed for adolescent red meat intake (p trend: 0.14). These findings suggest that higher adolescent animal fat intake is weakly associated with percent mammographic density in premenopausal women.

  6. Association of body size measurements and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Kim, Sun-Young

    2010-06-01

    Both greater body size and higher mammographic density seem to be associated with a risk of breast cancer. To understand a mechanism through which body size confers a higher risk of breast cancer, associations between mammographic measures and various measures of body size were examined. Study subjects were 730 Korean women selected from the Healthy Twin study. Body size measurements were completed according to standard protocol. Mammographic density was measured from digital mammograms using a computer-assisted method from which the total area and the dense area of the breast were calculated, and nondense area and percent of dense area were straightforwardly derived. Linear mixed models considering familial correlations were used for analyses. Total and nondense areas were positively associated with current body mass index (BMI), BMI at 35 years, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area was inversely associated with these characteristics in both premenopausal and postmenopausal women. Height was not associated with any mammographic measure. Total and nondense areas had strong positive genetic correlations with current BMI, total fat percent, waist circumference, and waist-hip ratio, whereas percent dense area had strong inverse genetic correlations with these body size measurements. Mammographic density and obesity are inversely associated with each other possibly from common genetic influences that have opposite effects on mammographic density and obesity in Korean women. The association between obesity and breast cancer does not seem to be mediated through mammographic density. Copyright 2010 AACR.

  7. How do the features of mindfulness-based cognitive therapy contribute to positive therapeutic change? A meta-synthesis of qualitative studies.

    PubMed

    Cairns, Victoria; Murray, Craig

    2015-05-01

    The exploration of Mindfulness-based Cognitive Therapy through qualitative investigation is a growing area of interest within current literature, providing valuable understanding of the process of change experienced by those engaging in this therapeutic approach. This meta-synthesis aims to gain a deeper understanding of how the features of Mindfulness-based Cognitive Therapy contribute to positive therapeutic change. Noblit and Hare's (1988) 7-step meta-ethnography method was conducted in order to synthesize the findings of seven qualitative studies. The process of reciprocal translation identified the following five major themes: i) Taking control through understanding, awareness and acceptance; ii) The impact of the group; (iii) Taking skills into everyday life; (iv) Feelings towards the self; (v) The role of expectations. The synthesis of translation identified the higher order concept of "The Mindfulness-based Cognitive Therapy Journey to Change", which depicts the complex interaction between the five themes in relation to how they contribute to positive therapeutic change. The findings are discussed in relation to previous research, theory and their implications for clinical practice.

  8. Increases in Serum Estrone Sulfate Level Are Associated with Increased Mammographic Density during Menopausal Hormone Therapy

    PubMed Central

    Crandall, Carolyn J.; Guan, Min; Laughlin, Gail A.; Ursin, Giske A.; Stanczyk, Frank Z.; Ingles, Sue A.; Barrett-Connor, Elizabeth; Greendale, Gail A.

    2009-01-01

    Background Menopausal hormone therapy increases mammographic density. We determined whether increases in serum estrone sulfate (E1S) levels during menopausal hormone therapy predict increased mammographic density. Methods We measured percent mammographic density and serum E1S levels in 428 participants of the Postmenopausal Estrogen/Progestin Interventions study who were randomly assigned to daily conjugated equine estrogen (CEE) 0.625 mg alone, CEE + daily medroxyprogesterone acetate (MPA) 2.5 mg, CEE + cyclical MPA (10 mg days 1-12 per 28-day cycle), or CEE + cyclical micronized progesterone (10 mg days 1-12). Serum E1S levels were determined by RIA. Information about covariates was determined by annual questionnaire. Using linear regression, we determined the association between change in E1S level from baseline to 12 months and change in percent mammographic density (by semiquantitative interactive threshold method). Results After controlling for baseline mammographic density, age, body mass index, alcohol intake, parity, smoking, ethnicity, physical activity, and age at first pregnancy, mammographic density increased by 1.3% for every 1 ng/mL increase in E1S level (P < 0.0001). The association between change in E1S level and change in mammographic density differed by treatment group (greater effect in CEE + cyclical MPA group versus CEE group; P = 0.05). After controlling for treatment group, change in the ratio of E1S to E1 was also positively associated with change in mammographic density. Conclusions Increases in serum E1S levels during menopausal hormone therapy are associated with increases in mammographic density. The relative contribution of E1S and E1 to stimulation of breast tissue awaits further elucidation. PMID:18628419

  9. Cyclic endogenous estrogen and progesterone vary by mammographic density phenotypes in premenopausal women

    PubMed Central

    Iversen, Anita; Furberg, Anne-Sofie; Flote, Vidar G.; Finstad, Sissi Espetvedt; McTiernan, Anne; Ursin, Giske; Wilsgaard, Tom; Ellison, Peter T.; Jasienska, Grazyna; Thune, Inger

    2016-01-01

    Estrogen and progesterone are key factors in the development of breast cancer, but it remains unclear whether these hormones are associated with mammographic density phenotypes in premenopausal women. We measured percent mammographic density, nondense area, and absolute mammographic density using computer-assisted breast density readings (Madena) from digitized mammograms taken on a scheduled day of the menstrual cycle (day 7–12) among 202 healthy, premenopausal women (Energy Balance and Breast cancer Aspects Study-I). Daily salivary concentrations of 17β-estradiol and progesterone throughout an entire menstrual cycle and fasting morning serum concentrations of hormones on 3 specific days of the menstrual cycle were assessed. Salivary and serum 17β-estradiol and progesterone were positively associated with percent mammographic density, we observed by 1 SD increase in overall salivary estradiol (β-value equal to 2.07, P=0.044), luteal salivary progesterone (β-value equal to 2.40, P=0.020). Women with above-median percent mammographic density had a 20% higher mean salivary 17β-estradiol level throughout the menstrual cycle. The odds ratio for having above-median percent mammographic density (>28.5%) per 1 SD increase in overall salivary 17β-estradiol was 1.66 (95% confidence interval 1.13–2.45). Women in the top tertile of the overall average daily 17β-estradiol concentrations had an odds ratio of 2.54 (confidence interval 1.05–6.16) of above-median percent mammographic density compared with women in the bottom tertile. Our finding of a relationship between estrogen, progesterone, and percent mammographic density and not with other mammographic density phenotypes in premenopausal women is biologically plausible, but needs to be replicated in larger studies. PMID:25714648

  10. CADx of mammographic masses and clustered microcalcifications: A review

    SciTech Connect

    Elter, Matthias; Horsch, Alexander

    2009-06-15

    Breast cancer is the most common type of cancer among women in the western world. While mammography is regarded as the most effective tool for the detection and diagnosis of breast cancer, the interpretation of mammograms is a difficult and error-prone task. Hence, computer aids have been developed that assist the radiologist in the interpretation of mammograms. Computer-aided detection (CADe) systems address the problem that radiologists often miss signs of cancers that are retrospectively visible in mammograms. Furthermore, computer-aided diagnosis (CADx) systems have been proposed that assist the radiologist in the classification of mammographic lesions as benign or malignant. While a broad variety of approaches to both CADe and CADx systems have been published in the past two decades, an extensive survey of the state of the art is only available for CADe approaches. Therefore, a comprehensive review of the state of the art of CADx approaches is presented in this work. Besides providing a summary, the goals for this article are to identify relations, contradictions, and gaps in literature, and to suggest directions for future research. Because of the vast amount of publications on the topic, this survey is restricted to the two most important types of mammographic lesions: masses and clustered microcalcifications. Furthermore, it focuses on articles published in international journals.

  11. Mammographic resolution: influence of focal spot intensity distribution and geometry.

    PubMed

    Nickoloff, E L; Donnelly, E; Eve, L; Atherton, J V; Asch, T

    1990-01-01

    The influence of focal spot intensity distribution and geometry upon mammographic image quality were evaluated. The modulation transfer functions (MTF's) for eight different intensity distributions were determined and plotted in a manner to eliminate the effects of magnification and focal spot dimension. The results indicated that the total cross-sectional area is important for focal spots with uniform intensity distributions and equivalent diameters. For equivalent focal spot dimensions, intensity distributions with edge bands were shown to have less spatial resolution than uniform intensity distributions. Focal spots with greater intensities towards their centers provided better resolution than either uniform intensity distributions or distributions with edge bands for equivalent sizes. The type of intensity distribution was also shown to affect the accuracy of star pattern measurements of focal spot size; this method of measurement is only precise for a uniform square intensity distribution. Errors obtained with several other intensity distributions were tabulated. The variations of the effective focal spot size with position along the anode-cathode axis were shown to be of a factor of approximately two to three. The combined effects of geometric blur and film/screen blur were present for various heights above the cassette tray on several different mammographic systems.

  12. Evaluation of a new mammographic film: methods and considerations.

    PubMed

    Tsalafoutas, Oannis A; Kolovos, Christos A; Tsapaki, Virginia; Betsou, Sofia; Koliakou, Eleni; Maniatis, Petros N; Xenofos, Stelios

    2008-04-01

    In this study the performance of a new mammographic film, the XMA (Retina), was evaluated in comparison with HT (Agfa). The comparison was made in terms of sensitometric characteristics and in terms of image quality and speed when combined with four different cassettes-HDS (Agfa), Min-R 2000 and Min-R 2190 (Kodak), and AD-MA (Fuji)-using the Leeds TOR(MAX) Mammographic Quality Control phantom. The entrance surface air kerma was calculated from exposure factors and the relative speed of each screen-film combination was determined. These tests revealed that XMA requires about 40% less dose than HT when combined with the same intensifying screen, at a penalty of less than 8% in image quality. When combined with AD-MA the XMA presents the greatest speed, whereas the Min-R 2190 is the best compromise between image quality and breast dose. The above values are indicative of the dilemma that medical physicists and radiologists face when it comes to the selection of a screen-film combination for mammography. Both image quality and breast dose should be considered, but strict instructions on what weight should be assigned to each parameter have not been established yet. Health Phys. 94(4):338-344; 2008.

  13. Evaluation of four mammographic density measures on HRT data

    NASA Astrophysics Data System (ADS)

    Raundahl, Jakob; Loog, Marco; Pettersen, Paola; Nielsen, Mads

    2007-03-01

    Numerous studies have investigated the relation between mammographic density and breast cancer risk. These studies indicate that women with dense breasts have a four to six fold risk increase. There is currently no gold standard for automatic assessment of mammographic density. In previous work two different automated methods for measuring the effect of HRT w.r.t. changes in breast density have been presented. One is a percentage density based on an adaptive global threshold, and the other is an intensity invariant measure, which provides structural information orthogonal to intensity-based methods. In this article we investigate the ability to detect density changes induced by HRT for these measures and compare to a radiologist's BI-RADS rating and interactive threshold percentage density. In the experiments, two sets of mammograms of 80 patients from a double blind, placebo controlled HRT experiment are used. The p-values for the statistical significance of the separation of density means, for the HRT group and the placebo group at end of study, are 0.2, 0.1, 0.02 and 0.02 for the automatic threshold, BI-RADS, the stripyness and the interactive threshold respectively.

  14. Hyperspectral analysis for qualitative and quantitative features related to acid mine drainage at a remediated open-pit mine

    NASA Astrophysics Data System (ADS)

    Davies, G.; Calvin, W. M.

    2015-12-01

    The exposure of pyrite to oxygen and water in mine waste environments is known to generate acidity and the accumulation of secondary iron minerals. Sulfates and secondary iron minerals associated with acid mine drainage (AMD) exhibit diverse spectral properties in the ultraviolet, visible and near-infrared regions of the electromagnetic spectrum. The use of hyperspectral imagery for identification of AMD mineralogy and contamination has been well studied. Fewer studies have examined the impacts of hydrologic variations on mapping AMD or the unique spectral signatures of mine waters. Open-pit mine lakes are an additional environmental hazard which have not been widely studied using imaging spectroscopy. A better understanding of AMD variation related to climate fluctuations and the spectral signatures of contaminated surface waters will aid future assessments of environmental contamination. This study examined the ability of multi-season airborne hyperspectral data to identify the geochemical evolution of substances and contaminant patterns at the Leviathan Mine Superfund site. The mine is located 24 miles southeast of Lake Tahoe and contains remnant tailings piles and several AMD collection ponds. The objectives were to 1) distinguish temporal changes in mineralogy at a the remediated open-pit sulfur mine, 2) identify the absorption features of mine affected waters, and 3) quantitatively link water spectra to known dissolved iron concentrations. Images from NASA's AVIRIS instrument were collected in the spring, summer, and fall seasons for two consecutive years at Leviathan (HyspIRI campaign). Images had a spatial resolution of 15 meters at nadir. Ground-based surveys using the ASD FieldSpecPro spectrometer and laboratory spectral and chemical analysis complemented the remote sensing data. Temporal changes in surface mineralogy were difficult to distinguish. However, seasonal changes in pond water quality were identified. Dissolved ferric iron and chlorophyll

  15. Evaluation of mammographic density patterns: reproducibility and concordance among scales.

    PubMed

    Garrido-Estepa, Macarena; Ruiz-Perales, Francisco; Miranda, Josefa; Ascunce, Nieves; González-Román, Isabel; Sánchez-Contador, Carmen; Santamariña, Carmen; Moreo, Pilar; Vidal, Carmen; Peris, Mercé; Moreno, María P; Váquez-Carrete, Jose A; Collado-García, Francisca; Casanova, Francisco; Ederra, María; Salas, Dolores; Pollán, Marina

    2010-09-13

    Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd) and compare them in terms of classifying mammograms as high- or low-density. The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonomous Regions. Each mammogram was read by an expert radiologist and classified using the Wolfe, Tabár, BI-RADS and Boyd scales. In addition, 375 mammograms randomly selected were read a second time to estimate intra-rater agreement for each scale using the kappa statistic. Owing to the ordinal nature of the scales, weighted kappa was computed. The entire set of mammograms (3572) was used to calculate agreement among the different scales in classifying high/low-density patterns, with the kappa statistic being computed on a pair-wise basis. High density was defined as follows: percentage of dense tissue greater than 50% for the Boyd, "heterogeneously dense and extremely dense" categories for the BI-RADS, categories P2 and DY for the Wolfe, and categories IV and V for the Tabár scales. There was good agreement between the first and second reading, with weighted kappa values of 0.84 for Wolfe, 0.71 for Tabár, 0.90 for BI-RADS, and 0.92 for Boyd scale. Furthermore, there was substantial agreement among the different scales in classifying high- versus low-density patterns. Agreement was almost perfect between the quantitative scales, Boyd and BI-RADS, and good for those based on the observed pattern, i.e., Tabár and Wolfe (kappa 0.81). Agreement was lower when comparing a pattern-based (Wolfe or Tabár) versus a quantitative-based (BI-RADS or Boyd) scale. Moreover, the Wolfe and Tabár scales classified more mammograms in the high-risk group, 46.61 and 37.32% respectively, while this percentage was lower for

  16. Evaluation of mammographic density patterns: reproducibility and concordance among scales

    PubMed Central

    2010-01-01

    Background Increased mammographic breast density is a moderate risk factor for breast cancer. Different scales have been proposed for classifying mammographic density. This study sought to assess intra-rater agreement for the most widely used scales (Wolfe, Tabár, BI-RADS and Boyd) and compare them in terms of classifying mammograms as high- or low-density. Methods The study covered 3572 mammograms drawn from women included in the DDM-Spain study, carried-out in seven Spanish Autonomous Regions. Each mammogram was read by an expert radiologist and classified using the Wolfe, Tabár, BI-RADS and Boyd scales. In addition, 375 mammograms randomly selected were read a second time to estimate intra-rater agreement for each scale using the kappa statistic. Owing to the ordinal nature of the scales, weighted kappa was computed. The entire set of mammograms (3572) was used to calculate agreement among the different scales in classifying high/low-density patterns, with the kappa statistic being computed on a pair-wise basis. High density was defined as follows: percentage of dense tissue greater than 50% for the Boyd, "heterogeneously dense and extremely dense" categories for the BI-RADS, categories P2 and DY for the Wolfe, and categories IV and V for the Tabár scales. Results There was good agreement between the first and second reading, with weighted kappa values of 0.84 for Wolfe, 0.71 for Tabár, 0.90 for BI-RADS, and 0.92 for Boyd scale. Furthermore, there was substantial agreement among the different scales in classifying high- versus low-density patterns. Agreement was almost perfect between the quantitative scales, Boyd and BI-RADS, and good for those based on the observed pattern, i.e., Tabár and Wolfe (kappa 0.81). Agreement was lower when comparing a pattern-based (Wolfe or Tabár) versus a quantitative-based (BI-RADS or Boyd) scale. Moreover, the Wolfe and Tabár scales classified more mammograms in the high-risk group, 46.61 and 37.32% respectively, while

  17. Reported Mammographic Density: Film-Screen versus Digital Acquisition

    PubMed Central

    Gard, Charlotte C.; Miglioretti, Diana L.; Yankaskas, Bonnie C.; Kerlikowske, Karla; Buist, Diana S. M.; Geller, Berta A.; Onega, Tracy L.

    2013-01-01

    Purpose: To test the hypothesis that American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories for breast density reported by radiologists are lower when digital mammography is used than those reported when film-screen (FS) mammography is used. Materials and Methods: This study was institutional review board approved and HIPAA compliant. Demographic data, risk factors, and BI-RADS breast density categories were collected from five mammography registries that were part of the Breast Cancer Surveillance Consortium. Active, passive, or waiver of consent was obtained for all participants. Women aged 40 years and older who underwent at least two screening mammographic examinations less than 36 months apart between January 1, 2000, and December 31, 2009, were included. Women with prior breast cancer, augmentation, or use of agents known to affect density were excluded. The main sample included 89 639 women with both FS and digital mammograms. The comparison group included 259 046 women with two FS mammograms and 87 066 women with two digital mammograms. BI-RADS density was cross-tabulated according to the order in which the two types of mammogram were acquired and by the first versus second interpretation. Results: Regardless of acquisition method, the percentage of women with a change in density from one reading to the next was similar. Breast density was lower in 19.8% of the women who underwent FS before digital mammography and 17.1% of those who underwent digital before FS mammography. Similarly, lower density classifications were reported on the basis of the second mammographic examination regardless of acquisition method (15.8%–19.8%). The percentage of agreement between density readings was similar regardless of mammographic types paired (67.3%–71.0%). Conclusion: The study results showed no difference in reported BI-RADS breast density categories according to acquisition method. Reported BI-RADS density categories may be

  18. A multiple circular path convolution neural network system for detection of mammographic masses.

    PubMed

    Lo, Shih-Chung B; Li, Huai; Wang, Yue; Kinnard, Lisa; Freedman, Matthew T

    2002-02-01

    A multiple circular path convolution neural network (MCPCNN) architecture specifically designed for the analysis of tumor and tumor-like structures has been constructed. We first divided each suspected tumor area into sectors and computed the defined mass features for each sector independently. These sector features were used on the input layer and were coordinated by convolution kernels of different sizes that propagated signals to the second layer in the neural network system. The convolution kernels were trained, as required, by presenting the training cases to the neural network. In this study, randomly selected mammograms were processed by a dual morphological enhancement technique. Radiodense areas were isolated and were delineated using a region growing algorithm. The boundary of each region of interest was then divided into 36 sectors using 36 equi-angular dividers radiated from the center of the region. A total of 144 Breast Imaging-Reporting and Data System-based features (i.e., four features per sector for 36 sectors) were computed as input values for the evaluation of this newly invented neural network system. The overall performance was 0.78-0.80 for the areas (Az) under the receiver operating characteristic curves using the conventional feed-forward neural network in the detection of mammographic masses. The performance was markedly improved with Az values ranging from 0.84 to 0.89 using the MCPCNN. This paper does not intend to claim the best mass detection system. Instead it reports a potentially better neural network structure for analyzing a set of the mass features defined by an investigator.

  19. Computer-aided classification of mammographic masses using the deep learning technology: a preliminary study

    NASA Astrophysics Data System (ADS)

    Qiu, Yuchen; Yan, Shiju; Tan, Maxine; Cheng, Samuel; Liu, Hong; Zheng, Bin

    2016-03-01

    Although mammography is the only clinically acceptable imaging modality used in the population-based breast cancer screening, its efficacy is quite controversy. One of the major challenges is how to help radiologists more accurately classify between benign and malignant lesions. The purpose of this study is to investigate a new mammographic mass classification scheme based on a deep learning method. In this study, we used an image dataset involving 560 regions of interest (ROIs) extracted from digital mammograms, which includes 280 malignant and 280 benign mass ROIs, respectively. An eight layer deep learning network was applied, which employs three pairs of convolution-max-pooling layers for automatic feature extraction and a multiple layer perception (MLP) classifier for feature categorization. In order to improve robustness of selected features, each convolution layer is connected with a max-pooling layer. A number of 20, 10, and 5 feature maps were utilized for the 1st, 2nd and 3rd convolution layer, respectively. The convolution networks are followed by a MLP classifier, which generates a classification score to predict likelihood of a ROI depicting a malignant mass. Among 560 ROIs, 420 ROIs were used as a training dataset and the remaining 140 ROIs were used as a validation dataset. The result shows that the new deep learning based classifier yielded an area under the receiver operation characteristic curve (AUC) of 0.810+/-0.036. This study demonstrated the potential superiority of using a deep learning based classifier to distinguish malignant and benign breast masses without segmenting the lesions and extracting the pre-defined image features.

  20. Developing a new case based computer-aided detection scheme and an adaptive cueing method to improve performance in detecting mammographic lesions

    NASA Astrophysics Data System (ADS)

    Tan, Maxine; Aghaei, Faranak; Wang, Yunzhi; Zheng, Bin

    2017-01-01

    The purpose of this study is to evaluate a new method to improve performance of computer-aided detection (CAD) schemes of screening mammograms with two approaches. In the first approach, we developed a new case based CAD scheme using a set of optimally selected global mammographic density, texture, spiculation, and structural similarity features computed from all four full-field digital mammography images of the craniocaudal (CC) and mediolateral oblique (MLO) views by using a modified fast and accurate sequential floating forward selection feature selection algorithm. Selected features were then applied to a ‘scoring fusion’ artificial neural network classification scheme to produce a final case based risk score. In the second approach, we combined the case based risk score with the conventional lesion based scores of a conventional lesion based CAD scheme using a new adaptive cueing method that is integrated with the case based risk scores. We evaluated our methods using a ten-fold cross-validation scheme on 924 cases (476 cancer and 448 recalled or negative), whereby each case had all four images from the CC and MLO views. The area under the receiver operating characteristic curve was AUC  =  0.793  ±  0.015 and the odds ratio monotonically increased from 1 to 37.21 as CAD-generated case based detection scores increased. Using the new adaptive cueing method, the region based and case based sensitivities of the conventional CAD scheme at a false positive rate of 0.71 per image increased by 2.4% and 0.8%, respectively. The study demonstrated that supplementary information can be derived by computing global mammographic density image features to improve CAD-cueing performance on the suspicious mammographic lesions.

  1. Developing a new case based computer-aided detection scheme and an adaptive cueing method to improve performance in detecting mammographic lesions.

    PubMed

    Tan, Maxine; Aghaei, Faranak; Wang, Yunzhi; Zheng, Bin

    2017-01-21

    The purpose of this study is to evaluate a new method to improve performance of computer-aided detection (CAD) schemes of screening mammograms with two approaches. In the first approach, we developed a new case based CAD scheme using a set of optimally selected global mammographic density, texture, spiculation, and structural similarity features computed from all four full-field digital mammography images of the craniocaudal (CC) and mediolateral oblique (MLO) views by using a modified fast and accurate sequential floating forward selection feature selection algorithm. Selected features were then applied to a 'scoring fusion' artificial neural network classification scheme to produce a final case based risk score. In the second approach, we combined the case based risk score with the conventional lesion based scores of a conventional lesion based CAD scheme using a new adaptive cueing method that is integrated with the case based risk scores. We evaluated our methods using a ten-fold cross-validation scheme on 924 cases (476 cancer and 448 recalled or negative), whereby each case had all four images from the CC and MLO views. The area under the receiver operating characteristic curve was AUC  =  0.793  ±  0.015 and the odds ratio monotonically increased from 1 to 37.21 as CAD-generated case based detection scores increased. Using the new adaptive cueing method, the region based and case based sensitivities of the conventional CAD scheme at a false positive rate of 0.71 per image increased by 2.4% and 0.8%, respectively. The study demonstrated that supplementary information can be derived by computing global mammographic density image features to improve CAD-cueing performance on the suspicious mammographic lesions.

  2. The importance of mammographic screening relative to the treatment of women with carcinoma of the breast.

    PubMed

    Solin, L J; Legorreta, A; Schultz, D J; Zatz, S; Goodman, R L

    1994-04-11

    The use of mammographic screening for the early detection of breast cancer has been shown to reduce the mortality from breast cancer. However, the impact of mammographic screening relative to the local treatment of the breast (ie, breast-conservation treatment vs mastectomy) is not well established. An analysis was performed of 206 newly diagnosed and treated breast cancers in 201 women identified in 1989 from a health maintenance organization (US Healthcare, Blue Bell, Pa). The 206 breast cancers were evaluated for eligibility for and actual local treatment of the breast with breast-conserving surgery and definitive breast irradiation as a function of mammographic screening for the early detection of breast cancer. Eligibility for local treatment of the breast with breast-conserving surgery and definitive breast irradiation was significantly increased for the breast cancers detected in women who had undergone mammographic screening compared with the breast cancers detected in women who had not undergone mammographic screening (88% vs 60%, respectively; P < .0001). For the breast cancers that were eligible on chart review for treatment with breast-conserving surgery and definitive breast irradiation, there was no significant difference in the actual local treatment of the breast with breast-conserving surgery and definitive breast irradiation for the eligible breast cancers detected in women who had undergone mammographic screening compared with the eligible breast cancers detected in women who had not undergone mammographic screening (44% vs 37%, respectively; P = .40); however, there was a statistically significant difference for the subgroup of women aged 50 years or more (49% vs 21%, respectively; P = .016). These results show that breast cancers detected in women who had undergone mammographic screening were more likely to be eligible for breast-conserving surgery and definitive breast irradiation compared with breast cancers detected in women who had not

  3. Relationship of Serum Estrogens and Metabolites with Area and Volume Mammographic Densities

    PubMed Central

    Gierach, Gretchen L.; Patel, Deesha A.; Falk, Roni T.; Pfeiffer, Ruth M.; Geller, Berta M.; Vacek, Pamela M.; Weaver, Donald L.; Chicoine, Rachael E.; Shepherd, John A.; Mahmoudzadeh, Amir Pasha; Wang, Jeff; Fan, Bo; Herschorn, Sally D.; Xu, Xia; Veenstra, Timothy; Fuhrman, Barbara; Sherman, Mark E.; Brinton, Louise A.

    2015-01-01

    Purpose Elevated mammographic density is a breast cancer risk factor, which has a suggestive, but unproven, relationship with increased exposure to sex-steroid hormones. We examined associations of serum estrogens and estrogen metabolites with area and novel volume mammographic density measures among 187 women, ages 40–65, undergoing diagnostic breast biopsies at an academic facility in Vermont. Methods Serum parent estrogens, estrone and estradiol, and their 2-, 4-, and 16-hydroxylated metabolites were measured using liquid chromatography-tandem mass spectrometry. Area mammographic density was measured in the breast contralateral to the biopsy using thresholding software; volume mammographic density was quantified using a density phantom. Linear regression was used to estimate associations of estrogens with mammographic densities, adjusted for age and body mass index, and stratified by menopausal status and menstrual cycle phase. Results Weak, positive associations between estrogens, estrogen metabolites and mammographic density were observed, primarily among postmenopausal women. Among premenopausal luteal phase women, the 16-pathway metabolite estriol was associated with percent area (p=0.04) and volume (p=0.05) mammographic densities and absolute area (p=0.02) and volume (p=0.05) densities. Among postmenopausal women, levels of total estrogens, the sum of parent estrogens, and 2-, 4- and 16-hydroxylation pathway metabolites were positively associated with area density measures (percent: p=0.03, p=0.04, p=0.01, p=0.02, p=0.07; absolute: p=0.02, p=0.02, p=0.01, p=0.02, p=0.03, respectively), but not volume density measures. Conclusions Our data suggest that serum estrogen profiles are weak determinants of mammographic density and that analysis of different density metrics may provide complementary information about relationships of exposures to breast tissue composition. PMID:25757805

  4. Relationship of serum estrogens and metabolites with area and volume mammographic densities.

    PubMed

    Gierach, Gretchen L; Patel, Deesha A; Falk, Roni T; Pfeiffer, Ruth M; Geller, Berta M; Vacek, Pamela M; Weaver, Donald L; Chicoine, Rachael E; Shepherd, John A; Mahmoudzadeh, Amir Pasha; Wang, Jeff; Fan, Bo; Herschorn, Sally D; Xu, Xia; Veenstra, Timothy; Fuhrman, Barbara; Sherman, Mark E; Brinton, Louise A

    2015-06-01

    Elevated mammographic density is a breast cancer risk factor, which has a suggestive, but unproven, relationship with increased exposure to sex steroid hormones. We examined associations of serum estrogens and estrogen metabolites with area and novel volume mammographic density measures among 187 women, ages 40-65, undergoing diagnostic breast biopsies at an academic facility in Vermont. Serum parent estrogens, estrone and estradiol, and their 2-, 4-, and 16-hydroxylated metabolites were measured using liquid chromatography-tandem mass spectrometry. Area mammographic density was measured in the breast contralateral to the biopsy using thresholding software; volume mammographic density was quantified using a density phantom. Linear regression was used to estimate associations of estrogens with mammographic densities, adjusted for age and body mass index, and stratified by menopausal status and menstrual cycle phase. Weak, positive associations between estrogens, estrogen metabolites, and mammographic density were observed, primarily among postmenopausal women. Among premenopausal luteal phase women, the 16-pathway metabolite estriol was associated with percent area (p = 0.04) and volume (p = 0.05) mammographic densities and absolute area (p = 0.02) and volume (p = 0.05) densities. Among postmenopausal women, levels of total estrogens, the sum of parent estrogens, and 2-, 4- and 16-hydroxylation pathway metabolites were positively associated with area density measures (percent: p = 0.03, p = 0.04, p = 0.01, p = 0.02, p = 0.07; absolute: p = 0.02, p = 0.02, p = 0.01, p = 0.02, p = 0.03, respectively) but not volume density measures. Our data suggest that serum estrogen profiles are weak determinants of mammographic density and that analysis of different density metrics may provide complementary information about relationships of estrogen exposure to breast tissue composition.

  5. Common variants in ZNF365 are associated with both mammographic density and breast cancer risk

    PubMed Central

    Lindström, Sara; Vachon, Celine M.; Li, Jingmei; Varghese, Jajini; Thompson, Deborah; Warren, Ruth; Brown, Judith; Leyland, Jean; Audley, Tina; Wareham, Nicholas J.; Loos, Ruth J.F.; Paterson, Andrew D.; Waggott, Darryl; Martin, Lisa J.; Scott, Christopher G.; Pankratz, V. Shane; Hankinson, Susan E.; Hazra, Aditi; Hunter, David J.; Hopper, John L.; Southey, Melissa C.; Chanock, Stephen J.; Silva, Isabel dos Santos; Liu, JianJun; Eriksson, Louise; Couch, Fergus J.; Stone, Jennifer; Apicella, Carmel; Czene, Kamila; Kraft, Peter; Hall, Per; Easton, Douglas F.; Boyd, Norman F.; Tamimi, Rulla M.

    2011-01-01

    High percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer. We conducted a meta-analysis of five genome-wide association studies of percent mammographic density and report an association with rs10995190 in ZNF365 (combined P=9×6·10−10). This finding might partly explain the underlying biology of the recently discovered association between common variants in ZNF365 and breast cancer risk. PMID:21278746

  6. Common variants in ZNF365 are associated with both mammographic density and breast cancer risk.

    PubMed

    Lindström, Sara; Vachon, Celine M; Li, Jingmei; Varghese, Jajini; Thompson, Deborah; Warren, Ruth; Brown, Judith; Leyland, Jean; Audley, Tina; Wareham, Nicholas J; Loos, Ruth J F; Paterson, Andrew D; Rommens, Johanna; Waggott, Darryl; Martin, Lisa J; Scott, Christopher G; Pankratz, V Shane; Hankinson, Susan E; Hazra, Aditi; Hunter, David J; Hopper, John L; Southey, Melissa C; Chanock, Stephen J; Silva, Isabel dos Santos; Liu, JianJun; Eriksson, Louise; Couch, Fergus J; Stone, Jennifer; Apicella, Carmel; Czene, Kamila; Kraft, Peter; Hall, Per; Easton, Douglas F; Boyd, Norman F; Tamimi, Rulla M

    2011-03-01

    High-percent mammographic density adjusted for age and body mass index is one of the strongest risk factors for breast cancer. We conducted a meta analysis of five genome-wide association studies of percent mammographic density and report an association with rs10995190 in ZNF365 (combined P = 9.6 × 10(-10)). Common variants in ZNF365 have also recently been associated with susceptibility to breast cancer.

  7. A spatial shape constrained clustering method for mammographic mass segmentation.

    PubMed

    Lou, Jian-Yong; Yang, Xu-Lei; Cao, Ai-Ze

    2015-01-01

    A novel clustering method is proposed for mammographic mass segmentation on extracted regions of interest (ROIs) by using deterministic annealing incorporating circular shape function (DACF). The objective function reported in this study uses both intensity and spatial shape information, and the dominant dissimilarity measure is controlled by two weighting parameters. As a result, pixels having similar intensity information but located in different regions can be differentiated. Experimental results shows that, by using DACF, the mass segmentation results in digitized mammograms are improved with optimal mass boundaries, less number of noisy patches, and computational efficiency. An average probability of segmentation error of 7.18% for well-defined masses (or 8.06% for ill-defined masses) was obtained by using DACF on MiniMIAS database, with 5.86% (or 5.55%) and 6.14% (or 5.27%) improvements as compared to the standard DA and fuzzy c-means methods.

  8. Statistical Segmentation of Regions of Interest on a Mammographic Image

    NASA Astrophysics Data System (ADS)

    Adel, Mouloud; Rasigni, Monique; Bourennane, Salah; Juhan, Valerie

    2007-12-01

    This paper deals with segmentation of breast anatomical regions, pectoral muscle, fatty and fibroglandular regions, using a Bayesian approach. This work is a part of a computer aided diagnosis project aiming at evaluating breast cancer risk and its association with characteristics (density, texture, etc.) of regions of interest on digitized mammograms. Novelty in this paper consists in applying and adapting Markov random field for detecting breast anatomical regions on digitized mammograms whereas most of previous works were focused on masses and microcalcifications. The developed method was tested on 50 digitized mammograms of the mini-MIAS database. Computer segmentation is compared to manual one made by a radiologist. A good agreement is obtained on 68% of the mini-MIAS mammographic image database used in this study. Given obtained segmentation results, the proposed method could be considered as a satisfying first approach for segmenting regions of interest in a breast.

  9. Computerized analysis of mammographic parenchymal patterns using fractal analysis

    NASA Astrophysics Data System (ADS)

    Li, Hui; Giger, Maryellen L.; Huo, Zhimin; Olopade, Olufunmilayo I.; Chinander, Michael R.; Lan, Li; Bonta, Ioana R.

    2003-05-01

    Mammographic parenchymal patterns have been shown to be associated with breast cancer risk. Fractal-based texture analyses, including box-counting methods and Minkowski dimension, were performed within parenchymal regions of normal mammograms of BRCA1/BRCA2 gene mutation carriers and within those of women at low risk for developing breast cancer. Receiver Operating Characteristic (ROC) analysis was used to assess the performance of the computerized radiographic markers in the task of distinguishing between high and low-risk subjects. A multifractal phenomenon was observed with the fractal analyses. The high frequency component of fractal dimension from the conventional box-counting technique yielded an Az value of 0.84 in differentiating between two groups, while using the LDA to estimate the fractal dimension yielded an Az value of 0.91 for the high frequency component. An Az value of 0.82 was obtained with fractal dimensions extracted using the Minkowski algorithm.

  10. Does raloxifene therapy affect mammographic breast cancer screening in postmenopausal patients?

    PubMed

    Cirpan, T; Akercan, F; Itil, I M; Gundem, G; Bilgen, I; Yucebilgin, M S

    2006-01-01

    The aim of the study was to determine mammographic breast density changes during raloxifene therapy in postmenopausal patients Fifty-five cases who were using raloxifen therapy were included in this retrospective analysis. Raloxifene was given for osteopenia and osteoporosis according to low bone mineral density measured by dual-energy X-ray absorptiometry (DEXA). None of the patients were using hormone replacement therapy 12 months before the initiation of raloxifene treatment or during the study. Mammographic breast density was determined by mammography before the initiation of raloxifene treatment (baseline) and after 12 to 16 months of therapy. The Breast Imaging Reporting and Data System (BI-RADS) breast density score was used for the evaluation of mammographic density. There was no change in mammographic breast density when the baseline and the first mammography taken after the initiation of therapy were compared (p = 0.32). There was no significant correlation between the duration of raloxifene treatment and mammographic density measured after raloxifene treatment (r = -0.158, p = 0.25). Only in one patient did the BI-RADS classification of 2 change to 3 after 12 months of therapy. In conclusion, raloxifene therapy for 12 to 16 months does not increase mammographic breast density in postmenopausal women with low bone mass.

  11. Reproductive factors associated with mammographic density: a Korean co-twin control study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Lee, Donghun

    2011-07-01

    To determine the mechanism by which menstrual and reproductive factors are associated with the risk of breast cancer, we examined the relationships between mammographic density and known menstrual and reproductive risk factors for breast cancer. A co-twin control study was conducted with 122 pairs of monozygotic Korean female twins selected from the Healthy Twin study. Mammographic density was measured from digital mammograms using a computer-assisted method. Information on selected menstrual and reproductive factors was collected through a self-administered questionnaire. Within-pair differences for each mammographic measure were regressed against within-pair differences for each menstrual and reproductive risk factor with an adjustment for body mass index and other menstrual and reproductive factors. The percent dense area was inversely associated with the age at the first full-term childbirth (FFTB) and the number of live births, although the associations were marginally significant with an adjustment for BMI and other reproductive factors. The non-dense area was positively associated with the age at the FFTB and the number of live births. The absolute dense area was positively associated with the duration of breast feeding. The age at menarche was not associated with any component of the mammographic measures. This finding suggests that mammographic density can mediate the protective effect of greater parity against breast cancer, at least in part while age at menarche, age at the FFTB, and breast feeding do not exert their effects through mammographic density.

  12. The relationship between bone mineral density and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung

    2011-09-01

    Mammographic density is one of the strong risk factors for breast cancer. A potential mechanism for this association is that cumulative exposure to mammographic density may reflect cumulative exposure to hormones that stimulate cell division in breast stroma and epithelium, which may have corresponding effects on breast cancer development. Bone mineral density (BMD), a marker of lifetime estrogen exposure, has been found to be associated with breast cancer. We examined the association between BMD and mammographic density in a Korean population. Study subjects were 730 Korean women selected from the Healthy Twin study. BMD (g/cm(2)) was measured with dual-energy X-ray absorptiometry. Mammographic density was measured from digital mammograms using a computer-assisted thresholding method. Linear mixed model considering familial correlations and a wide range of covariates was used for analyses. Quantitative genetic analysis was completed using SOLAR. In premenopausal women, positive associations existed between absolute dense area and BMD at ribs, pelvis, and legs, and between percent dense area and BMD at pelvis and legs. However, in postmenopausal women, there was no association between BMD at any site and mammographic density measures. An evaluation of additive genetic cross-trait correlation showed that absolute dense area had a weak-positive additive genetic cross-trait correlation with BMD at ribs and spines after full adjustment of covariates. This finding suggests that the association between mammographic density and breast cancer could, at least in part, be attributable to an estrogen-related hormonal mechanism.

  13. Metabolic syndrome and mammographic density in Mexican women.

    PubMed

    Rice, Megan S; Biessy, Carine; Lajous, Martin; Bertrand, Kimberly A; Tamimi, Rulla M; Torres-Mejía, Gabriela; López-Ridaura, Ruy; Romieu, Isabelle

    2013-07-01

    Metabolic syndrome has been associated with an increased risk of breast cancer; however, little is known about the association between metabolic syndrome and percent mammographic density, a strong predictor of breast cancer. We analyzed cross-sectional data from 789 premenopausal and 322 postmenopausal women in the Mexican Teacher's Cohort (ESMaestras). Metabolic syndrome was defined according to the harmonized definition. We measured percent density on mammograms using a computer-assisted thresholding method. Multivariable linear regression was used to estimate the association between density and metabolic syndrome, as well as its components by state (Jalisco, Veracruz) and menopausal status (premenopausal, postmenopausal). Among premenopausal women in Jalisco, women with metabolic syndrome had higher percent density than those without after adjusting for potential confounders including BMI [difference = 4.76; 95% confidence interval (CI), 1.72-7.81]. Among the metabolic syndrome components, only low high-density lipoprotein levels (<50 mg/dL) were associated with significantly higher percent density among premenopausal women in Jalisco (difference = 4.62; 95% CI, 1.73-7.52). Metabolic syndrome was not associated with percent density among premenopausal women in Veracruz (difference = -2.91; 95% CI, -7.19 to 1.38), nor among postmenopausal women in either state. Metabolic syndrome was associated with higher percent density among premenopausal women in Jalisco, Mexico, but was not associated with percent density among premenopausal women in Veracruz, Mexico, or among postmenopausal women in either Jalisco or Veracruz. These findings provide some support for a possible role of metabolic syndrome in mammographic density among premenopausal women; however, results were inconsistent across states and require further confirmation in larger studies. ©2013 AACR.

  14. Metabolic syndrome and mammographic density in Mexican women

    PubMed Central

    Rice, Megan; Biessy, Carine; Lajous, Martin; Bertrand, Kimberly A.; Tamimi, Rulla M.; Torres-Mejía, Gabriela; López-Ridaura, Ruy; Romieu, Isabelle

    2014-01-01

    Background Metabolic syndrome has been associated with an increased risk of breast cancer; however little is known about the association between metabolic syndrome and percent mammographic density, a strong predictor of breast cancer. Methods We analyzed cross-sectional data from 789 premenopausal and 322 postmenopausal women in the Mexican Teacher's Cohort (ESMaestras). Metabolic syndrome was defined according to the harmonized definition. We measured percent density on mammograms using a computer-assisted thresholding method. Multivariable linear regression was used to estimate the association between density and metabolic syndrome, as well as its components by state (Jalisco, Veracruz) and menopausal status (premenopausal, postmenopausal). Results Among premenopausal women in Jalisco, women with metabolic syndrome had higher percent density compared to those without after adjusting for potential confounders including BMI (difference = 4.76, 95%CI: 1.72, 7.81). Among the metabolic syndrome components, only low high-density lipoprotein levels (<50mg/dl) were associated with significantly higher percent density among premenopausal women in Jalisco (difference=4.62, 95%CI: 1.73, 7.52). Metabolic syndrome was not associated with percent density among premenopausal women in Veracruz (difference=-2.91, 95% CI: -7.19, 1.38), nor among postmenopausal women in either state. Conclusion Metabolic syndrome was associated with higher percent density among premenopausal women in Jalisco, Mexico, but was not associated with percent density among premenopausal women in Veracruz, Mexico or among postmenopausal women in either Jalisco or Veracruz. These findings provide some support for a possible role of metabolic syndrome in mammographic density among premenopausal women; however results were inconsistent across states and require further confirmation in larger studies. PMID:23682074

  15. An Investigation into the Consistency in Mammographic Density Identification by Radiologists: Effect of Radiologist Expertise and Mammographic Appearance.

    PubMed

    Li, Yanpeng; Brennan, Patrick C; Lee, Warwick; Nickson, Carolyn; Pietrzyk, Mariusz W; Ryan, Elaine A

    2015-10-01

    The aim of this work is to investigate how radiologist expertise and image appearance may have an impact on inter-reader variability of mammographic density (MD) identification. Seventeen radiologists, divided into three expertise groups, were asked to manually segment the areas they consider to be MD in 40 clinical images. The variation in identification of MD for each image was quantified by finding the range of segmentation areas. The impact of radiologist expertise and image appearance on this variation was explored. The range of areas chosen by participating radiologists varied from 7 to 73% across the 40 images, with a mean range of 35 ± 13%. Participants with high expertise were more likely to choose similar areas to one another, compared to participants with medium and low expertise levels (mean range were 19 ± 10%, 29 ± 13% and 25 ± 14 %, respectively, p < 0.0001). There was a significantly higher average grey level for the area segmented by all radiologists as MD compared to the area of variation, with mean grey level value for 8-bit images being 146 ± 19 vs. 99 ± 14, respectively. MD segmentation borders were consistent in areas where there was a sharp intensity change within a short distance. In conclusion, radiologists with high expertise tend to have a higher agreement when identifying MD. Tissues which have a lower contrast and a less visually sharp gradient change at the interface between high density tissue and adipose background lead to inter-reader variation in choosing mammographic density.

  16. Paget disease of the breast: mammographic, US, and MR imaging findings with pathologic correlation.

    PubMed

    Lim, Hyo Soon; Jeong, Su Jin; Lee, Ji Shin; Park, Min Ho; Kim, Jin Woong; Shin, Sang Soo; Park, Jin Gyoon; Kang, Heoung Keun

    2011-01-01

    Paget disease is a rare malignancy of the breast characterized by infiltration of the nipple epidermis by adenocarcinoma cells. The clinical features of Paget disease are characteristic and should increase the likelihood of the diagnosis being made. An important point is that more than 90% of cases of Paget disease are associated with an additional underlying breast malignancy. Paget disease is frequently associated with ductal carcinoma in situ (DCIS) in the underlying lactiferous ducts of the nipple-areolar complex; it may even be associated with DCIS or invasive breast cancer elsewhere in the breast, at least 2 cm from the nipple-areolar complex. Nevertheless, mammographic findings may be negative in up to 50% of cases. Magnetic resonance (MR) imaging can be useful in patients with Paget disease for evaluation of the nipple-areolar complex and identification of an additional underlying malignancy in the breast. The appropriate surgical treatment must be carefully selected and individualized on the basis of radiologic findings, especially those obtained with breast MR imaging.

  17. Predictive Modeling of Human Perception Subjectivity: Feasibility Study of Mammographic Lesion Similarity

    SciTech Connect

    Xu, Songhua; Tourassi, Georgia

    2012-01-01

    The majority of clinical content-based image retrieval (CBIR) studies disregard human perception subjectivity, aiming to duplicate the consensus expert assessment of the visual similarity on example cases. The purpose of our study is twofold: (i) discern better the extent of human perception subjectivity when assessing the visual similarity of two images with similar semantic content, and (ii) explore the feasibility of personalized predictive modeling of visual similarity. We conducted a human observer study in which five observers of various expertise were shown ninety-nine triplets of mammographic masses with similar BI-RADS descriptors and were asked to select the two masses with the highest visual relevance. Pairwise agreement ranged between poor and fair among the five observers, as assessed by the kappa statistic. The observers' self-consistency rate was remarkably low, based on repeated questions where either the orientation or the presentation order of a mass was changed. Various machine learning algorithms were explored to determine whether they can predict each observer's personalized selection using textural features. Many algorithms performed with accuracy that exceeded each observer's self-consistency rate, as determined using a cross-validation scheme. This accuracy was statistically significantly higher than would be expected by chance alone (two-tailed p-value ranged between 0.001 and 0.01 for all five personalized models). The study confirmed that human perception subjectivity should be taken into account when developing CBIR-based medical applications.

  18. Predictive modeling of human perception subjectivity: feasibility study of mammographic lesion similarity

    NASA Astrophysics Data System (ADS)

    Xu, Songhua; Hudson, Kathleen; Bradley, Yong; Daley, Brian J.; Frederick-Dyer, Katherine; Tourassi, Georgia

    2012-02-01

    The majority of clinical content-based image retrieval (CBIR) studies disregard human perception subjectivity, aiming to duplicate the consensus expert assessment of the visual similarity on example cases. The purpose of our study is twofold: i) discern better the extent of human perception subjectivity when assessing the visual similarity of two images with similar semantic content, and (ii) explore the feasibility of personalized predictive modeling of visual similarity. We conducted a human observer study in which five observers of various expertise were shown ninety-nine triplets of mammographic masses with similar BI-RADS descriptors and were asked to select the two masses with the highest visual relevance. Pairwise agreement ranged between poor and fair among the five observers, as assessed by the kappa statistic. The observers' self-consistency rate was remarkably low, based on repeated questions where either the orientation or the presentation order of a mass was changed. Various machine learning algorithms were explored to determine whether they can predict each observer's personalized selection using textural features. Many algorithms performed with accuracy that exceeded each observer's self-consistency rate, as determined using a cross-validation scheme. This accuracy was statistically significantly higher than would be expected by chance alone (two-tailed p-value ranged between 0.001 and 0.01 for all five personalized models). The study confirmed that human perception subjectivity should be taken into account when developing CBIR-based medical applications.

  19. Occupation and mammographic density: A population-based study (DDM-Occup).

    PubMed

    García-Pérez, Javier; Pollán, Marina; Pérez-Gómez, Beatriz; González-Sánchez, Mario; Cortés Barragán, Rosa Ana; Maqueda Blasco, Jerónimo; González-Galarzo, María Carmen; Alba, Miguel Ángel; van der Haar, Rudolf; Casas, Silvia; Vicente, Cándida; Medina, Pilar; Ederra, María; Santamariña, Carmen; Moreno, María Pilar; Casanova, Francisco; Pedraz-Pingarrón, Carmen; Moreo, Pilar; Ascunce, Nieves; García, Montse; Salas-Trejo, Dolores; Sánchez-Contador, Carmen; Llobet, Rafael; Lope, Virginia

    2017-11-01

    High mammographic density is one of the main risk factors for breast cancer. Although several occupations have been associated with breast cancer, there are no previous occupational studies exploring the association with mammographic density. Our objective was to identify occupations associated with high mammographic density in Spanish female workers. We conducted a population-based cross-sectional study of occupational determinants of high mammographic density in Spain, based on 1476 women, aged 45-68 years, recruited from seven screening centers within the Spanish Breast Cancer Screening Program network. Reproductive, family, personal, and occupational history data were collected. The latest occupation of each woman was collected and coded according to the 1994 National Classification of Occupations. Mammographic density was assessed from the cranio-caudal mammogram of the left breast using a semi-automated computer-assisted tool. Association between mammographic density and occupation was evaluated by using mixed linear regression models, using log-transformed percentage of mammographic density as dependent variable. Models were adjusted for age, body mass index, menopausal status, parity, smoking, alcohol intake, educational level, type of mammography, first-degree relative with breast cancer, and hormonal replacement therapy use. Screening center and professional reader were included as random effects terms. Mammographic density was higher, although non-statistically significant, among secondary school teachers (e(β) = 1.41; 95%CI = 0.98-2.03) and nurses (e(β) = 1.23; 95%CI = 0.96-1.59), whereas workers engaged in the care of people (e(β) = 0.81; 95%CI = 0.66-1.00) and housewives (e(β) = 0.87; 95%CI = 0.79-0.95) showed an inverse association with mammographic density. A positive trend for every 5 years working as secondary school teachers was also detected (p-value = 0.035). Nurses and secondary school teachers were the occupations with the highest

  20. Differences in mammographic density between Asian and Caucasian populations: a comparative analysis.

    PubMed

    Rajaram, Nadia; Mariapun, Shivaani; Eriksson, Mikael; Tapia, Jose; Kwan, Pui Yoke; Ho, Weang Kee; Harun, Faizah; Rahmat, Kartini; Czene, Kamila; Taib, Nur Aishah Mohd; Hall, Per; Teo, Soo Hwang

    2017-01-01

    Mammographic density is a measurable and modifiable biomarker that is strongly and independently associated with breast cancer risk. Paradoxically, although Asian women have lower risk of breast cancer, studies of minority Asian women in predominantly Caucasian populations have found that Asian women have higher percent density. In this cross-sectional study, we compared the distribution of mammographic density for a matched cohort of Asian women from Malaysia and Caucasian women from Sweden, and determined if variations in mammographic density could be attributed to population differences in breast cancer risk factors. Volumetric mammographic density was compared for 1501 Malaysian and 4501 Swedish healthy women, matched on age and body mass index. We used multivariable log-linear regression to determine the risk factors associated with mammographic density and mediation analysis to identify factors that account for differences in mammographic density between the two cohorts. Compared to Caucasian women, percent density was 2.0% higher among Asian women (p < 0.001), and dense volume was 5.7 cm(3) higher among pre-menopausal Asian women (p < 0.001). Dense volume was 3.0 cm(3) lower among post-menopausal Asian women (p = 0.009) compared to post-menopausal Caucasian women, and this difference was attributed to population differences in height, weight, and parity (p < 0.001). Our analysis suggests that among post-menopausal women, population differences in mammographic density and risk to breast cancer may be accounted for by height, weight, and parity. Given that pre-menopausal Asian and Caucasian women have similar population risk to breast cancer but different dense volume, development of more appropriate biomarkers of risk in pre-menopausal women is required.

  1. The relative effect of mammographic screening on breast cancer mortality by socioeconomic status.

    PubMed

    Ripping, Theodora M; van der Waal, Danielle; Verbeek, André L M; Broeders, Mireille J M

    2016-08-01

    Breast cancer incidence and mortality are higher in women with a high socioeconomic status (SES). The potential to prevent death from breast cancer is therefore greater in the high SES group. This does, however, require that the effectiveness of screening in the high SES group is equal to or greater than the effectiveness in the low SES group. The aim of this study is to assess the relative effectiveness of mammographic screening on breast cancer mortality by SES.In Nijmegen, the Netherlands, women are invited to participate in biennial mammographic screening since 1975. Postal code is collected at each round and is used to calculate the SES of each woman based on the SES indicator of the Netherlands Institute for Social Research. The Dutch average was used to classify the SES score of each woman as either high or low. We designed a case-control study to investigate the effect of mammographic screening in women aged 50 to 75, 40 to 75, and 50 to 69 years, and calculated the odds ratios (ORs) and 95% confidence intervals (CIs).Among the women invited to the mammographic screening program in Nijmegen, 10% had a high SES. In women aged 50 to 75 years, the breast cancer death rate was 38% lower in screened women than in unscreened women. The ORs for women with high SES (OR 0.82, 95% CI 0.31-2.19) and low SES did not differ significantly (OR 0.61, 95% CI 0.47-0.78).Mammographic screening reduces breast cancer mortality, but we did not observe a significant difference in the relative effectiveness of screening by SES. If the effectiveness of mammographic screening is indeed not dependent on SES status, the absolute number of breast cancer deaths prevented by mammographic screening will be greater in the high SES than low SES group, because women with a high SES have a greater risk of breast cancer death.

  2. Association of a mammographic parenchymal pattern (MPP) descriptor with breast cancer risk: a case-control study

    NASA Astrophysics Data System (ADS)

    Wei, Jun; Chan, Heang-Ping; Zhou, Chuan; Helvie, Mark A.; Hadjiiski, Lubomir M.; Sahiner, Berkman

    2010-03-01

    We are investigating the feasibility of improving breast cancer risk prediction by computerized mammographic parenchymal pattern (MPP) analysis. A case-control study was conducted to investigate the association of the MPP measures with breast cancer risk. The case group included 168 contralateral CC-view mammograms of breast cancer patients dated at least one year prior to cancer diagnosis, and the control group included 522 CC-view mammograms from one breast of normal subjects. We extracted and compared four types of statistical texture feature spaces that included run length statistics and region size statistics (RLS/RSS) features, spatial gray level dependence (SGLD) features, gray level difference statistics (GLDS) features, and the feature space combining these three types of texture features. A linear discriminant analysis (LDA) classifier with stepwise feature selection was trained and tested with leave-one-case-out resampling to evaluate whether the breast parenchyma of future cancer patients could be distinguished from those of normal subjects in each feature space. The areas under ROC curves (Az) were 0.71, 0.72, 0.71 and 0.76 for the four feature spaces, respectively. The Az obtained from the combined feature space was significantly (p<0.05) higher than those from the individual feature spaces. Odd ratios (OR) were used to assess the association between breast cancer risk and four categories of MPP measures: <0.1 (C1), 0.1-0.15 (C2), 0.15-0.2 (C3), and >0.2 (C4) while patient age was treated as a confounding factor. The adjusted ORs of breast cancer for C2, C3 and C4 were 3.23, 7.77 and 25.43, respectively. The preliminary result indicated that our proposed computerized MPP measures were strongly associated with breast cancer risk.

  3. Association between mammographic density and basal-like and luminal A breast cancer subtypes

    PubMed Central

    2013-01-01

    Introduction Mammographic density is a strong risk factor for breast cancer overall, but few studies have examined the association between mammographic density and specific subtypes of breast cancer, especially aggressive basal-like breast cancers. Because basal-like breast cancers are less frequently screen-detected, it is important to understand how mammographic density relates to risk of basal-like breast cancer. Methods We estimated associations between mammographic density and breast cancer risk according to breast cancer subtype. Cases and controls were participants in the Carolina Breast Cancer Study (CBCS) who also had mammograms recorded in the Carolina Mammography Registry (CMR). A total of 491 cases had mammograms within five years prior to and one year after diagnosis and 528 controls had screening or diagnostic mammograms close to the dates of selection into CBCS. Mammographic density was reported to the CMR using Breast Imaging Reporting and Data System categories. The expression of estrogen receptor (ER), progesterone receptor (PR), human epidermal growth factor receptor 1 and 2 (HER1 and HER2), and cytokeratin 5/6 (CK5/6) were assessed by immunohistochemistry and dichotomized as positive or negative, with ER+ and/or PR+, and HER2- tumors classified as luminal A and ER-, PR-, HER2-, HER1+ and/or CK5/6+ tumors classified as basal-like breast cancer. Triple negative tumors were defined as negative for ER, PR and HER2. Of the 491 cases 175 were missing information on subtypes; the remaining cases included 181 luminal A, 17 luminal B, 48 basal-like, 29 ER-/PR-/HER2+, and 41 unclassified subtypes. Odds ratios comparing each subtype to all controls and case-case odds ratios comparing mammographic density distributions in basal-like to luminal A breast cancers were estimated using logistic regression. Results Mammographic density was associated with increased risk of both luminal A and basal-like breast cancers, although estimates were imprecise. The

  4. Increased peri-ductal collagen micro-organization may contribute to raised mammographic density.

    PubMed

    McConnell, James C; O'Connell, Oliver V; Brennan, Keith; Weiping, Lisa; Howe, Miles; Joseph, Leena; Knight, David; O'Cualain, Ronan; Lim, Yit; Leek, Angela; Waddington, Rachael; Rogan, Jane; Astley, Susan M; Gandhi, Ashu; Kirwan, Cliona C; Sherratt, Michael J; Streuli, Charles H

    2016-01-08

    High mammographic density is a therapeutically modifiable risk factor for breast cancer. Although mammographic density is correlated with the relative abundance of collagen-rich fibroglandular tissue, the causative mechanisms, associated structural remodelling and mechanical consequences remain poorly defined. In this study we have developed a new collaborative bedside-to-bench workflow to determine the relationship between mammographic density, collagen abundance and alignment, tissue stiffness and the expression of extracellular matrix organising proteins. Mammographic density was assessed in 22 post-menopausal women (aged 54-66 y). A radiologist and a pathologist identified and excised regions of elevated non-cancerous X-ray density prior to laboratory characterization. Collagen abundance was determined by both Masson's trichrome and Picrosirius red staining (which enhances collagen birefringence when viewed under polarised light). The structural specificity of these collagen visualisation methods was determined by comparing the relative birefringence and ultrastructure (visualised by atomic force microscopy) of unaligned collagen I fibrils in reconstituted gels with the highly aligned collagen fibrils in rat tail tendon. Localised collagen fibril organisation and stiffness was also evaluated in tissue sections by atomic force microscopy/spectroscopy and the abundance of key extracellular proteins was assessed using mass spectrometry. Mammographic density was positively correlated with the abundance of aligned periductal fibrils rather than with the abundance of amorphous collagen. Compared with matched tissue resected from the breasts of low mammographic density patients, the highly birefringent tissue in mammographically dense breasts was both significantly stiffer and characterised by large (>80 μm long) fibrillar collagen bundles. Subsequent proteomic analyses not only confirmed the absence of collagen fibrosis in high mammographic density tissue, but

  5. Can mammographic assessments lead to consider density as a risk factor for breast cancer?

    PubMed

    Colin, C; Prince, V; Valette, P J

    2013-03-01

    Admitting that mammographic breast density is an important independent risk factor for breast cancer in the general population, has a crucial economical health care impact, since it might lead to increasing screening frequency or reinforcing additional modalities. Thus, the impact of density as a risk factor has to be carefully investigated and might be debated. Some authors suggested that high density would be either a weak factor or confused with a masking effect. Others concluded that most of the studies have methodological biases in basic physics to quantify percentage of breast density, as well as in mammographic acquisition parameters. The purpose of this review is to evaluate mammographic procedures and density assessments in published studies regarding density as a breast cancer risk. No standardization was found in breast density assessments and compared density categories. High density definitions varied widely from 25 to 75% of dense tissues on mammograms. Some studies showed an insufficient follow-up to reveal masking effect related to mammographic false negatives. Evaluating breast density impact needs thorough studies with consensual mammographic procedures, methods of density measurement, breast density classification as well as a standardized definition of high breast density. Digital mammography, more effective in dense breasts, should help to re-evaluate the issue of density as a risk factor for breast cancer. Copyright © 2010 Elsevier Ireland Ltd. All rights reserved.

  6. Stress signaling from human mammary epithelial cells contributes to phenotypes of mammographic density.

    PubMed

    DeFilippis, Rosa Anna; Fordyce, Colleen; Patten, Kelley; Chang, Hang; Zhao, Jianxin; Fontenay, Gerald V; Kerlikowske, Karla; Parvin, Bahram; Tlsty, Thea D

    2014-09-15

    Telomere malfunction and other types of DNA damage induce an activin A-dependent stress response in mortal nontumorigenic human mammary epithelial cells that subsequently induces desmoplastic-like phenotypes in neighboring fibroblasts. Some characteristics of this fibroblast/stromal response, such as reduced adipocytes and increased extracellular matrix content, are observed not only in tumor tissues but also in disease-free breast tissues at high risk for developing cancer, especially high mammographic density tissues. We found that these phenotypes are induced by repression of the fatty acid translocase CD36, which is seen in desmoplastic and disease-free high mammographic density tissues. In this study, we show that epithelial cells from high mammographic density tissues have more DNA damage signaling, shorter telomeres, increased activin A secretion and an altered DNA damage response compared with epithelial cells from low mammographic density tissues. Strikingly, both telomere malfunction and activin A expression in epithelial cells can repress CD36 expression in adjacent fibroblasts. These results provide new insights into how high mammographic density arises and why it is associated with breast cancer risk, with implications for the definition of novel invention targets (e.g., activin A and CD36) to prevent breast cancer.

  7. Stress Signaling from Human Mammary Epithelial Cells Contributes to Phenotypes of Mammographic Density

    PubMed Central

    Patten, Kelley; Chang, Hang; Zhao, Jianxin; Fontenay, Gerald V.; Kerlikowske, Karla; Parvin, Bahram; Tlsty, Thea D.

    2014-01-01

    Telomere malfunction and other types of DNA damage induce an activin A-dependent stress response in mortal non-tumorigenic human mammary epithelial cells that subsequently induces desmoplastic-like phenotypes in neighboring fibroblasts. Some characteristics of this fibroblast/stromal response, such as reduced adipocytes and increased extracellular matrix content, are observed not only in tumor tissues but also in disease-free breast tissues at high risk for developing cancer, especially high mammographic density tissues. We found that these phenotypes are induced by repression of the fatty acid translocase CD36, which is seen in desmoplastic and disease-free high mammographic density tissues. In this study, we show that epithelial cells from high mammographic density tissues have more DNA damage signaling, shorter telomeres, increased activin A secretion and an altered DNA damage response compared to epithelial cells from low mammographic density tissues. Strikingly, both telomere malfunction and activin A expression in epithelial cells can repress CD36 expression in adjacent fibroblasts. These results provide new insights into how high mammographic density arises and why it is associated with breast cancer risk, with implications for the definition of novel invention targets (e.g. activin A, CD36) to prevent breast cancer. PMID:25172842

  8. Breast Tissue Composition and Immunophenotype and Its Relationship with Mammographic Density in Women at High Risk of Breast Cancer.

    PubMed

    Pang, Jia-Min B; Byrne, David J; Takano, Elena A; Jene, Nicholas; Petelin, Lara; McKinley, Joanne; Poliness, Catherine; Saunders, Christobel; Taylor, Donna; Mitchell, Gillian; Fox, Stephen B

    2015-01-01

    To investigate the cellular and immunophenotypic basis of mammographic density in women at high risk of breast cancer. Mammograms and targeted breast biopsies were accrued from 24 women at high risk of breast cancer. Mammographic density was classified into Wolfe categories and ranked by increasing density. The histological composition and immunophenotypic profile were quantified from digitized haematoxylin and eosin-stained and immunohistochemically-stained (ERα, ERβ, PgR, HER2, Ki-67, and CD31) slides and correlated to mammographic density. Increasing mammographic density was significantly correlated with increased fibrous stroma proportion (rs (22) = 0.5226, p = 0.0088) and significantly inversely associated with adipose tissue proportion (rs (22) = -0.5409, p = 0.0064). Contrary to previous reports, stromal expression of ERα was common (19/20 cases, 95%). There was significantly higher stromal PgR expression in mammographically-dense breasts (p=0.026). The proportion of stroma and fat underlies mammographic density in women at high risk of breast cancer. Increased expression of PgR in the stroma of mammographically dense breasts and frequent and unexpected presence of stromal ERα expression raises the possibility that hormone receptor expression in breast stroma may have a role in mediating the effects of exogenous hormonal therapy on mammographic density.

  9. Breast Tissue Composition and Immunophenotype and Its Relationship with Mammographic Density in Women at High Risk of Breast Cancer

    PubMed Central

    Pang, Jia-Min B.; Byrne, David J.; Takano, Elena A.; Jene, Nicholas; Petelin, Lara; McKinley, Joanne; Poliness, Catherine; Saunders, Christobel; Taylor, Donna; Mitchell, Gillian; Fox, Stephen B.

    2015-01-01

    Aim To investigate the cellular and immunophenotypic basis of mammographic density in women at high risk of breast cancer. Methods Mammograms and targeted breast biopsies were accrued from 24 women at high risk of breast cancer. Mammographic density was classified into Wolfe categories and ranked by increasing density. The histological composition and immunophenotypic profile were quantified from digitized haematoxylin and eosin-stained and immunohistochemically-stained (ERα, ERβ, PgR, HER2, Ki-67, and CD31) slides and correlated to mammographic density. Results Increasing mammographic density was significantly correlated with increased fibrous stroma proportion (rs (22) = 0.5226, p = 0.0088) and significantly inversely associated with adipose tissue proportion (rs (22) = -0.5409, p = 0.0064). Contrary to previous reports, stromal expression of ERα was common (19/20 cases, 95%). There was significantly higher stromal PgR expression in mammographically-dense breasts (p=0.026). Conclusions The proportion of stroma and fat underlies mammographic density in women at high risk of breast cancer. Increased expression of PgR in the stroma of mammographically dense breasts and frequent and unexpected presence of stromal ERα expression raises the possibility that hormone receptor expression in breast stroma may have a role in mediating the effects of exogenous hormonal therapy on mammographic density. PMID:26110820

  10. Monochromatic Mammographic Imaging Using X-Ray Polycapillary Optics

    NASA Astrophysics Data System (ADS)

    Sugiro, Francisca

    2002-06-01

    Monochromatic imaging is typically done with synchrotron sources. These sources are expensive and not practical for clinical settings. However, conventional laboratory sources normally have insufficient intensity. Polycapillary x-ray optics can be used to efficiently produce an intense parallel beam, which can be diffracted from a crystal to create monochromatic radiation. Monochromatic parallel beam imaging produces high subject contrast, high resolution, and low patient dose. Contrast, resolution, and intensity measurements were performed with both high and low angular acceptance crystals. Testing was first done at 8 keV with an intense copper rotating anode source. Preliminary l7.5 kev measurements were then made with a molybdenum source. At 8 keV, contrast enhancement was a factor of five relative to the polychromatic case, in good agreement with theoretical values. At l7.5 kev, monochromatic subject contrast was a factor of two times greater than the conventional polychromatic contrast. The measured angular resolution with a silicon crystal is 0.6 mrad at 8 keV, and 0.2 - 0.3 mrad at 17.5 keV. For a 50-mm thick patient, this angle corresponds to 50 lp/mm with an ideal detector. The use of polychromatic collimating optics allow monochromatic mammographic imaging measurements with a conventional x-ray source in a practical clinical setting.

  11. Mammographic breast density patterns in asymptomatic mexican women.

    PubMed

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ(2)) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns.

  12. Local mammographic density as a predictor of breast cancer

    NASA Astrophysics Data System (ADS)

    Otsuka, Mayu; Harkness, Elaine F.; Chen, Xin; Moschidis, Emmanouil; Bydder, Megan; Gadde, Soujanya; Lim, Yit Y.; Maxwell, Anthony J.; Evans, Gareth D.; Howell, Anthony; Stavrinos, Paula; Wilson, Mary; Astley, Susan M.

    2015-03-01

    High overall mammographic density is associated with both an increased risk of developing breast cancer and the risk of cancer being masked. We compared local density at cancer sites in diagnostic images with corresponding previous screening mammograms (priors), and matched controls. VolparaTM density maps were obtained for 54 mammograms showing unilateral breast cancer and their priors which had been previously read as normal. These were each matched to 3 controls on age, menopausal status, hormone replacement therapy usage, body mass index and year of prior. Local percent density was computed in 15mm square regions at lesion sites and similar locations in the corresponding images. Conditional logistic regression was used to predict case-control status. In diagnostic and prior images, local density was increased at the lesion site compared with the opposite breast (medians 21.58%, 9.18%, p<0.001 diagnostic; 18.82%, 9.45%, p <0.001 prior). Women in the highest tertile of local density in priors were more likely to develop cancer than those in the lowest tertile (OR 42.09, 95% CI 5.37-329.94). Those in the highest tertile of VolparaTM gland volume were also more likely to develop cancer (OR 2.89, 95% CI 1.30-6.42). Local density is increased where cancer will develop compared with corresponding regions in the opposite breast and matched controls, and its measurement could enhance computer-aided mammography.

  13. Hormone metabolism genes and mammographic density in Singapore Chinese women

    PubMed Central

    Lee, Eunjung; Su, Yu-Chen; Lewinger, Juan Pablo; Hsu, Chris; Van den Berg, David; Ursin, Giske; Koh, Woon-Puay; Yuan, Jian-Min; Stram, Daniel O.; Yu, Mimi C.; Wu, Anna H.

    2014-01-01

    Background Female steroid hormone levels and exogenous hormone use influence breast cancer risk. We investigated the association between genetic variation in the hormone metabolism and signaling pathway and mammographic density (MD), a strong predictor of breast cancer risk. Methods We genotyped 161 SNPs in 15 hormone metabolism pathway gene regions and evaluated MD in 2,038 Singapore Chinese women. Linear regression analysis was used to investigate SNP-MD association. An overall pathway summary was obtained using the adaptive ranked truncated product test. Results We did not find any of the individually tested SNPs to be associated with MD after a multiple testing correction. There was no evidence of an overall effect on MD of genetic variation in the hormone metabolism pathway. Conclusions In this cross-sectional study, genetic variation in hormone metabolism pathway was not associated with MD in Singapore Chinese women. Impact Consistent with existing data from Caucasian populations, polymorphisms in hormone pathway genes are not likely to be strong predictors of MD in Asian women. PMID:23429186

  14. Evaluating Thin Compression Paddles for Mammographically Compatible Ultrasound

    PubMed Central

    Booi, Rebecca C.; Krücker, Jochen F.; Goodsitt, Mitchell M.; O’Donnell, Matthew; Kapur, Ajay; LeCarpentier, Gerald L.; Roubidoux, Marilyn A.; Fowlkes, J. Brian; Carson, Paul L.

    2007-01-01

    We are developing a combined digital mammography/3D ultrasound system to improve detection and/or characterization of breast lesions. Ultrasound scanning through a mammographic paddle could significantly reduce signal level, degrade beam focusing, and create reverberations. Thus, appropriate paddle choice is essential for accurate sonographic lesion detection and assessment with this system. In this study, we characterized ultrasound image quality through paddles of varying materials (lexan, polyurethane, TPX, mylar) and thicknesses (0.25–2.5 mm). Analytical experiments focused on lexan and TPX, which preliminary results demonstrated were most competitive. Spatial and contrast resolution, sidelobe and range lobe levels, contrast and signal strength were compared with no-paddle images. When the beamforming of the system was corrected to account for imaging through the paddle, the TPX 2.5 mm paddle performed the best. Test objects imaged through this paddle demonstrated ≤ 15% reduction in spatial resolution, ≤ 7.5 dB signal loss, ≤ 3 dB contrast loss, and range lobe levels ≥ 35 dB below signal maximum over 4 cm. TPX paddles < 2.5 mm could also be used with this system, depending on imaging goals. In 10 human subjects with cysts, small CNR losses were observed but were determined to be statistically insignificant. Radiologists concluded that 75% of cysts in through-paddle scans were at least as detectable as in their corresponding direct-contact scans. (Email: rbooi@umich.edu) PMID:17280765

  15. Mammographic density and risk of breast cancer in Korean women.

    PubMed

    Kim, Bo-Kyoung; Choi, Yoon-Ho; Nguyen, Tuong L; Nam, Seok Jin; Lee, Jeong Eon; Hopper, John L; Sung, Joohon; Song, Yun-Mi

    2015-09-01

    We carried out this study to evaluate the association between mammographic density adjusted for age and BMI and early-onset breast cancer in Asian women. We recruited 213 Korean patients with breast cancer (45% diagnosed before the age of 50 years) and 630 controls matched for age, menopausal status, and examination date. The percentage and absolute size of dense areas on digital mammograms were measured using a computer-assisted thresholding technique (Cumulus). We carried out an analysis using the conditional logistic regression model with adjustment for covariates. An increase by 1 SD in age and BMI-adjusted absolute dense area and percentage dense area was associated with a 1.15-fold (95% confidence interval: 1.03, 1.29) and 1.20-fold (95% confidence interval: 1.06, 1.37) increased risk of breast cancer, respectively. These associations were stronger for premenopausal disease (P=0.07 and 0.01, respectively) and for disease diagnosed before age 50 (P=0.07 and 0.02, respectively) than for postmenopausal disease (P=0.16 and 0.23, respectively) or later onset disease (P=0.10 and 0.10, respectively). There was no difference in the associations with premenopausal versus postmenopausal and early-onset versus late-onset disease. After adjusting for age and BMI, both a greater absolute dense area and a greater percentage dense area were associated with an increased risk of breast cancer, particularly at a young age.

  16. Multiple metabolic risk factors and mammographic breast density

    PubMed Central

    Tehranifar, Parisa; Reynolds, Diane; Fan, Xiaozhou; Boden-Albala, Bernadette; Engmann, Natalie J.; Flom, Julie D.; Terry, Mary Beth

    2014-01-01

    Purpose We examined whether obesity and a history of diabetes, hypertension, and elevated cholesterol, individually and in combination, are associated with breast density, a strong risk factor for breast cancer. Methods We measured percent density and dense area using a computer-assisted method (n=191; age range=40-61 years). We used linear regression models to examine the associations of each metabolic condition and the number of metabolic conditions (0, 1, 2, and 3 or 4 conditions) with breast density. Results Among individual metabolic conditions, only high blood cholesterol was inversely associated with percent density (β=-5.4, 95% CI: -8.5, -2.2) and dense area (β= -6.7, 95% CI=-11.1, -2.4). Having multiple metabolic conditions was also associated with lower breast density, with 2 conditions and 3 or 4 conditions vs. 0 conditions associated with 6.4% (95% CI:-11.2, -1.6) and 7.4% (95% CI:-12.9, -1.9) reduction in percent density and with 6.5 cm2 (95% CI: -13.1, -0.1) and 9.5 cm2 (95% CI: -17.1, -1.9) smaller dense area. Conclusions A history of high blood cholesterol and multiple metabolic conditions were associated with lower relative and absolute measures of breast density. The positive association between metabolic abnormalities and breast cancer risk may be driven by pathways unrelated to mammographic breast density. PMID:24698111

  17. Breast cancer risk and participation in mammographic screening.

    PubMed Central

    Taplin, S; Anderman, C; Grothaus, L

    1989-01-01

    Within the context of an organized breast cancer screening program we conducted a prospective evaluation of the relation between breast cancer risk and participation in mammographic screening. The influence on participation of known breast cancer risk factors, as well as a summary risk label, (i.e. "high", or "moderate") were examined. The overall participation rate was 71 percent among 2,422 women, 50 to 79 years of age, invited to a centralized clinic. Multivariate analyses showed participation to be somewhat decreased among women with late menopause and definitely increased among women with any of the following factors: 1) increased age; 2) a family history of breast cancer; and 3) a previous breast biopsy. Women in the high-risk group were most likely to participate but the effect of the label was stronger among women ages 50 to 59 compared to women ages 60 to 79. The study results are generally consistent with previous findings that participants in screening programs have higher rates of breast cancer. The results also suggest the possibility that providing breast cancer risk information may encourage participation in screening. PMID:2817159

  18. Mammographic Breast Density Patterns in Asymptomatic Mexican Women

    PubMed Central

    Calderón-Garcidueñas, Ana Laura; Sanabria-Mondragón, Mónica; Hernández-Beltrán, Lourdes; López-Amador, Noé; Cerda-Flores, Ricardo M.

    2012-01-01

    Breast density (BD) is a risk factor for breast cancer. Aims. To describe BD patterns in asymptomatic Mexican women and the pathological mammographic findings. Methods and Material. Prospective, descriptive, and comparative study. Women answered a questionnaire and their mammograms were analyzed according to BI-RADS. Univariate (χ 2) and conditional logistic regression analyses were performed. Results. In 300 women studied the BD patterns were fat 56.7% (170), fibroglandular 29% (87), heterogeneously dense 5.7% (17), and dense pattern 8.6% (26). Prevalence of fat pattern was significantly different in women under 50 years (37.6%, 44/117) and older than 50 (68.8%, 126/183). Patterns of high breast density (BD) (dense + heterogeneously dense) were observed in 25.6% (30/117) of women ≤50 years and 7.1% (13/183) of women >50. Asymmetry in BD was observed in 22% (66/300). Compression cone ruled out underlying disease in 56 cases. In the remaining 10, biopsy revealed one fibroadenoma, one complex cyst, and 6 invasive and 2 intraductal carcinomas. 2.6% (8/300) of patients had non-palpable carcinomas. Benign lesions were observed in 63.3% (190/300) of cases, vascular calcification in 150 cases (78.9%), and fat necrosis in 38 cases (20%). Conclusions. Mexican women have a low percentage of high-density patterns. PMID:23346398

  19. Mammographic density and breast cancer risk in White and African American Women.

    PubMed

    Razzaghi, Hilda; Troester, Melissa A; Gierach, Gretchen L; Olshan, Andrew F; Yankaskas, Bonnie C; Millikan, Robert C

    2012-09-01

    Mammographic density is a strong risk factor for breast cancer, but limited data are available in African American (AA) women. We examined the association between mammographic density and breast cancer risk in AA and white women. Cases (n = 491) and controls (n = 528) were from the Carolina Breast Cancer Study (CBCS) who also had mammograms recorded in the Carolina Mammography Registry (CMR). Mammographic density was reported to CMR using Breast Imaging Reporting and Data System (BI-RADS) categories. Increasing mammographic density was associated with increased breast cancer risk among all women. After adjusting for potential confounders, a monotonically increasing risk of breast cancer was observed between the highest versus the lowest BI-RADS density categories [OR = 2.45, (95 % confidence interval: 0.99, 6.09)]. The association was stronger in whites, with ~40 % higher risk among those with extremely dense breasts compared to those with scattered fibroglandular densities [1.39, (0.75, 2.55)]. In AA women, the same comparison suggested lower risk [0.75, (0.30, 1.91)]. Because age, obesity, and exogenous hormones have strong associations with breast cancer risk, mammographic density, and race in the CBCS, effect measure modification by these factors was considered. Consistent with previous literature, density-associated risk was greatest among those with BMI > 30 and current hormone users (P value = 0.02 and 0.01, respectively). In the CBCS, mammographic density is associated with increased breast cancer risk, with some suggestion of effect measure modification by race, although results were not statistically significant. However, exposures such as BMI and hormone therapy may be important modifiers of this association and merit further investigation.

  20. No Effect of Aspirin on Mammographic Density in a Randomized Controlled Clinical Trial

    PubMed Central

    McTiernan, Anne; Wang, CY; Sorensen, Bess; Xiao, Liren; Buist, Diana S. M.; Bowles, Erin J. Aiello; White, Emily; Rossing, Mary Anne; Potter, John; Urban, Nicole

    2009-01-01

    Background: Epidemiologic studies suggest a reduced risk of breast cancer among women who regularly use aspirin; a plausible mechanism is through aspirin effect on mammographic breast density, a breast cancer risk factor, possibly mediated through aspirin interference with estrogen synthesis. Methods: In a 2-arm randomized placebo-controlled clinical trial, we evaluated the effects of 6-months administration of 325 mg/day aspirin on total mammographic breast dense area and percent of the mammographic breast image occupied by dense areas (% density) in 143 postmenopausal women. Eligible women, recruited 2005-7, were healthy, not taking hormone therapy, with elevated mammographic breast density (American College of Radiology Breast Imaging Reporting and Data System (BI-RADS®) density category 2, 3 or 4) within 6 months prior to enrollment. Results: Women were a mean (s.d.) 59.5 (5.5) years. Geometric mean baseline percent density was 17.6% (95% CI 14.8, 20.9) in women randomized to aspirin and 19.2% (95% CI 16.3, 22.7) in women randomized to placebo. Percent density decreased in women randomized to aspirin by an absolute 0.8% vs. an absolute decrease of 1.2% in controls (p = 0.84). Total breast area and dense area decreased to a similar degree in women assigned to aspirin and in those assigned to placebo, with no differences statistically significantly different between trial arms. Conclusions: A single daily administration of adult-dose aspirin for 6 months had no effect on mammographic density in postmenopausal women. If aspirin affects breast cancer risk in postmenopausal women, it may do so through alternative pathways than mammographic breast density. PMID:19423529

  1. Childhood body mass index and adult mammographic density measures that predict breast cancer risk.

    PubMed

    Hopper, John L; Nguyen, Tuong L; Stone, Jennifer; Aujard, Kelly; Matheson, Melanie C; Abramson, Michael J; Burgess, John A; Walters, E Haydn; Dite, Gillian S; Bui, Minh; Evans, Christopher; Makalic, Enes; Schmidt, Daniel F; Ward, Gail; Jenkins, Mark A; Giles, Graham G; Dharmage, Shyamali C; Apicella, Carmel

    2016-02-01

    The aim of the present study is to determine if body mass index (BMI) during childhood is associated with the breast cancer risk factor 'adult mammographic density adjusted for age and BMI'. In 1968, the Tasmanian Longitudinal Health Study studied every Tasmanian school child born in 1961. We obtained measured heights and weights from annual school medical records across ages 7-15 years and imputed missing values. Between 2009 and 2012, we administered to 490 women a questionnaire that asked current height and weight and digitised at least one mammogram per woman. Absolute and percent mammographic densities were measured using the computer-assisted method CUMULUS. We used linear regression and adjusted for age at interview and log current BMI. The mammographic density measures were negatively associated: with log BMI at each age from 7 to 15 years (all p < 0.05); with the average of standardised log BMIs across ages 7-15 years (p < 0.0005); and more strongly with standardised log BMI measures closer to age 15 years (p < 0.03). Childhood BMI measures explained 7 and 10 % of the variance in absolute and percent mammographic densities, respectively, and 25 and 20 % of the association between current BMI and absolute and percent mammographic densities, respectively. Associations were not altered by adjustment for age at menarche. There is a negative association between BMI in late childhood and the adult mammographic density measures that predict breast cancer risk. This could explain, at least in part, why BMI in adolescence is negatively associated with breast cancer risk.

  2. Mammographic density and breast cancer risk in White and African American Women

    PubMed Central

    Troester, Melissa A.; Gierach, Gretchen L.; Olshan, Andrew F.; Yankaskas, Bonnie C.; Millikan, Robert C.

    2013-01-01

    Mammographic density is a strong risk factor for breast cancer, but limited data are available in African American (AA) women. We examined the association between mammographic density and breast cancer risk in AA and white women. Cases (n = 491) and controls (n = 528) were from the Carolina Breast Cancer Study (CBCS) who also had mammograms recorded in the Carolina Mammography Registry (CMR). Mammographic density was reported to CMR using Breast Imaging Reporting and Data System (BI-RADS) categories. Increasing mammographic density was associated with increased breast cancer risk among all women. After adjusting for potential confounders, a monotonically increasing risk of breast cancer was observed between the highest versus the lowest BI-RADS density categories [OR = 2.45, (95 % confidence interval: 0.99, 6.09)]. The association was stronger in whites, with ~40 % higher risk among those with extremely dense breasts compared to those with scattered fibroglandular densities [1.39, (0.75, 2.55)]. In AA women, the same comparison suggested lower risk [0.75, (0.30, 1.91)]. Because age, obesity, and exogenous hormones have strong associations with breast cancer risk, mammographic density, and race in the CBCS, effect measure modification by these factors was considered. Consistent with previous literature, density-associated risk was greatest among those with BMI > 30 and current hormone users (P value = 0.02 and 0.01, respectively). In the CBCS, mammographic density is associated with increased breast cancer risk, with some suggestion of effect measure modification by race, although results were not statistically significant. However, exposures such as BMI and hormone therapy may be important modifiers of this association and merit further investigation. PMID:22864770

  3. Risk assessment from automated feature analysis of digitized mammograms

    NASA Astrophysics Data System (ADS)

    Byng, Jeffrey W.; Yaffe, Martin J.; Little, L.; Lockwood, G.; Jong, Roberta A.; Fishell, E.; Tritchler, D.; Boyd, Norman F.

    1995-05-01

    The identification of women at increased risk for breast cancer has important implications in both the surveillance for cancer and research into causes of the disease. The parenchymal pattern of the breast, revealed by mammography, and rated subjectively by observer, has been found to provide strong factors of risk for breast cancer. To provide a more quantitative measure of the proportion of mammographically dense tissue in the breast, we have previously described and evaluated an interactive technique in which an observer selects a threshold brightness level to separate dense from fatty tissue in the image. Measurement of mammographic density in this way provides an estimate of relative risk of 4, that is among leading indicators of the risk of developing breast cancer. To remove the variability associated with identification of thresholds by observer, we are investigating an automated threshold prediction based on independent features characterizing mammographic parenchyma. These features are based on regional measurements of image brightness variations (histogram analysis) and texture variations (fractal analysis) within digitized mammographic images. Preliminary results from an investigative model are presented.

  4. Performance of a subsidised mammographic screening programme in Malaysia, a middle-income Asian country.

    PubMed

    Lee, Marianne; Mariapun, Shivaani; Rajaram, Nadia; Teo, Soo-Hwang; Yip, Cheng-Har

    2017-01-28

    The incidence of breast cancer in Asia is increasing because of urbanization and lifestyle changes. In the developing countries in Asia, women present at late stages, and mortality is high. Mammographic screening is the only evidence-based screening modality that reduces breast cancer mortality. To date, only opportunistic screening is offered in the majority of Asian countries because of the lack of justification and funding. Nevertheless, there have been few reports on the effectiveness of such programmes. In this study, we describe the cancer detection rate and challenges experienced in an opportunistic mammographic screening programme in Malaysia. From October 2011 to June 2015, 1,778 asymptomatic women, aged 40-74 years, underwent subsidised mammographic screening. All patients had a clinical breast examination before mammographic screening, and women with mammographic abnormalities were referred to a surgeon. The cancer detection rate and variables associated with a recommendation for adjunct ultrasonography were determined. The mean age for screening was 50.8 years and seven cancers (0.39%) were detected. The detection rate was 0.64% in women aged 50 years and above, and 0.12% in women below 50 years old. Adjunct ultrasonography was recommended in 30.7% of women, and was significantly associated with age, menopausal status, mammographic density and radiologist's experience. The main reasons cited for recommendation of an adjunct ultrasound was dense breasts and mammographic abnormalities. The cancer detection rate is similar to population-based screening mammography programmes in high-income Asian countries. Unlike population-based screening programmes in Caucasian populations where the adjunct ultrasonography rate is 2-4%, we report that 3 out of 10 women attending screening mammography were recommended for adjunct ultrasonography. This could be because Asian women attending screening are likely premenopausal and hence have denser breasts. Radiologists who

  5. Spectral analysis of mammographic images using a multitaper method

    SciTech Connect

    Wu Gang; Mainprize, James G.; Yaffe, Martin J.

    2012-02-15

    Purpose: Power spectral analysis in radiographic images is conventionally performed using a windowed overlapping averaging periodogram. This study describes an alternative approach using a multitaper technique and compares its performance with that of the standard method. This tool will be valuable in power spectrum estimation of images, whose content deviates significantly from uniform white noise. The performance of the multitaper approach will be evaluated in terms of spectral stability, variance reduction, bias, and frequency precision. The ultimate goal is the development of a useful tool for image quality assurance. Methods: A multitaper approach uses successive data windows of increasing order. This mitigates spectral leakage allowing one to calculate a reduced-variance power spectrum. The multitaper approach will be compared with the conventional power spectrum method in several typical situations, including the noise power spectra (NPS) measurements of simulated projection images of a uniform phantom, NPS measurement of real detector images of a uniform phantom for two clinical digital mammography systems, and the estimation of the anatomic noise in mammographic images (simulated images and clinical mammograms). Results: Examination of spectrum variance versus frequency resolution and bias indicates that the multitaper approach is superior to the conventional single taper methods in the prevention of spectrum leakage and variance reduction. More than four times finer frequency precision can be achieved with equivalent or less variance and bias. Conclusions: Without any shortening of the image data length, the bias is smaller and the frequency resolution is higher with the multitaper method, and the need to compromise in the choice of regions of interest size to balance between the reduction of variance and the loss of frequency resolution is largely eliminated.

  6. Mammographic density and breast cancer risk: a mediation analysis.

    PubMed

    Rice, Megan S; Bertrand, Kimberly A; VanderWeele, Tyler J; Rosner, Bernard A; Liao, Xiaomei; Adami, Hans-Olov; Tamimi, Rulla M

    2016-09-21

    High mammographic density (MD) is a strong risk factor for breast cancer. However, it is unclear whether high MD is an intermediate phenotype or whether breast cancer risk factors influence breast cancer risk and MD independently. Our study population included 1290 invasive breast cancer cases and 3422 controls from the Nurses' Health Studies. We estimated the percent of the total association between the risk factor and breast cancer that was mediated by MD. In both pre- and postmenopausal women, the association between history of biopsy-confirmed benign breast disease and risk was partially mediated by percent MD (percent mediated (PM) = 17 %, p < 0.01 and PM = 33 %, p = 0.04, respectively). In premenopausal women, the associations between early life body size (adolescent somatotype and BMI at age 18) and breast cancer risk were substantially mediated by percent MD (PM = 73 %, p = 0.05 and PM = 82 %, p = 0.04, respectively). In postmenopausal women, the proportion of the associations of childhood somatotype and adolescent somatotype that were mediated by percent MD were lower (PM = 26 %, p = 0.01 for both measures). Hormone therapy use at mammogram was significantly mediated by percent MD in postmenopausal women (PM = 22 %, p < 0.01). Associations with other risk factors, such as age at menarche or family history of breast cancer, were not mediated by percent MD. Percent MD partially mediated some of the associations between risk factors and breast cancer, though the magnitude varied by risk factor and menopausal status. These findings suggest that high MD may be an intermediate in some biological pathways for breast cancer development.

  7. Time-frequency analysis of functional optical mammographic images

    NASA Astrophysics Data System (ADS)

    Barbour, Randall L.; Graber, Harry L.; Schmitz, Christoph H.; Tarantini, Frank; Khoury, Georges; Naar, David J.; Panetta, Thomas F.; Lewis, Theophilus; Pei, Yaling

    2003-07-01

    We have introduced working technology that provides for time-series imaging of the hemoglobin signal in large tissue structures. In this study we have explored our ability to detect aberrant time-frequency responses of breast vasculature for subjects with Stage II breast cancer at rest and in response to simple provocations. The hypothesis being explored is that time-series imaging will be sensitive to the known structural and functional malformations of the tumor vasculature. Mammographic studies were conducted using an adjustable hemisheric measuring head containing 21 source and 21 detector locations (441 source-detector pairs). Simultaneous dual-wavelength studies were performed at 760 and 830 nm at a framing rate of ~2.7 Hz. Optical measures were performed on women lying prone with the breast hanging in a pendant position. Two class of measures were performed: (1) 20- minute baseline measure wherein the subject was at rest; (2) provocation studies wherein the subject was asked to perform some simple breathing maneuvers. Collected data were analyzed to identify the time-frequency structure and central tendencies of the detector responses and those of the image time series. Imaging data were generated using the Normalized Difference Method (Pei et al., Appl. Opt. 40, 5755-5769, 2001). Results obtained clearly document three classes of anomalies when compared to the normal contralateral breast. 1) Breast tumors exhibit altered oxygen supply/demand imbalance in response to an oxidative challenge (breath hold). 2) The vasomotor response of the tumor vasculature is mainly depressed and exhibits an altered modulation. 3) The affected area of the breast wherein the altered vasomotor signature is seen extends well beyond the limits of the tumor itself.

  8. Mammographic density and serum 25-hydroxyvitamin D levels

    PubMed Central

    2014-01-01

    Background Vitamin D, which influences cellular proliferation and breast tissue characteristics, has been inversely correlated with breast cancer risk. Dietary vitamin D intake has been associated with lower mammographic density (MD), a strong intermediate marker of breast cancer risk. Findings We examined the relationship between MD and serum 25-hydroxyvitamin D [25(OH)D], an integrated measure of vitamin D status from dietary sources and sunlight exposure, in a multi-ethnic cohort of women undergoing screening mammography. We recruited women age 40–60 years without a history of breast cancer at the time of their routine screening mammogram, and conducted in-person interviews and collected blood specimens. We enrolled 195 women from 2007–2008, 120 gave blood, and 114 were evaluable, including 25% white, 41% African American, 18% African Caribbean, and 16% Hispanic. We digitized mammograms and calculated percent density, dense area, and non-dense area on cranial-caudal images. We measured serum 25(OH)D in batched, archived specimens. Median serum 25(OH)D was 22 ng/ml (range, 8–66 ng/ml). In univariable analysis, higher serum 25(OH)D was associated with white race, higher educational level, ever breast feeding, and blood draw during the summer. After adjusting for body mass index and other confounders, we found no association between serum 25(OH)D and different measures of MD. However, when stratified by season, 25(OH)D was inversely associated with dense area during July-December (p = 0.034). Conclusions Overall, our findings suggest that circulating vitamin D, a potentially modifiable breast cancer risk factor, is not associated with MD; the seasonal effects we observed need to be replicated in larger cohorts. PMID:24742098

  9. Mammographic screening programmes in Europe: organization, coverage and participation.

    PubMed

    Giordano, Livia; von Karsa, Lawrence; Tomatis, Mariano; Majek, Ondrej; de Wolf, Chris; Lancucki, Lesz; Hofvind, Solveig; Nyström, Lennarth; Segnan, Nereo; Ponti, Antonio; Van Hal, G; Martens, P; Májek, O; Danes, J; von Euler-Chelpin, M; Aasmaa, A; Anttila, A; Becker, N; Péntek, Z; Budai, A; Mádai, S; Fitzpatrick, P; Mooney, T; Zappa, M; Ventura, L; Scharpantgen, A; Hofvind, S; Seroczynski, P; Morais, A; Rodrigues, V; Bento, M J; Gomes de Carvalho, J; Natal, C; Prieto, M; Sánchez-Contador Escudero, C; Zubizarreta Alberti, R; Fernández Llanes, S B; Ascunce, N; Ederra Sanza, M; Sarriugarte Irigoien, G; Salas Trejo, D; Ibáñez Cabanell, J; Wiege, M; Ohlsson, G; Törnberg, S; Korzeniewska, M; de Wolf, C; Fracheboud, J; Patnick J, J; Lancucki, L; Ducarroz, S; Suonio, E

    2012-01-01

    To summarize participation and coverage rates in population mammographic screening programmes for breast cancer in Europe. We used the European Network for Information on Cancer (EUNICE), a web-based data warehouse (EUNICE Breast Cancer Screening Monitoring, EBCSM) for breast cancer screening, to obtain information on programme characteristics, coverage and participation from its initial application in 10 national and 16 regional programmes in 18 European countries. The total population targeted by the screening programme services covered in the report comprised 26.9 million women predominantly aged 50-69. Most of the collected data relates to 2005, 2006 and/or 2007. The average participation rate across all programmes was 53.4% (range 19.4-88.9% of personally invited); or 66.4% excluding Poland, a large programme that initiated personal invitations in 2007. Thirteen of the 26 programmes achieved the European Union benchmark of acceptable participation (>70%), nine achieved the desirable level (>75%). Despite considerable invitation coverage across all programmes (79.3%, range 50.9-115.2%) only 48.2% (range 28.4-92.1%) of the target population were actually screened. The overall invitation and examination coverage excluding Poland was 70.9% and 50.3%, respectively. The results demonstrate the feasibility of European-wide screening monitoring using the EBCSM data warehouse, although further efforts to refine the system and to harmonize standards and data collection practices will be required, to fully integrate all European countries. The more than three-fold difference in the examination coverage should be taken into account in the evaluation of service screening programmes.

  10. High and low mammographic density human breast tissues maintain histological differential in murine tissue engineering chambers.

    PubMed

    Chew, G L; Huang, D; Lin, S J; Huo, C; Blick, T; Henderson, M A; Hill, P; Cawson, J; Morrison, W A; Campbell, I G; Hopper, J L; Southey, M C; Haviv, I; Thompson, E W

    2012-08-01

    Mammographic density (MD) is the area of breast tissue that appears radiologically white on mammography. Although high MD is a strong risk factor for breast cancer, independent of BRCA1/2 mutation status, the molecular basis of high MD and its associated breast cancer risk is poorly understood. MD studies will benefit from an animal model, where hormonal, gene and drug perturbations on MD can be measured in a preclinical context. High and low MD tissues were selectively sampled by stereotactic biopsy from operative specimens of high-risk women undergoing prophylactic mastectomy. The high and low MD tissues were transferred into separate vascularised biochambers in the groins of SCID mice. Chamber material was harvested after 6 weeks for histological analyses and immunohistochemistry for cytokeratins, vimentin and a human-specific mitochondrial antigen. Within-individual analysis was performed in replicate mice, eliminating confounding by age, body mass index and process-related factors, and comparisons were made to the parental human tissue. Maintenance of differential MD post-propagation was assessed radiographically. Immunohistochemical staining confirmed the preservation of human glandular and stromal components in the murine biochambers, with maintenance of radiographic MD differential. Propagated high MD regions had higher stromal (p = 0.0002) and lower adipose (p = 0.0006) composition, reflecting the findings in the original human breast tissue, although glands appeared small and non-complex in both high and low MD groups. No significant differences were observed in glandular area (p = 0.4) or count (p = 0.4) between high and low MD biochamber tissues. Human mammary glandular and stromal tissues were viably maintained in murine biochambers, with preservation of differential radiographic density and histological features. Our study provides a murine model for future studies into the biomolecular basis of MD as a risk factor for breast cancer.

  11. Matching mammographic regions in mediolateral oblique and cranio caudal views: a probabilistic approach

    NASA Astrophysics Data System (ADS)

    Samulski, Maurice; Karssemeijer, Nico

    2008-03-01

    Most of the current CAD systems detect suspicious mass regions independently in single views. In this paper we present a method to match corresponding regions in mediolateral oblique (MLO) and craniocaudal (CC) mammographic views of the breast. For every possible combination of mass regions in the MLO view and CC view, a number of features are computed, such as the difference in distance of a region to the nipple, a texture similarity measure, the gray scale correlation and the likelihood of malignancy of both regions computed by single-view analysis. In previous research, Linear Discriminant Analysis was used to discriminate between correct and incorrect links. In this paper we investigate if the performance can be improved by employing a statistical method in which four classes are distinguished. These four classes are defined by the combinations of view (MLO/CC) and pathology (TP/FP) labels. We use distance-weighted k-Nearest Neighbor density estimation to estimate the likelihood of a region combination. Next, a correspondence score is calculated as the likelihood that the region combination is a TP-TP link. The method was tested on 412 cases with a malignant lesion visible in at least one of the views. In 82.4% of the cases a correct link could be established between the TP detections in both views. In future work, we will use the framework presented here to develop a context dependent region matching scheme, which takes the number and likelihood of possible alternatives into account. It is expected that more accurate determination of matching probabilities will lead to improved CAD performance.

  12. A Qualitative Study of the UK Academic Role: Positive Features, Negative Aspects and Associated Stressors in a Mainly Teaching-Focused University

    ERIC Educational Resources Information Center

    Darabi, Mitra; Macaskill, Ann; Reidy, Lisa

    2017-01-01

    The literature demonstrates that stress in the working life of academics has increased over recent years. However, qualitative research on how academics cope with this is very scarce. Using online interviewing with thematic analysis, this paper examines how 31 academics in a post-92 predominantly teaching-focused UK university cope with the…

  13. Fractal analysis of visual search activity for mass detection during mammographic screening.

    PubMed

    Alamudun, Folami; Yoon, Hong-Jun; Hudson, Kathleen B; Morin-Ducote, Garnetta; Hammond, Tracy; Tourassi, Georgia D

    2017-03-01

    The objective of this study was to assess the complexity of human visual search activity during mammographic screening using fractal analysis and to investigate its relationship with case and reader characteristics. The study was performed for the task of mammographic screening with simultaneous viewing of four coordinated breast views as typically done in clinical practice. Eye-tracking data and diagnostic decisions collected for 100 mammographic cases (25 normal, 25 benign, 50 malignant) from 10 readers (three board certified radiologists and seven Radiology residents), formed the corpus for this study. The fractal dimension of the readers' visual scanning pattern was computed with the Minkowski-Bouligand box-counting method and used as a measure of gaze complexity. Individual factor and group-based interaction ANOVA analysis was performed to study the association between fractal dimension, case pathology, breast density, and reader experience level. The consistency of the observed trends depending on gaze data representation was also examined. Case pathology, breast density, reader experience level, and individual reader differences are all independent predictors of the complexity of visual scanning pattern when screening for breast cancer. No higher order effects were found to be significant. Fractal characterization of visual search behavior during mammographic screening is dependent on case properties and image reader characteristics. © 2017 American Association of Physicists in Medicine.

  14. Fractal Analysis of Visual Search Activity for Mass Detection During Mammographic Screening

    DOE PAGES

    Alamudun, Folami T.; Yoon, Hong-Jun; Hudson, Kathy; ...

    2017-02-21

    Purpose: The objective of this study was to assess the complexity of human visual search activity during mammographic screening using fractal analysis and to investigate its relationship with case and reader characteristics. Methods: The study was performed for the task of mammographic screening with simultaneous viewing of four coordinated breast views as typically done in clinical practice. Eye-tracking data and diagnostic decisions collected for 100 mammographic cases (25 normal, 25 benign, 50 malignant) and 10 readers (three board certified radiologists and seven radiology residents), formed the corpus data for this study. The fractal dimension of the readers’ visual scanning patternsmore » was computed with the Minkowski–Bouligand box-counting method and used as a measure of gaze complexity. Individual factor and group-based interaction ANOVA analysis was performed to study the association between fractal dimension, case pathology, breast density, and reader experience level. The consistency of the observed trends depending on gaze data representation was also examined. Results: Case pathology, breast density, reader experience level, and individual reader differences are all independent predictors of the visual scanning pattern complexity when screening for breast cancer. No higher order effects were found to be significant. Conclusions: Fractal characterization of visual search behavior during mammographic screening is dependent on case properties and image reader characteristics.« less

  15. Radiologist agreement for mammographic recall by case difficulty and finding type.

    PubMed

    Onega, Tracy; Smith, Megan; Miglioretti, Diana L; Carney, Patricia A; Geller, Berta A; Kerlikowske, Karla; Buist, Diana S M; Rosenberg, Robert D; Smith, Robert A; Sickles, Edward A; Haneuse, Sebastien; Anderson, Melissa L; Yankaskas, Bonnie

    2012-11-01

    The aim of this study was to assess agreement of mammographic interpretations by community radiologists with consensus interpretations of an expert radiology panel to inform approaches that improve mammographic performance. From 6 mammographic registries, 119 community-based radiologists were recruited to assess 1 of 4 randomly assigned test sets of 109 screening mammograms with comparison studies for no recall or recall, giving the most significant finding type (mass, calcifications, asymmetric density, or architectural distortion) and location. The mean proportion of agreement with an expert radiology panel was calculated by cancer status, finding type, and difficulty level of identifying the finding at the patient, breast, and lesion level. Concordance in finding type between study radiologists and the expert panel was also examined. For each finding type, the proportion of unnecessary recalls, defined as study radiologist recalls that were not expert panel recalls, was determined. Recall agreement was 100% for masses and for examinations with obvious findings in both cancer and noncancer cases. Among cancer cases, recall agreement was lower for lesions that were subtle (50%) or asymmetric (60%). Subtle noncancer findings and benign calcifications showed 33% agreement for recall. Agreement for finding responsible for recall was low, especially for architectural distortions (43%) and asymmetric densities (40%). Most unnecessary recalls (51%) were asymmetric densities. Agreement in mammographic interpretation was low for asymmetric densities and architectural distortions. Training focused on these interpretations could improve the accuracy of mammography and reduce unnecessary recalls. Copyright © 2012 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  16. Results of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS).

    PubMed

    Fowble, B; Hanlon, A L; Fein, D A; Hoffman, J P; Sigurdson, E R; Patchefsky, A; Kessler, H

    1997-07-15

    The role of conservative surgery and radiation for mammographically detected ductal carcinoma in situ (DCIS) is controversial. In particular, there is little data for outcome with radiation in a group of patients comparable to those treated with local excision and surveillance (mammographic calcifications < or = 2.5 cm, negative resection margins, negative postbiopsy mammogram). This study reports outcome of conservative surgery and radiation for mammographically detected DCIS with an emphasis on results in patients considered candidates for excision alone. From 1983 to 1992, 110 women with mammographically detected DCIS (77% calcifications +/- mass) and no prior history of breast cancer underwent needle localization and biopsy with (55%) or without a reexcision and radiation. Final margins of resection were negative in 62%, positive 7%, close 11%, and unknown 20%. The median patient age was 56 years. The most common histologic subtype was comedo (54%), followed by cribriform (22%). The median pathologic tumor size was 8 mm (range 2 mm to 5 cm). Forty-seven percent of patients with calcifications only had a negative postbiopsy mammogram prior to radiation. Radiation consisted of treatment to the entire breast (median 50.00 Gy) and a boost to the primary site (97%) for a median total dose of 60.40 Gy. With a median follow-up of 5.3 years, three patients developed a recurrence in the treated breast. The median interval to recurrence was 8.8 years and all were invasive cancers. Two (67%) occurred outside the initial quadrant. The 5- and 10-year actuarial rates of recurrence were 1 and 15%. Cause-specific survival was 100% at 5 and 10 years. Contralateral breast cancer developed in two patients. There were too few failures for statistical significance to be achieved with any of the following factors: patient age, family history, race, mammographic findings, location primary, pathologic size, histologic subtype, reexcision, or final margin status. However, young age

  17. Sclerosing adenosis: Ultrasonographic and mammographic findings and correlation with histopathology

    PubMed Central

    Chen, Ya-Ling; Chen, Jia-Jian; Chang, Cai; Gao, Yi; Wu, Jiong; Yang, Wen-Tao; Gu, Ya-Jia

    2017-01-01

    The present study was conducted to evaluate the radiological findings, particularly the ultrasonographic (US) characteristics of sclerosing adenosis (SA), and their correlation with histopathological results. A retrospective review identified 191 patients with a total of 200 lesions histopathologically confirmed as SA following breast surgery between July 2009 and December 2012. Of the 191 patients, 145 (151 lesions) with SA as the major component were included for US and mammographic (MG) analysis. All 145 patients analyzed were female, with a mean age ± standard deviation of 46.8±7.8 years (range, 25–71 years). All 145 patients underwent US examination and the imaging findings included heterogeneously echogenic areas in 9.3% (14/151), masses in 51.7% (78/151), masses with calcifications in 13.9% (21/151), focal acoustic shadowing in 4.0% (6/151) and were negative in 21.2% (32/151) patients. Among the 119 lesions with visible abnormalities, 87.4% (104/119) were hypoechoic, 58.0% (69/119) were irregular in shape, 52.1% (62/119) had an ill-defined margin, calcifications were found in 17.6% (21/119) and 7.6% (9/119) were hypervascular, while none of the characteristics mentioned above were significantly correlated with histopathology. A total of 136 patients underwent MG at the Fudan University Shanghai Cancer Center, and the imaging findings included microcalcifications in 31.6% (43/136), masses in 23.5% (32/136), asymmetric focal density in 14.7% (20/136), focal architectural distortion in 22.8% (31/136), and were negative in 7.4% (10/136). The mass lesions were fewer on MG compared with US (23.5 vs. 65.6%, respectively). The area under the curve of US distinguishing between benign and malignant lesions was significantly larger compared with that of MG (0.547 vs. 0.497, respectively; P=0.036). In the 60 lesions that were overestimated by Breast Imaging Reporting and Data System US category, one or more characteristics of malignancy were found on US imaging. The

  18. An investigation of mammographic density and gene variants in healthy women.

    PubMed

    Maskarinec, Gertraud; Lurie, Galina; Williams, Andrew E; Le Marchand, Loic

    2004-11-20

    This cross-sectional study examined if polymorphisms in genes that code for enzymes involved in the production and metabolism of estrogens are associated with mammographic density, a strong predictor of breast cancer risk. The study included 328 healthy women of different ethnicities who underwent mammographic screening and donated a blood or mouthwash sample for DNA analysis. After digitizing cranio-caudal views of the mammograms, we performed computer-assisted mammographic density assessment. Following DNA extraction, samples were analyzed for polymorphisms in the COMT (Val158Met), CYP1A1 (Ile462Val), CYP1B1 (Val432Leu), CYP1A2 (*1F) and CYP17 (T27C) genes using PCR-RFLP. Breast density was lower in Caucasians than in Asians. Caucasian women were less likely to carry the CYP1A1 variant allele and more likely to carry the variant alleles for CYP1B1 and COMT than women with Asian or Hawaiian ancestry. The low-activity COMT and CYP1A2 variant alleles were weakly related to lower percent mammographic density after adjustment for age, ethnicity, body mass index and reproductive variables (p for gene-dosage =0.08 and 0.05, respectively). These relations were observed in premenopausal women only and were similar in direction and magnitude after stratification by ethnicity. We found no significant associations between breast density and the variant alleles for CYP1A1, CYP1B1 and CYP17. Our data suggest lower mammographic density for women carrying the COMT and CYP1A2 variant alleles than for women carrying the common alleles, though this is the opposite of what is commonly hypothesized from the enzyme function.

  19. Robust estimation of mammographic breast density: a patient-based approach

    NASA Astrophysics Data System (ADS)

    Heese, Harald S.; Erhard, Klaus; Gooßen, Andre; Bulow, Thomas

    2012-02-01

    Breast density has become an established risk indicator for developing breast cancer. Current clinical practice reflects this by grading mammograms patient-wise as entirely fat, scattered fibroglandular, heterogeneously dense, or extremely dense based on visual perception. Existing (semi-) automated methods work on a per-image basis and mimic clinical practice by calculating an area fraction of fibroglandular tissue (mammographic percent density). We suggest a method that follows clinical practice more strictly by segmenting the fibroglandular tissue portion directly from the joint data of all four available mammographic views (cranio-caudal and medio-lateral oblique, left and right), and by subsequently calculating a consistently patient-based mammographic percent density estimate. In particular, each mammographic view is first processed separately to determine a region of interest (ROI) for segmentation into fibroglandular and adipose tissue. ROI determination includes breast outline detection via edge-based methods, peripheral tissue suppression via geometric breast height modeling, and - for medio-lateral oblique views only - pectoral muscle outline detection based on optimizing a three-parameter analytic curve with respect to local appearance. Intensity harmonization based on separately acquired calibration data is performed with respect to compression height and tube voltage to facilitate joint segmentation of available mammographic views. A Gaussian mixture model (GMM) on the joint histogram data with a posteriori calibration guided plausibility correction is finally employed for tissue separation. The proposed method was tested on patient data from 82 subjects. Results show excellent correlation (r = 0.86) to radiologist's grading with deviations ranging between -28%, (q = 0.025) and +16%, (q = 0.975).

  20. Improving CAD performance by fusion of the bilateral mammographic tissue asymmetry information

    NASA Astrophysics Data System (ADS)

    Wang, Xingwei; Li, Lihua; Liu, Wei; Xu, Weidong; Lederman, Dror; Zheng, Bin

    2012-03-01

    Bilateral mammographic tissue density asymmetry could be an important factor in assessing risk of developing breast cancer and improving the detection of the suspicious lesions. This study aims to assess whether fusion of the bilateral mammographic density asymmetrical information into a computer-aided detection (CAD) scheme could improve CAD performance in detecting mass-like breast cancers. A testing dataset involving 1352 full-field digital mammograms (FFDM) acquired from 338 cases was used. In this dataset, half (169) cases are positive containing malignant masses and half are negative. Two computerized schemes were first independently applied to process FFDM images of each case. The first single-image based CAD scheme detected suspicious mass regions on each image. The second scheme detected and computed the bilateral mammographic tissue density asymmetry for each case. A fusion method was then applied to combine the output scores of the two schemes. The CAD performance levels using the original CAD-generated detection scores and the new fusion scores were evaluated and compared using a free-response receiver operating characteristic (FROC) type data analysis method. By fusion with the bilateral mammographic density asymmetrical scores, the case-based CAD sensitivity was increased from 79.2% to 84.6% at a false-positive rate of 0.3 per image. CAD also cued more "difficult" masses with lower CAD-generated detection scores while discarded some "easy" cases. The study indicated that fusion between the scores generated by a single-image based CAD scheme and the computed bilateral mammographic density asymmetry scores enabled to increase mass detection sensitivity in particular to detect more subtle masses.

  1. Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures.

    PubMed

    Stone, Jennifer; Thompson, Deborah J; Dos Santos Silva, Isabel; Scott, Christopher; Tamimi, Rulla M; Lindstrom, Sara; Kraft, Peter; Hazra, Aditi; Li, Jingmei; Eriksson, Louise; Czene, Kamila; Hall, Per; Jensen, Matt; Cunningham, Julie; Olson, Janet E; Purrington, Kristen; Couch, Fergus J; Brown, Judith; Leyland, Jean; Warren, Ruth M L; Luben, Robert N; Khaw, Kay-Tee; Smith, Paula; Wareham, Nicholas J; Jud, Sebastian M; Heusinger, Katharina; Beckmann, Matthias W; Douglas, Julie A; Shah, Kaanan P; Chan, Heang-Ping; Helvie, Mark A; Le Marchand, Loic; Kolonel, Laurence N; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher; Giles, Graham G; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C; Apicella, Carmel; Andrulis, Irene L; Knight, Julia A; Ursin, Giske; Alnaes, Grethe I Grenaker; Kristensen, Vessela N; Borresen-Dale, Anne-Lise; Gram, Inger Torhild; Bolla, Manjeet K; Wang, Qin; Michailidou, Kyriaki; Dennis, Joe; Simard, Jacques; Pharoah, Paul; Dunning, Alison M; Easton, Douglas F; Fasching, Peter A; Pankratz, V Shane; Hopper, John L; Vachon, Celine M

    2015-06-15

    Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk, but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute nondense area adjusted for study, age, and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1), and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all P < 10(-5)). Of 41 recently discovered breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and nondense areas, and between rs17356907 (NTN4) and adjusted absolute nondense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiologic pathways implicated in how mammographic density predicts breast cancer risk. ©2015 American Association for Cancer Research.

  2. Novel Associations between Common Breast Cancer Susceptibility Variants and Risk-Predicting Mammographic Density Measures

    PubMed Central

    Stone, Jennifer; Thompson, Deborah J.; dos-Santos-Silva, Isabel; Scott, Christopher; Tamimi, Rulla M.; Lindstrom, Sara; Kraft, Peter; Hazra, Aditi; Li, Jingmei; Eriksson, Louise; Czene, Kamila; Hall, Per; Jensen, Matt; Cunningham, Julie; Olson, Janet E.; Purrington, Kristen; Couch, Fergus J.; Brown, Judith; Leyland, Jean; Warren, Ruth M. L.; Luben, Robert N.; Khaw, Kay-Tee; Smith, Paula; Wareham, Nicholas J.; Jud, Sebastian M.; Heusinger, Katharina; Beckmann, Matthias W.; Douglas, Julie A.; Shah, Kaanan P.; Chan, Heang-Ping; Helvie, Mark A.; Le Marchand, Loic; Kolonel, Laurence N.; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher; Giles, Graham G.; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C.; Apicella, Carmel; Andrulis, Irene L.; Knight, Julia A.; Ursin, Giske; Grenaker Alnaes, Grethe I.; Kristensen, Vessela N.; Borresen-Dale, Anne-Lise; Gram, Inger Torhild; Bolla, Manjeet K.; Wang, Qin; Michailidou, Kyriaki; Dennis, Joe; Simard, Jacques; Paroah, Paul; Dunning, Alison M.; Easton, Douglas F.; Fasching, Peter A.; Pankratz, V. Shane; Hopper, John; Vachon, Celine M.

    2015-01-01

    Mammographic density measures adjusted for age and body mass index (BMI) are heritable predictors of breast cancer risk but few mammographic density-associated genetic variants have been identified. Using data for 10,727 women from two international consortia, we estimated associations between 77 common breast cancer susceptibility variants and absolute dense area, percent dense area and absolute non-dense area adjusted for study, age and BMI using mixed linear modeling. We found strong support for established associations between rs10995190 (in the region of ZNF365), rs2046210 (ESR1) and rs3817198 (LSP1) and adjusted absolute and percent dense areas (all p <10−5). Of 41 recently discovered breast cancer susceptibility variants, associations were found between rs1432679 (EBF1), rs17817449 (MIR1972-2: FTO), rs12710696 (2p24.1), and rs3757318 (ESR1) and adjusted absolute and percent dense areas, respectively. There were associations between rs6001930 (MKL1) and both adjusted absolute dense and non-dense areas, and between rs17356907 (NTN4) and adjusted absolute non-dense area. Trends in all but two associations were consistent with those for breast cancer risk. Results suggested that 18% of breast cancer susceptibility variants were associated with at least one mammographic density measure. Genetic variants at multiple loci were associated with both breast cancer risk and the mammographic density measures. Further understanding of the underlying mechanisms at these loci could help identify etiological pathways implicated in how mammographic density predicts breast cancer risk. PMID:25862352

  3. Amount of stroma is associated with mammographic density and stromal expression of oestrogen receptor in normal breast tissues.

    PubMed

    Gabrielson, Marike; Chiesa, Flaminia; Paulsson, Janna; Strell, Carina; Behmer, Catharina; Rönnow, Katarina; Czene, Kamila; Östman, Arne; Hall, Per

    2016-07-01

    Following female sex and age, mammographic density is considered one of the strongest risk factors for breast cancer. Despite the association between mammographic density and breast cancer risk, little is known about the underlying histology and biological basis of breast density. To better understand the mechanisms behind mammographic density we assessed morphology, proliferation and hormone receptor status in relation to mammographic density in breast tissues from healthy women. Tissues were obtained from 2012-2013 by ultrasound-guided core needle biopsy from 160 women as part of the Karma (Karolinska mammography project for risk prediction for breast cancer) project. Mammograms were collected through routine mammography screening and mammographic density was calculated using STRATUS. The histological composition, epithelial and stromal proliferation status and hormone receptor status were assessed through immunohistochemical staining. Higher mammographic density was significantly associated with a greater proportion of stromal and epithelial tissue and a lower proportion of adipose tissue. Epithelial expression levels of Ki-67, oestrogen receptor (ER) and progesterone receptor (PR) were not associated with mammographic density. Epithelial Ki-67 was associated with a greater proportion of epithelial tissue, and epithelial PR was associated with a greater proportion of stromal and a lower proportion of adipose tissue. Epithelial ER was not associated with any tissues. In contrast, expression of ER in the stroma was significantly associated with a greater proportion of stroma, and negatively associated with the amount of adipose tissue. High mammographic density is associated with higher amount of stroma and epithelium and less amount of fat, but is not associated with a change in epithelial proliferation or receptor status. Increased expressions of both epithelial PR and stromal ER are associated with a greater proportion of stroma, suggesting hormonal involvement

  4. Background risk of breast cancer and the association between physical activity and mammographic density.

    PubMed

    Trinh, Thang; Eriksson, Mikael; Darabi, Hatef; Bonn, Stephanie E; Brand, Judith S; Cuzick, Jack; Czene, Kamila; Sjölander, Arvid; Bälter, Katarina; Hall, Per

    2015-04-02

    High physical activity has been shown to decrease the risk of breast cancer, potentially by a mechanism that also reduces mammographic density. We tested the hypothesis that the risk of developing breast cancer in the next 10 years according to the Tyrer-Cuzick prediction model influences the association between physical activity and mammographic density. We conducted a population-based cross-sectional study of 38,913 Swedish women aged 40-74 years. Physical activity was assessed using the validated web-questionnaire Active-Q and mammographic density was measured by the fully automated volumetric Volpara method. The 10-year risk of breast cancer was estimated using the Tyrer-Cuzick (TC) prediction model. Linear regression analyses were performed to assess the association between physical activity and volumetric mammographic density and the potential interaction with the TC breast cancer risk. Overall, high physical activity was associated with lower absolute dense volume. As compared to women with the lowest total activity level (<40 metabolic equivalent hours [MET-h] per day), women with the highest total activity level (≥50 MET-h/day) had an estimated 3.4 cm(3) (95% confidence interval, 2.3-4.7) lower absolute dense volume. The inverse association was seen for any type of physical activity among women with <3.0% TC 10-year risk, but only for total and vigorous activities among women with 3.0-4.9% TC risk, and only for vigorous activity among women with ≥5.0% TC risk. The association between total activity and absolute dense volume was modified by the TC breast cancer risk (P interaction = 0.05). As anticipated, high physical activity was also associated with lower non-dense volume. No consistent association was found between physical activity and percent dense volume. Our results suggest that physical activity may decrease breast cancer risk through reducing mammographic density, and that the physical activity needed to reduce mammographic density may depend

  5. Computerized analysis of mammographic parenchymal patterns on a large clinical dataset of full-field digital mammograms: robustness study with two high-risk datasets.

    PubMed

    Li, Hui; Giger, Maryellen L; Lan, Li; Bancroft Brown, Jeremy; MacMahon, Aoife; Mussman, Mary; Olopade, Olufunmilayo I; Sennett, Charlene

    2012-10-01

    The purpose of this study was to demonstrate the robustness of our prior computerized texture analysis method for breast cancer risk assessment, which was developed initially on a limited dataset of screen-film mammograms. This current study investigated the robustness by (1) evaluating on a large clinical dataset, (2) using full-field digital mammograms (FFDM) as opposed to screen-film mammography, and (3) incorporating analyses over two types of high-risk patient sets, as well as patients at low risk for breast cancer. The evaluation included the analyses on the parenchymal patterns of women at high risk of developing of breast cancer, including both BRCA1/2 gene mutation carriers and unilateral cancer patients, and of women at low risk of developing breast cancer. A total of 456 cases, including 53 women with BRCA1/2 gene mutations, 75 women with unilateral cancer, and 328 low-risk women, were retrospectively collected under an institutional review board approved protocol. Regions-of-interest (ROIs), were manually selected from the central breast region immediately behind the nipple. These ROIs were subsequently used in computerized feature extraction to characterize the mammographic parenchymal patterns in the images. Receiver operating characteristic analysis was used to assess the performance of the computerized texture features in the task of distinguishing between high-risk and low-risk subjects. In a round robin evaluation on the FFDM dataset with Bayesian artificial neural network analysis, AUC values of 0.82 (95% confidence interval [0.75, 0.88]) and 0.73 (95% confidence interval [0.67, 0.78]) were obtained between BRCA1/2 gene mutation carriers and low-risk women, and between unilateral cancer and low-risk women, respectively. These results from computerized texture analysis on digital mammograms demonstrated that high-risk and low-risk women have different mammographic parenchymal patterns. On this large clinical dataset, we validated our methods for

  6. Negative estrogen-receptor invasive breast carcinoma: mammographic aspects, correlations with HER2/neu oncoprotein status.

    PubMed

    Enache, Dana Elena; Georgescu, Claudia Valentina; Pătrană, Nicoleta

    2012-01-01

    This study involved 40 ER-negative female patients with invasive breast cancer, aged between 25 and 88 years, diagnosed at Emergency County Hospital of Craiova, Romania, during a two-year interval (2010-2011). All patients that took part in the study were subjected to a preoperative mammography exam, and later to HP and IHC exams, in order to detect the ER, PR and HER2 status. These exams were followed by CISH in ambiguous HER2 cases. The tumor detection method was palpation in 16 cases, whereas in 24 cases the method used was the screening mammography. Histopathologically, the analyzed tumors were infiltrative ductal carcinoma (35 cases), lobular carcinoma (one case), mucinous (two cases) and metaplastic carcinoma (two cases). Depending on the status of the oncoprotein HER2, the 40 ER-negative female patients included in the study formed two groups: the ER-negative, HER2-positive (11 cases, 27.5%) formed the first group and the ER-negative, HER2-negative (29 cases, 72.5%) formed the second group. Depending on the expression of the receptors for progesterone, 60% of cases were classified as triple negative mammary carcinomas (ER-, PR-, HER2-). The comparative study of the ER-negative, HER2-positive and the ER-negative, HER2-negative mammary carcinomas showed that the tumors of the ER-negative, HER2-positive group were mostly high degree cancers (80% vs. 56%), with negative progesterone receptors (81.81% vs. 48.27%), associated with axillary lymph node metastasis (63.63% vs. 48.27%), and were detected at a higher cancer stage (II/III) (81.81% vs. 62.06%). Regarding the mammographic features, the ER-negative HER2-positive breast cancers are more likely to be irregular masses (62.5% vs. 33.33%), with spiculated margins (45.45% vs. 6.9%), frequently associated with dense or heterogeneously dense breast (82% vs. 69%) and pleomorphic calcifications (62.5% vs. 28.57%) comparative with ER-negative HER2-negative cancers that were more frequently round/oval mass, with

  7. Breast cancer CAD{sub x} based on BI-RADS trade mark sign descriptors from two mammographic views

    SciTech Connect

    Gupta, Shalini; Chyn, Priscilla F.; Markey, Mia K.

    2006-06-15

    In this study we compared the performance of computer aided diagnosis (CAD{sub x}) algorithms based on Breast Imaging Reporting And Data System (BI-RADS trade mark sign ) descriptors from one or two views. To select cases for the study with different mediolateral (MLO) and craniocaudal (CC) view descriptors, we assessed the agreement in BI-RADS trade mark sign lesion descriptors, BI-RADS trade mark sign assessment, and subtlety ratings for 1626 cases from the Digital Database for Screening Mammogrpahy (DDSM) using kappa statistics. We used 115 mass cases with different descriptors for the two views to design linear discriminant analysis (LDA) based CAD{sub x} algorithms. The CAD{sub x} algorithms used BI-RADS trade mark sign descriptors and patient age as features. The algorithms based on BI-RADS trade mark sign descriptors from both the views performed marginally better than algorithms based on BI-RADS trade mark sign descriptors from a single view. A system that averaged the results of two classifiers trained separately on the MLO and CC views displayed the best performance (A{sub z}=0.920{+-}0.027). Thus, some improvement in performance of BI-RADS trade mark sign based CAD{sub x} algorithms may be achieved by combining information from two mammographic views.

  8. Mammographic density and breast cancer risk: current understanding and future prospects

    PubMed Central

    2011-01-01

    Variations in percent mammographic density (PMD) reflect variations in the amounts of collagen and number of epithelial and non-epithelial cells in the breast. Extensive PMD is associated with a markedly increased risk of invasive breast cancer. The PMD phenotype is important in the context of breast cancer prevention because extensive PMD is common in the population, is strongly associated with risk of the disease, and, unlike most breast cancer risk factors, can be changed. Work now in progress makes it likely that measurement of PMD will be improved in the near future and that understanding of the genetics and biological basis of the association of PMD with breast cancer risk will also improve. Future prospects for the application of PMD include mammographic screening, risk prediction in individuals, breast cancer prevention research, and clinical decision making. PMID:22114898

  9. The Problem of Mammographic Breast Density - The Position of the DEGUM Working Group on Breast Ultrasound.

    PubMed

    Mueller-Schimpfle, M P; Brandenbusch, V C; Degenhardt, F; Duda, V; Madjar, H; Mundinger, A; Rathmann, R; Hahn, M

    2016-04-01

    Mammographic breast density correlates with breast cancer risk and also with the number of false-negative calls. In the USA these facts lead to the "Breast Density and Mammography Reporting Act" of 2011. In the case of mammographically dense breasts, the Working Group on Breast Ultrasound in Germany recommends explaining the advantages of adjunct imaging to women, depending on the individual breast cancer risk. Due to the particular structure of German healthcare, quality-assured breast ultrasound would be the first choice. Possible overdiagnosis, costs, potentially increased emotional stress should be addressed. In high familial breast cancer risk, genetic counselling and an intensified early detection program should be performed. © Georg Thieme Verlag KG Stuttgart · New York.

  10. The relationship of obesity, mammographic breast density, and magnetic resonance imaging in patients with breast cancer.

    PubMed

    Gillman, Jennifer; Chun, Jennifer; Schwartz, Shira; Schnabel, Freya; Moy, Linda

    The purpose was to evaluate the relationship between body mass index (BMI), mammographic breast density, magnetic resonance (MR) background parenchymal enhancement (BPE), and MR fibroglandular tissue (FGT) in women with breast cancer. Our institutional database was queried for patients with preoperative mammography and breast MR imaging. There were 573 women eligible for analysis. Elevated BMI was associated with advanced stage of disease (P=.01), lower mammographic density (P<.0001), lower FGT (P<.0001), higher BPE (P=.005), and nonpalpable lesions (P=.04). Higher BMI was associated with decreased breast density and FGT. Higher BMI was also associated with advanced stage disease and nonpalpable tumors on clinical exam. Copyright © 2016 Elsevier Inc. All rights reserved.

  11. Sampling in Qualitative Research

    PubMed Central

    LUBORSKY, MARK R.; RUBINSTEIN, ROBERT L.

    2011-01-01

    In gerontology the most recognized and elaborate discourse about sampling is generally thought to be in quantitative research associated with survey research and medical research. But sampling has long been a central concern in the social and humanistic inquiry, albeit in a different guise suited to the different goals. There is a need for more explicit discussion of qualitative sampling issues. This article will outline the guiding principles and rationales, features, and practices of sampling in qualitative research. It then describes common questions about sampling in qualitative research. In conclusion it proposes the concept of qualitative clarity as a set of principles (analogous to statistical power) to guide assessments of qualitative sampling in a particular study or proposal. PMID:22058580

  12. Reproductive and menstrual factors in relation to mammographic parenchymal patterns among perimenopausal women.

    PubMed Central

    Gram, I. T.; Funkhouser, E.; Tabar, L.

    1995-01-01

    The relationship between mammographic patterns and reproductive and menstrual factors was examined in 3640 Norwegian women, aged 40-56 years, participating in the Third Tromsö study conducted in 1986-87. Epidemiological data were obtained from questionnaires. The mammograms were categorised into five groups. This categorisation is based on anatomic-mammographic correlations, following three-dimensional (thick slice technique) histopathologic-mammographic comparisons, rather than simple pattern reading. Patterns 1-3 were combined into a low-risk group and patterns 4 and 5 into a high-risk group for analysis. Women who had more than four children were 90% less likely to have a high-risk pattern than nulliparous women (OR = 0.09, 95% CI 0.04-0.16) controlling for age, weight, height and menopausal status. Furthermore, those who first gave birth over 34 years of age were more than twice as likely to have a high-risk pattern than those giving birth in their teens (OR = 2.37, 95% CI 1.23-4.56) adjusting for parity. Among post-menopausal women, age at menarche was negatively (P for trend = 0.015) and late age at menopause positively (P for trend = 0.072) related to high-risk patterns. Among premenopausal women, age at menarche was positively related to high-risk patterns (P for trend = 0.001). Also, menopausal status rather than age was associated with high-risk patterns. These findings support the opinion that reproductive and menstrual factors are involved in determining the mammographic parenchymal pattern among perimenopausal women. PMID:7880753

  13. The influence of mammographic technologists on radiologists’ ability to interpret screening mammograms in community practice

    PubMed Central

    Henderson, Louise M.; Benefield, Thad; Marsh, Mary W.; Schroeder, Bruce F.; Durham, Danielle; Yankaskas, Bonnie C.; Bowling, J. Michael

    2014-01-01

    Purpose To determine whether the mammographic technologist has an effect on the radiologists’ interpretative performance of screening mammography in community practice. Materials and Methods In this institutional review board approved retrospective cohort study, we included Carolina Mammography Registry (CMR) data from 372 radiologists and 356 mammographic technologists from 1994 to 2009 who performed 1,003,276 screening mammograms. Measures of interpretative performance (recall rate, sensitivity, specificity, positive predictive value (PPV1), and cancer detection rate (CDR)) were ascertained prospectively with cancer outcomes collected from the state cancer registry and pathology reports. To determine if the mammographic technologist influenced the radiologists’ performance, we employed mixed effects logistic regression models, including a radiologist-specific random effect and taking into account the clustering of examinations across women, separately for screen-film mammography (SFM) and full field digital mammography (FFDM). Results Of the 356 mammographic technologists included, 343 performed 889,347 SFM examinations and 51 performed 113,929 FFDM examinations, and 38 performed both SFM and FFDM. A total of 4,328 cancers were reported for SFM and 564 cancers for FFDM. The technologists had a statistically significant effect on the radiologists’ recall rate, sensitivity, specificity and CDR for both SFM and FFDM (p-values<0.01). For PPV1, variability by technologist was observed for SFM (p-value<0.0001) but not for FFDM (p-value=0.088). Conclusion The interpretative performance of radiologists in screening mammography varies substantially by the technologist performing the examination. Additional studies should aim to identify technologist characteristics that may explain this variation. PMID:25435185

  14. Mammographic quantitative image analysis and biologic image composition for breast lesion characterization and classification

    SciTech Connect

    Drukker, Karen Giger, Maryellen L.; Li, Hui; Duewer, Fred; Malkov, Serghei; Joe, Bonnie; Kerlikowske, Karla; Shepherd, John A.; Flowers, Chris I.; Drukteinis, Jennifer S.

    2014-03-15

    Purpose: To investigate whether biologic image composition of mammographic lesions can improve upon existing mammographic quantitative image analysis (QIA) in estimating the probability of malignancy. Methods: The study population consisted of 45 breast lesions imaged with dual-energy mammography prior to breast biopsy with final diagnosis resulting in 10 invasive ductal carcinomas, 5 ductal carcinomain situ, 11 fibroadenomas, and 19 other benign diagnoses. Analysis was threefold: (1) The raw low-energy mammographic images were analyzed with an established in-house QIA method, “QIA alone,” (2) the three-compartment breast (3CB) composition measure—derived from the dual-energy mammography—of water, lipid, and protein thickness were assessed, “3CB alone”, and (3) information from QIA and 3CB was combined, “QIA + 3CB.” Analysis was initiated from radiologist-indicated lesion centers and was otherwise fully automated. Steps of the QIA and 3CB methods were lesion segmentation, characterization, and subsequent classification for malignancy in leave-one-case-out cross-validation. Performance assessment included box plots, Bland–Altman plots, and Receiver Operating Characteristic (ROC) analysis. Results: The area under the ROC curve (AUC) for distinguishing between benign and malignant lesions (invasive and DCIS) was 0.81 (standard error 0.07) for the “QIA alone” method, 0.72 (0.07) for “3CB alone” method, and 0.86 (0.04) for “QIA+3CB” combined. The difference in AUC was 0.043 between “QIA + 3CB” and “QIA alone” but failed to reach statistical significance (95% confidence interval [–0.17 to + 0.26]). Conclusions: In this pilot study analyzing the new 3CB imaging modality, knowledge of the composition of breast lesions and their periphery appeared additive in combination with existing mammographic QIA methods for the distinction between different benign and malignant lesion types.

  15. Prognosis for Mammographically Occult, Early-Stage Breast Cancer Patients Treated With Breast-Conservation Therapy

    SciTech Connect

    Yang, Tzu-I. J.; Yang Qifeng; Haffty, Bruce G.; Moran, Meena S.

    2010-01-15

    Purpose: To compare mammographically occult (MamOcc) and mammographically positive (MamPos) early-stage breast cancer patients treated with breast-conservation therapy (BCT), to analyze differences between the two cohorts. Methods and Materials: Our two cohorts consisted of 214 MamOcc and 2168 MamPos patients treated with BCT. Chart reviews were conducted to assess mammogram reports and method of detection. All clinical-pathologic and outcome parameters were analyzed to detect differences between the two cohorts. Results: Median follow-up was 7 years. There were no differences in final margins, T stage, nodal status, estrogen/progesterone receptor status, or 'triple-negative' status. Significant differences included younger age at diagnosis (p < 0.0001), more positive family history (p = 0.0033), less HER-2+ disease (p = 0.0294), and 1{sup o} histology (p < 0.0001). At 10 years, the differences in overall survival, cause-specific survival, and distant relapse between the two groups did not differ significantly. The MamOcc cohort had more breast relapses (15% vs. 8%; p = 0.0357), but on multivariate analysis this difference was not significant (hazard ratio 1.0, 95% confidence interval 0.993-1.007, p = 0.9296). Breast relapses were mammographically occult in 32% of the MamOcc and 12% of the MamPos cohorts (p = 0.0136). Conclusions: Although our study suggests that there are clinical-pathologic variations for the MamOcc cohort vs. MamPos patients that may ultimately affect management, breast relapse after BCT was not significantly different. Breast recurrences were more often mammographically occult in the MamOcc cohort; consideration should be given to closer follow-up and alternative imaging strategies (ultrasound, breast MRI) for routine posttreatment examination. To our knowledge, this represents the largest series addressing the prognostic significance of MamOcc cancers treated with BCT.

  16. The influence of mammographic technologists on radiologists' ability to interpret screening mammograms in community practice.

    PubMed

    Henderson, Louise M; Benefield, Thad; Marsh, Mary W; Schroeder, Bruce F; Durham, Danielle D; Yankaskas, Bonnie C; Bowling, J Michael

    2015-03-01

    To determine whether the mammographic technologist has an effect on the radiologists' interpretative performance of screening mammography in community practice. In this institutional review board-approved retrospective cohort study, we included Carolina Mammography Registry data from 372 radiologists and 356 mammographic technologists from 1994 to 2009 who performed 1,003,276 screening mammograms. Measures of interpretative performance (recall rate, sensitivity, specificity, positive predictive value [PPV1], and cancer detection rate [CDR]) were ascertained prospectively with cancer outcomes collected from the state cancer registry and pathology reports. To determine if the mammographic technologist influenced the radiologists' performance, we used mixed effects logistic regression models, including a radiologist-specific random effect and taking into account the clustering of examinations across women, separately for screen-film mammography (SFM) and full-field digital mammography (FFDM). Of the 356 mammographic technologists included, 343 performed 889,347 SFM examinations, 51 performed 113,929 FFDM examinations, and 38 performed both SFM and FFDM examinations. A total of 4328 cancers were reported for SFM and 564 cancers for FFDM. The technologists had a statistically significant effect on the radiologists' recall rate, sensitivity, specificity, and CDR for both SFM and FFDM (P values <.01). For PPV1, variability by technologist was observed for SFM (P value <.0001) but not for FFDM (P value = .088). The interpretative performance of radiologists in screening mammography varies substantially by the technologist performing the examination. Additional studies should aim to identify technologist characteristics that may explain this variation. Copyright © 2015 AUR. Published by Elsevier Inc. All rights reserved.

  17. Mammographic screening of women aged 40-49 years. Benefit, risk, and cost considerations.

    PubMed

    Feig, S A

    1995-11-15

    A recently published meta-analysis of seven randomized trials showed a statistically significant 24% reduction in mortality rate with the use of mammographic screening for women age 40-49 years. The benefit would have been even greater if screening had been performed at shorter annual intervals with the most up-to-date mammographic equipment. Additionally, these trials underestimated benefit due to inclusion of breast cancer deaths among study group women who refused to undergo screening. In contrast to these documented benefits, no woman has ever been shown to have developed breast cancer as a result of mammography, even with multiple examinations at doses many times higher than the current 0.25 cGy from a two-view-per-breast examination. The possibility of low dose risk has been theorized based on excess rates of cancer among populations that have received doses of 100 to more than 1000 cGy, such as atomic-bomb survivors. If there is a risk, it is negligible or nonexistent compared with the screening benefit. The total cost of screening is a summation of the following costs: (1) screening mammogram plus down-stream costs of supplementary mammographic views and/or ultrasound for further evaluation of some screenees; (2) mammographic follow-up; and (3) core or excisional biopsy for those women in whom a suspicious abnormality persists after workup. Based on a range of procedural costs, a 30% reduction in breast cancer deaths due to incidence screening of women age 40-49 will cost $6,930.00-$13,413.00 per year of life expectancy gained.

  18. Ethnic differences in mammographic densities: an Asian cross-sectional study.

    PubMed

    Mariapun, Shivaani; Li, Jingmei; Yip, Cheng Har; Taib, Nur Aishah Mohd; Teo, Soo-Hwang

    2015-01-01

    Mammographic density is a strong risk factor for breast cancer and is highly variable, but, to date, few studies have examined density in Asian women, particularly those in low and middle-income Asian countries where genetic and lifestyle determinants may be significantly different. A total of 1,240 women who attended an opportunistic mammogram screening programme were eligible for analysis. Mammographic density was estimated using a fully-automated thresholding method and differences across ethnic groups were examined using linear regression in 205 randomly selected Chinese women, 138 Malay and 199 Indian women. Percent density was significantly higher in Chinese women (28.5%; 95% CI 27.0%, 30.0%) compared to Malay (24.2%; 95% CI 22.5%, 26.0%) and Indian (24.3%; 95% CI 22.8%, 25.7%) women (p<0.001), after adjustment for age, BMI, menopausal status, parity and age at first full term pregnancy. Correspondingly, adjusted nondense area was significantly lower in Chinese (72.2cm2; 95% CI 67.9cm2, 76.5cm2) women compared to Malay (92.1cm2; 95% CI 86.9cm2, 97.2cm2) and Indian (97.7cm2; 95% CI 93.4cm2, 101.9cm2) women (p<0.001), but dense area did not differ across the three ethnic groups. Our study shows that higher percent density and lower nondense area reflect the higher incidence of breast cancer in Chinese compared to Malay and Indian women in Malaysia. Known lifestyle determinants of mammographic density do not fully account for the ethnic variations observed in mammographic density in this Asian cohort.

  19. The use of lower resolution viewing devices for mammographic interpretation: implications for education and training.

    PubMed

    Chen, Yan; James, Jonathan J; Turnbull, Anne E; Gale, Alastair G

    2015-10-01

    To establish whether lower resolution, lower cost viewing devices have the potential to deliver mammographic interpretation training. On three occasions over eight months, fourteen consultant radiologists and reporting radiographers read forty challenging digital mammography screening cases on three different displays: a digital mammography workstation, a standard LCD monitor, and a smartphone. Standard image manipulation software was available for use on all three devices. Receiver operating characteristic (ROC) analysis and ANOVA (Analysis of Variance) were used to determine the significance of differences in performance between the viewing devices with/without the application of image manipulation software. The effect of reader's experience was also assessed. Performance was significantly higher (p < .05) on the mammography workstation compared to the other two viewing devices. When image manipulation software was applied to images viewed on the standard LCD monitor, performance improved to mirror levels seen on the mammography workstation with no significant difference between the two. Image interpretation on the smartphone was uniformly poor. Film reader experience had no significant effect on performance across all three viewing devices. Lower resolution standard LCD monitors combined with appropriate image manipulation software are capable of displaying mammographic pathology, and are potentially suitable for delivering mammographic interpretation training. • This study investigates potential devices for training in mammography interpretation. • Lower resolution standard LCD monitors are potentially suitable for mammographic interpretation training. • The effect of image manipulation tools on mammography workstation viewing is insignificant. • Reader experience had no significant effect on performance in all viewing devices. • Smart phones are not suitable for displaying mammograms.

  20. Qualitative research.

    PubMed

    Gelling, Leslie

    2015-03-25

    Qualitative research has an important role in helping nurses and other healthcare professionals understand patient experiences of health and illness. Qualitative researchers have a large number of methodological options and therefore should take care in planning and conducting their research. This article offers a brief overview of some of the key issues qualitative researchers should consider.

  1. Quantitative 3D breast magnetic resonance imaging fibroglandular tissue analysis and correlation with qualitative assessments: a feasibility study.

    PubMed

    Ha, Richard; Mema, Eralda; Guo, Xiaotao; Mango, Victoria; Desperito, Elise; Ha, Jason; Wynn, Ralph; Zhao, Binsheng

    2016-04-01

    The amount of fibroglandular tissue (FGT) has been linked to breast cancer risk based on mammographic density studies. Currently, the qualitative assessment of FGT on mammogram (MG) and magnetic resonance imaging (MRI) is prone to intra and inter-observer variability. The purpose of this study is to develop an objective quantitative FGT measurement tool for breast MRI that could provide significant clinical value. An IRB approved study was performed. Sixty breast MRI cases with qualitative assessment of mammographic breast density and MRI FGT were randomly selected for quantitative analysis from routine breast MRIs performed at our institution from 1/2013 to 12/2014. Blinded to the qualitative data, whole breast and FGT contours were delineated on T1-weighted pre contrast sagittal images using an in-house, proprietary segmentation algorithm which combines the region-based active contours and a level set approach. FGT (%) was calculated by: [segmented volume of FGT (mm(3))/(segmented volume of whole breast (mm(3))] ×100. Statistical correlation analysis was performed between quantified FGT (%) on MRI and qualitative assessments of mammographic breast density and MRI FGT. There was a significant positive correlation between quantitative MRI FGT assessment and qualitative MRI FGT (r=0.809, n=60, P<0.001) and mammographic density assessment (r=0.805, n=60, P<0.001). There was a significant correlation between qualitative MRI FGT assessment and mammographic density assessment (r=0.725, n=60, P<0.001). The four qualitative assessment categories of FGT correlated with the calculated mean quantitative FGT (%) of 4.61% (95% CI, 0-12.3%), 8.74% (7.3-10.2%), 18.1% (15.1-21.1%), 37.4% (29.5-45.3%). Quantitative measures of FGT (%) were computed with data derived from breast MRI and correlated significantly with conventional qualitative assessments. This quantitative technique may prove to be a valuable tool in clinical use by providing computer generated standardized

  2. International Consortium on Mammographic Density: Methodology and Population Diversity captured across 22 Countries

    PubMed Central

    McCormack, Valerie A.; Burton, Anya; dos-Santos-Silva, Isabel; Hipwell, John H.; Dickens, Caroline; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Ling Lee, Charmaine Pei; Chia, Kee-Seng; Ozmen, Vahit; Aribal, Mustafa Erkin; Flugelman, Anath Arzee; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; van Gils, Carla H.; Wanders, Johanna O.P.; Vinayak, Sudhir; Ndumia, Rose; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Lee, Jong Won; Kim, Jisun; Pereira, Ana; Garmendia, Maria Luisa; Sirous, Reza; Sirous, Mehri; Peplonska, Beata; Bukowska, Agnieszka; Tamimi, Rulla M.; Bertrand, Kimberly; Nagata, Chisato; Kwong, Ava; Vachon, Celine; Scott, Christopher; Perez-Gomez, Beatriz; Pollan, Marina; Maskarinec, Gertraud; Giles, Graham; Hopper, John; Stone, Jennifer; Rajaram, Nadia; Teo, Soo-Hwang; Mariapun, Shivaani; Yaffe, Martin J.; Schüz, Joachim; Chiarelli, Anna; Linton, Linda; Boyd, Norman F.

    2015-01-01

    Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD by a core team to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses. PMID:26724463

  3. International Consortium on Mammographic Density: Methodology and population diversity captured across 22 countries.

    PubMed

    McCormack, Valerie A; Burton, Anya; dos-Santos-Silva, Isabel; Hipwell, John H; Dickens, Caroline; Salem, Dorria; Kamal, Rasha; Hartman, Mikael; Lee, Charmaine Pei Ling; Chia, Kee-Seng; Ozmen, Vahit; Aribal, Mustafa Erkin; Flugelman, Anath Arzee; Lajous, Martín; Lopez-Riduara, Ruy; Rice, Megan; Romieu, Isabelle; Ursin, Giske; Qureshi, Samera; Ma, Huiyan; Lee, Eunjung; van Gils, Carla H; Wanders, Johanna O P; Vinayak, Sudhir; Ndumia, Rose; Allen, Steve; Vinnicombe, Sarah; Moss, Sue; Won Lee, Jong; Kim, Jisun; Pereira, Ana; Garmendia, Maria Luisa; Sirous, Reza; Sirous, Mehri; Peplonska, Beata; Bukowska, Agnieszka; Tamimi, Rulla M; Bertrand, Kimberly; Nagata, Chisato; Kwong, Ava; Vachon, Celine; Scott, Christopher; Perez-Gomez, Beatriz; Pollan, Marina; Maskarinec, Gertraud; Giles, Graham; Hopper, John; Stone, Jennifer; Rajaram, Nadia; Teo, Soo-Hwang; Mariapun, Shivaani; Yaffe, Martin J; Schüz, Joachim; Chiarelli, Anna M; Linton, Linda; Boyd, Norman F

    2016-02-01

    Mammographic density (MD) is a quantitative trait, measurable in all women, and is among the strongest markers of breast cancer risk. The population-based epidemiology of MD has revealed genetic, lifestyle and societal/environmental determinants, but studies have largely been conducted in women with similar westernized lifestyles living in countries with high breast cancer incidence rates. To benefit from the heterogeneity in risk factors and their combinations worldwide, we created an International Consortium on Mammographic Density (ICMD) to pool individual-level epidemiological and MD data from general population studies worldwide. ICMD aims to characterize determinants of MD more precisely, and to evaluate whether they are consistent across populations worldwide. We included 11755 women, from 27 studies in 22 countries, on whom individual-level risk factor data were pooled and original mammographic images were re-read for ICMD to obtain standardized comparable MD data. In the present article, we present (i) the rationale for this consortium; (ii) characteristics of the studies and women included; and (iii) study methodology to obtain comparable MD data from original re-read films. We also highlight the risk factor heterogeneity captured by such an effort and, thus, the unique insight the pooled study promises to offer through wider exposure ranges, different confounding structures and enhanced power for sub-group analyses. Copyright © 2015 Elsevier Ltd. All rights reserved.

  4. High-density lipoprotein cholesterol, obesity, and mammographic density in Korean women: the Healthy Twin study.

    PubMed

    Sung, Joohon; Song, Yun-Mi; Stone, Jennifer; Lee, Kayoung; Kim, Sun-Young

    2011-01-01

    High-density lipoprotein cholesterol (HDL-C) is reported to be associated with breast cancer risk. To better understand this association, we examined the relationship between HDL-C and mammographic density, a putative intermediate risk factor for breast cancer. The study subjects were 711 Korean women from the Healthy Twin study. Lipid parameters were assayed enzymatically in fresh sera, and percent dense area (PDA) and absolute dense area were measured from digital mammograms using a computer-assisted method. PDA was positively associated with HDL-C in both premenopausal and postmenopausal women in a multivariable-adjusted linear mixed model, but the association did not persist when the model was additionally adjusted for body mass index (BMI). BMI was inversely associated with PDA, and this association did not change after additional adjustment for any lipid parameter. Multivariable-adjusted analysis showed that there were significant additive genetic cross-trait correlations between PDA and both HDL-C (coefficient, 0.175) and triglyceride (coefficient, -0.262). However, those correlations disappeared after additional adjustment for BMI. HDL-C alone is unlikely to increase the risk of breast cancer in Korean women, particularly through changes in breast parenchyma that are apparent in mammographic density. BMI should be included in studies using analytical models where mammographic density is used as an intermediate risk factor for breast cancer.

  5. A GaAs pixel detectors-based digital mammographic system: Performances and imaging tests results

    NASA Astrophysics Data System (ADS)

    Annovazzi, A.; Amendolia, S. R.; Bigongiari, A.; Bisogni, M. G.; Catarsi, F.; Cesqui, F.; Cetronio, A.; Colombo, F.; Delogu, P.; Fantacci, M. E.; Gilberti, A.; Lanzieri, C.; Lavagna, S.; Novelli, M.; Passuello, G.; Paternoster, G.; Pieracci, M.; Poletti, M.; Quattrocchi, M.; Rosso, V.; Stefanini, A.; Testa, A.; Venturelli, L.

    2007-06-01

    The prototype presented in this paper is based on GaAs pixel detectors read-out by the PCC/MEDIPIX I circuit. The active area of a sensor is about 1 cm 2 therefore to cover the typical irradiation field used in mammography (18×24 cm 2), 18 GaAs detection units have been organized in two staggered rows of nine chips each and moved by a stepper motor in the orthogonal direction. The system is integrated in a mammographic equipment which comprehends the X-ray tube, the bias and data acquisition systems and the PC-based control system. The prototype has been developed in the framework of the Integrated Mammographic Imaging (IMI) project, an industrial research activity aiming to develop innovative instrumentation for morphologic and functional imaging. The project has been supported by the Italian Ministry of Education, University and Research (MIUR) and by five Italian High Tech companies, Alenia Marconi Systems (AMS), CAEN, Gilardoni, LABEN and Poli.Hi.Tech., in collaboration with the universities of Ferrara, Roma "La Sapienza", Pisa and the Istituto Nazionale di Fisica Nucleare (INFN). In this paper, we report on the electrical characterization and the first imaging test results of the digital mammographic system. To assess the imaging capability of such a detector we have built a phantom, which simulates the breast tissue with malignancies. The radiographs of the phantom, obtained by delivering an entrance dose of 4.8 mGy, have shown particulars with a measured contrast below 1%.

  6. Diagnosis of breast cancer in light microscopic and mammographic images textures using relative entropy via kernel estimation.

    PubMed

    Korkmaz, Sevcan Aytac; Korkmaz, Mehmet Fatih; Poyraz, Mustafa

    2016-04-01

    The aim of this article was to provide early detection of breast cancer by using both mammography and histopathology images of the same patient. When the studies in the literature are examined, it is seen that the mammography and histopathology images of the same patient are not used together for early diagnosis of breast cancer. Mammographic and microscopic images can be limited when using only one of them for the early detection of the breast cancer. Therefore, multi-modality solutions that give more accuracy results than single solutions have been realized in this paper. 3 × 50 microscopic (histopathology) and 3 × 50 mammography image sets have been taken from Firat University Medicine Faculty Pathology and Radiology Laboratories, respectively. Optimum feature space has been obtained by minimum redundancy and maximum relevance via mutual information method applying to the 3 × 50 microscopic and mammography images. Then, probabilistic values of suspicious lesions in the image for selected features have been found by exponential curve fitting. Jensen Shannon, Hellinger, and Triangle measurements have been used for the diagnosis of breast cancer. It has been proved that these measures have been related to each other. Weight values for selected each feature have been found using these measures. These weight values have been used in object function. Afterward, histopathology and mammography images have been classified as normal, malign, and benign utilizing object function. In the result of this classifier, the accuracy of diagnosis of breast cancer has been estimated probabilistically. Furthermore, classifications have been probabilistically visualized on a pie chart. Consequently, the performances of Jensen Shannon, Hellinger, and Triangle measures have been compared with ROC analysis using histopathology and mammography test images. It has been observed that Jensen Shannon measure has higher performance than Hellinger and Triangle measures. Accuracy rates of

  7. Introduction of an automated user-independent quantitative volumetric magnetic resonance imaging breast density measurement system using the Dixon sequence: comparison with mammographic breast density assessment.

    PubMed

    Wengert, Georg Johannes; Helbich, Thomas H; Vogl, Wolf-Dieter; Baltzer, Pascal; Langs, Georg; Weber, Michael; Bogner, Wolfgang; Gruber, Stephan; Trattnig, Siegfried; Pinker, Katja

    2015-02-01

    The purposes of this study were to introduce and assess an automated user-independent quantitative volumetric (AUQV) breast density (BD) measurement system on the basis of magnetic resonance imaging (MRI) using the Dixon technique as well as to compare it with qualitative and quantitative mammographic (MG) BD measurements. Forty-three women with normal mammogram results (Breast Imaging Reporting and Data System 1) were included in this institutional review board-approved prospective study. All participants were subjected to BD assessment with MRI using the following sequence with the Dixon technique (echo time/echo time, 6 milliseconds/2.45 milliseconds/2.67 milliseconds; 1-mm isotropic; 3 minutes 38 seconds). To test the reproducibility, a second MRI after patient repositioning was performed. The AUQV magnetic resonance (MR) BD measurement system automatically calculated percentage (%) BD. The qualitative BD assessment was performed using the American College of Radiology Breast Imaging Reporting and Data System BD categories. Quantitative BD was estimated semiautomatically using the thresholding technique Cumulus4. Appropriate statistical tests were used to assess the agreement between the AUQV MR measurements and to compare them with qualitative and quantitative MG BD estimations. The AUQV MR BD measurements were successfully performed in all 43 women. There was a nearly perfect agreement of AUQV MR BD measurements between the 2 MR examinations for % BD (P < 0.001; intraclass correlation coefficient, 0.998) with no significant differences (P = 0.384). The AUQV MR BD measurements were significantly lower than quantitative and qualitative MG BD assessment (P < 0.001). The AUQV MR BD measurement system allows a fully automated, user-independent, robust, reproducible, as well as radiation- and compression-free volumetric quantitative BD assessment through different levels of BD. The AUQV MR BD measurements were significantly lower than the currently used qualitative

  8. Reduced mammographic density with use of a gonadotropin-releasing hormone agonist-based chemoprevention regimen in BRCA1 carriers.

    PubMed

    Weitzel, Jeffrey N; Buys, Saundra S; Sherman, William H; Daniels, AnnaMarie; Ursin, Giske; Daniels, John R; MacDonald, Deborah J; Blazer, Kathleen R; Pike, Malcolm C; Spicer, Darcy V

    2007-01-15

    Women with a BRCA1 mutation (BRCA1(mut)) need risk reduction options beyond mastectomy and oophorectomy. We evaluated the efficacy, safety, and tolerability of hormonal chemoprevention with a gonadotropin-releasing hormone agonist (GnRHA) with low-dose add-back steroids in BRCA1(mut) carriers. The 12-month open label clinical trial used the GnRHA deslorelin, ultra-low-dose estradiol (E(2)), and replacement testosterone, administered via daily intranasal spray in premenopausal women with a BRCA1(mut), and intermittent oral medroxyprogesterone acetate. The end points included mammographic percent density, bone mineral density, endometrial hyperplasia, symptom inventory, and quality of life (Medical Outcomes SF-36 survey). Six of eight BRCA1(mut) women (mean age, 30.3 years; range, 25-36 years) completed the study. Mammographic percent density was significantly reduced at 12 months (median absolute mammographic percent density decrease, 8.3%; P = 0.043), representing a 29.2% median reduction in mammographic percent density. Bone mineral density remained within reference limits for all participants; there were no cases of atypical endometrial hyperplasia and menses resumed within a median of 67 days (range, 35-110 days) after last drug treatment day. The treatment was well tolerated; hypoestrogenic side effects were minimal and transient; and there were no significant changes in quality of life. The GnRHA deslorelin, with low-dose add-back steroids, was well tolerated and significantly decreased mammographic percent density in BRCA1(mut) carriers. This regimen may reduce breast cancer risk and improve the usefulness of mammographic surveillance by reducing density. This is the first demonstration, to our knowledge, of a direct reduction of mammographic densities in young BRCA1(mut) carriers.

  9. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer.

    PubMed

    Li, Jingmei; Humphreys, Keith; Eriksson, Louise; Edgren, Gustaf; Czene, Kamila; Hall, Per

    2013-06-20

    Tamoxifen treatment is associated with a reduction in mammographic density and an improved survival. However, the extent to which change in mammographic density during adjuvant tamoxifen therapy can be used to measure response to treatment is unknown. Overall, 974 postmenopausal patients with breast cancer who had both a baseline and a follow-up mammogram were eligible for analysis. On the basis of treatment information abstracted from medical records, 474 patients received tamoxifen treatment and 500 did not. Mammographic density was measured by using an automated thresholding method and expressed as absolute dense area. Change in mammographic density was calculated as percentage change from baseline. Survival analysis was performed by using delayed-entry Cox proportional hazards regression models, with death as a result of breast cancer as the end point. Analyses were adjusted for a range of patient and tumor characteristics. During a 15-year follow-up, 121 patients (12.4%) died from breast cancer. Women treated with tamoxifen who experienced a relative density reduction of more than 20% between baseline and first follow-up mammogram had a reduced risk of death as a result of breast cancer of 50% (hazard ratio, 0.50; 95% CI, 0.27 to 0.93) compared with women with stable mammographic density. In the no-tamoxifen group, there was no statistically significant association between mammographic density change and survival. The survival advantage was not observed when absolute dense areas at baseline or follow-up were evaluated separately. A decrease in mammographic density after breast cancer diagnosis appears to serve as a prognostic marker for improved long-term survival in patients receiving adjuvant tamoxifen, and these data should be externally validated.

  10. Qualitative modeling.

    PubMed

    Forbus, Kenneth D

    2011-07-01

    Qualitative modeling concerns the representations and reasoning that people use to understand continuous aspects of the world. Qualitative models formalize everyday notions of causality and provide accounts of how to ground symbolic, relational representations in perceptual processes. This article surveys the basic ideas of qualitative modeling and their applications from a cognitive science perspective. It describes the basic principles of qualitative modeling, and a variety of qualitative representations that have been developed for quantities and for relationships between them, providing a kind of qualitative mathematics. Three ontological frameworks for organizing modeling knowledge (processes, components, and field) are summarized, along with research on automatically assembling models for particular tasks from such knowledge. Qualitative simulation and how it carves up time into meaningful units is discussed. We discuss several accounts of causal reasoning about dynamical systems, based on different choices of qualitative mathematics and ontology. Qualitative spatial reasoning is explored, both in terms of relational systems and visual reasoning. Applications of qualitative models of particular interest to cognitive scientists are described, including how they have been used to capture the expertise of scientists and engineers and how they have been used in education. Open questions and frontiers are also discussed, focusing on relationships between ideas developed in the qualitative modeling community and other areas of cognitive science. WIREs Cogni Sci 2011 2 374-391 DOI: 10.1002/wcs.115 For further resources related to this article, please visit the WIREs website.

  11. HIV is Now a Manageable Long-Term Condition, But What Makes it Unique? A Qualitative Study Exploring Views About Distinguishing Features from Multi-Professional HIV Specialists in North West England.

    PubMed

    Jelliman, Pauline; Porcellato, Lorna

    HIV is evolving from a life-threatening infection to a long-term, manageable condition because of medical advances, radical changes in health and social care policy, and the impact of an aging population. However, HIV remains complex, presenting unique characteristics distinguishing it from other long-term conditions (LTCs). Our aim in this qualitative descriptive study was to identify and explore these features in the context of LTCs. A focus group (FG) method was used to gather the views and experiences of multi-professional HIV specialists who worked in North West England. Twenty-four staff participated in FGs (n = 3), which were audio recorded, manually transcribed, and thematically analyzed. We found four main themes: (a) stigma, (b) challenges faced by HIV specialists, (c) lack HIV-related knowledge, and (d) unique features, termed "stand alone." We concluded that these distinguishing features hindered full recognition and acceptance of HIV as an LTC. Crown Copyright © 2016. Published by Elsevier Inc. All rights reserved.

  12. Demographic changes in breast cancer incidence, stage at diagnosis and age associated with population-based mammographic screening.

    PubMed

    Verdial, Francys C; Etzioni, Ruth; Duggan, Catherine; Anderson, Benjamin O

    2017-04-01

    Breast cancer incidence and mortality are influenced by early-detection methods, including mammographic screening. Demographic changes in US statistics serve as a model for changes that can be anticipated in countries where mammographic screening has not been implemented. SEER statistics (1973-2013) for breast cancer mortality, incidence, stage at diagnosis, and age at diagnosis were examined. Temporal associations between screening changes and breast cancer demographics in the US were documented. Before 1982 (pre-screening), breast cancer incidence in the US remained stable, with similar incidence of localized and regional cancers, and with in-situ disease comprising <2% of diagnosed disease.(1) During the transitional phase of mammographic screening, breast cancer incidence increased. In 1991, breast cancer age-adjusted mortality rates began decreasing and have continued to decrease. In the post-screening phase, stage distribution stabilized, but now with localized and in-situ disease representing the majority of diagnosed cases. The median age at diagnosis has increased to 61 years. Mammographic screening increases breast cancer incidence, shifts the stage distribution toward earlier stage disease, and in high-income countries, is associated with improved survival. Whether similar improvement in breast cancer survival can be achieved in the absence of mammographic screening has yet to be conclusively demonstrated. © 2017 Wiley Periodicals, Inc.

  13. The implementation of an AR (augmented reality) approach to support mammographic interpretation training: an initial feasibility study

    NASA Astrophysics Data System (ADS)

    Tang, Qiang; Chen, Yan; Gale, Alastair G.

    2017-03-01

    Appropriate feedback plays an important role in optimising mammographic interpretation training whilst also ensuring good interpretation performance. The traditional keyboard, mouse and workstation technical approach has a critical limitation in providing supplementary image-related information and providing complex feedback in real time. Augmented Reality (AR) provides a possible superior approach in this situation, as feedback can be provided directly overlaying the displayed mammographic images so making a generic approach which can also be vendor neutral. In this study, radiological feedback was dynamically remapped virtually into the real world, using perspective transformation, in order to provide a richer user experience in mammographic interpretation training. This is an initial attempt of an AR approach to dynamically superimpose pre-defined feedback information of a DICOM image on top of a radiologist's view, whilst the radiologist is examining images on a clinical workstation. The study demonstrates the feasibility of the approach, although there are limitations on interactive operations which are due to the hardware used. The results of this fully functional approach provide appropriate feedback/image correspondence in a simulated mammographic interpretation environment. Thus, it is argued that employing AR is a feasible way to provide rich feedback in the delivery of mammographic interpretation training.

  14. Pregnancy-like (pseudolactational) hyperplasia: a primary diagnosis in mammographically detected lesions of the breast and its relationship to cystic hypersecretory hyperplasia.

    PubMed

    Shin, S J; Rosen, P P

    2000-12-01

    Pregnancy-like (pseudolactational) hyperplasia (PLH) has long been recognized as an incidental finding in breast biopsies performed for various clinically detected benign and malignant conditions. The histologic features of PLH have been well described, including some instances exhibiting cytologic and structural atypia. The presence of calcifications in these lesions was rarely mentioned and was considered to be of little consequence. More recently, however, calcifications in PLH have become the target of needle localization and needle core biopsies. The authors report 12 instances in which PLH was the primary diagnosis in biopsy specimens obtained for radiographic abnormalities, usually calcifications. Six of 12 procedures (50.0%) were performed for mammographically detected calcifications, four cases for a mass, one for an "abnormal mammogram," and one for galactorrhea. Calcifications were present in PLH in 10 biopsies, in benign terminal ducts in one specimen, and were not identified histologically in the remaining specimen. In most instances, calcifications associated with PLH had smooth round or lobulated contours and distinctive, internal, unevenly spaced laminations. Cystic hypersecretory hyperplasia (CHH) was present in five specimens. In four of the five specimens, CHH merged with PLH (PLH/CHH). Four of 12 specimens (33.3%) showed atypia within foci of PLH/CHH. PLH should be recognized as a primary diagnosis in breast biopsies for mammographically detected abnormalities such as calcifications. Some calcifications associated with PLH have a distinctive histologic appearance, and their recognition can aid in the diagnosis of PLH. Additional cases of PLH/CHH must be studied to ascertain the clinical significance, if any, of this previously undescribed entity. The precancerous significance of PLH/CHH and of PLH with atypia has not been determined. In most instances, surgical excision would be prudent if PLH/ CHH or PLH with atypia is present in a needle core

  15. Breast density changes associated with hormone replacement therapy in postmenopausal women. Effects on the specificity and sensitivity of mammographic screening.

    PubMed

    Patella, A; Marziani, R; Schippa, A; Benedetti, S; Mossa, S; Mossa, B

    2005-01-01

    Postmenopausal HRT use is associated with an increase of mammographic density and reduction of sensitivity and specificity of mammography results and an increase of false-positive and false-negative outcomes. The increased density does not allow a good evaluation of the exam. Mammographic density is an independent risk factor for breast cancer, but the link between changes in breast density and difference in breast cancer risk, remain uncertain. On the other hand, today specific guidelines and protocols to optimize the screening of neoplastic breast pathology in HRT users do not exist and it is unknown if short-term suspension of therapy improves mammographic sensitivity. More information is required to define this important risk factor.

  16. Development of a sampling strategy and sample size calculation to estimate the distribution of mammographic breast density in Korean women.

    PubMed

    Jun, Jae Kwan; Kim, Mi Jin; Choi, Kui Son; Suh, Mina; Jung, Kyu-Won

    2012-01-01

    Mammographic breast density is a known risk factor for breast cancer. To conduct a survey to estimate the distribution of mammographic breast density in Korean women, appropriate sampling strategies for representative and efficient sampling design were evaluated through simulation. Using the target population from the National Cancer Screening Programme (NCSP) for breast cancer in 2009, we verified the distribution estimate by repeating the simulation 1,000 times using stratified random sampling to investigate the distribution of breast density of 1,340,362 women. According to the simulation results, using a sampling design stratifying the nation into three groups (metropolitan, urban, and rural), with a total sample size of 4,000, we estimated the distribution of breast density in Korean women at a level of 0.01% tolerance. Based on the results of our study, a nationwide survey for estimating the distribution of mammographic breast density among Korean women can be conducted efficiently.

  17. Association of Catechol-O-methyltransferase polymorphism Val158Met and mammographic density: A meta-analysis.

    PubMed

    Kallionpää, Roope A; Uusitalo, Elina; Peltonen, Juha

    2017-08-15

    The Val158Met polymorphism in catechol-O-methyltransferase (COMT) enzyme reduces the methylation of catechol estrogens, which may affect mammographic density. High mammographic density is a known risk factor of breast cancer. Our aim was to perform meta-analysis of the effect of COMT Val158Met polymorphism on mammographic density. Original studies reporting data on mammographic density, stratified by the presence of COMT Val158Met polymorphism, were identified and combined using genetic models Met/Val vs. Val/Val, Met/Met vs. Val/Val, Val/Met+Met/Met vs. Val/Val (dominant model) and Met/Met vs. Val/Met+Val/Val (recessive model). Subgroup analyses by breast cancer status, menopausal status and use of hormone replacement therapy (HRT) were also performed. Eight studies were included in the meta-analysis. The overall effect in percent mammographic density was -1.41 (CI -2.86 to 0.05; P=0.06) in the recessive model. Exclusion of breast cancer patients increased the effect size to -1.93 (CI -3.49 to -0.37; P=0.02). The results suggested opposite effect of COMT Val158Met for postmenopausal users of HRT versus premenopausal women or postmenopausal non-users of HRT. COMT Val158Met polymorphism may be associated with mammographic density at least in healthy women. Menopausal status and HRT should be taken into account in future studies to avoid masking of the underlying effects. Copyright © 2017 Elsevier B.V. All rights reserved.

  18. Mammographic density and breast cancer risk by family history in women of white and Asian ancestry.

    PubMed

    Maskarinec, Gertraud; Nakamura, Kaylae L; Woolcott, Christy G; Conroy, Shannon M; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Vachon, Celine M

    2015-04-01

    Mammographic density, i.e., the radiographic appearance of the breast, is a strong predictor of breast cancer risk. To determine whether the association of breast density with breast cancer is modified by a first-degree family history of breast cancer (FHBC) in women of white and Asian ancestry, we analyzed data from four case-control studies conducted in the USA and Japan. The study population included 1,699 breast cancer cases and 2,422 controls, of whom 45% reported white (N = 1,849) and 40% Asian (N = 1,633) ancestry. To standardize mammographic density assessment, a single observer re-read all mammograms using one type of interactive thresholding software. Logistic regression was applied to estimate odds ratios (OR) while adjusting for confounders. Overall, 496 (12%) of participants reported a FHBC, which was significantly associated with breast cancer risk in the adjusted model (OR 1.51; 95% CI 1.23-1.84). There was a statistically significant interaction on a multiplicative scale between FHBC and continuous percent density (per 10 % density: p = 0.03). The OR per 10% increase in percent density was higher among women with a FHBC (OR 1.30; 95% CI 1.13-1.49) than among those without a FHBC (OR 1.14; 1.09-1.20). This pattern was apparent in whites and Asians. The respective ORs were 1.45 (95% CI 1.17-1.80) versus 1.22 (95% CI 1.14-1.32) in whites, whereas the values in Asians were only 1.24 (95% CI 0.97-1.58) versus 1.09 (95% CI 1.00-1.19). These findings support the hypothesis that women with a FHBC appear to have a higher risk of breast cancer associated with percent mammographic density than women without a FHBC.

  19. Varying performance in mammographic interpretation across two countries: Do results indicate reader or population variances?

    NASA Astrophysics Data System (ADS)

    Soh, BaoLin P.; Lee, Warwick B.; Wong, Jill; Sim, Llewellyn; Hillis, Stephen L.; Tapia, Kriscia A.; Brennan, Patrick C.

    2016-03-01

    Aim: To compare the performance of Australian and Singapore breast readers interpreting a single test-set that consisted of mammographic examinations collected from the Australian population. Background: In the teleradiology era, breast readers are interpreting mammographic examinations from different populations. The question arises whether two groups of readers with similar training backgrounds, demonstrate the same level of performance when presented with a population familiar only to one of the groups. Methods: Fifty-three Australian and 15 Singaporean breast radiologists participated in this study. All radiologists were trained in mammogram interpretation and had a median of 9 and 15 years of experience in reading mammograms respectively. Each reader interpreted the same BREAST test-set consisting of sixty de-identified mammographic examinations arising from an Australian population. Performance parameters including JAFROC, ROC, case sensitivity as well as specificity were compared between Australian and Singaporean readers using a Mann Whitney U test. Results: A significant difference (P=0.036) was demonstrated between the JAFROC scores of the Australian and Singaporean breast radiologists. No other significant differences were observed. Conclusion: JAFROC scores for Australian radiologists were higher than those obtained by the Singaporean counterparts. Whilst it is tempting to suggest this is down to reader expertise, this may be a simplistic explanation considering the very similar training and audit backgrounds of the two populations of radiologists. The influence of reading images that are different from those that radiologists normally encounter cannot be ruled out and requires further investigation, particularly in the light of increasing international outsourcing of radiologic reporting.

  20. Metabolic syndrome, insulin resistance, and mammographic density in pre- and postmenopausal women.

    PubMed

    Kim, Bo-Kyoung; Chang, Yoosoo; Ahn, Jiin; Jung, Hyun-Suk; Kim, Chan-Won; Yun, Kyung Eun; Kwon, Min-Jung; Suh, Byung-Seong; Chung, Eun Chul; Shin, Hocheol; Ryu, Seungho

    2015-09-01

    Little is known about the association of metabolic syndrome (MetS) or insulin resistance (IR) with mammographic density, a strong risk factor for breast cancer. The goal of this study was to evaluate these associations in pre- and postmenopausal women. A cross-sectional study was performed in 73,974 adult women who underwent a comprehensive health screening examination that included a mammogram between 2011 and 2013 (mean age 42.6 years). MetS was defined according to the modified National Cholesterol Education Program Adult Treatment Panel III. IR was assessed with the homeostasis model assessment-insulin resistance (HOMA-IR). Adjusted odds ratios (ORs) with 95% confidence intervals (CIs) for dense breast were estimated using logistic regression models after adjustment for potential confounders. In premenopausal women, MetS and all its components except waist circumference were associated with dense breast. After adjustment for potential confounders, the OR (95% CI) for dense breast in women with MetS compared with those without MetS was 1.22 (1.06-1.39). In postmenopausal women, however, there was positive but non-significant association between MetS and dense breast. In both pre- and postmenopausal women, high blood glucose and IR were positively associated with dense breast. The OR (95% CI) for dense breast between the highest and lowest quartiles of HOMA-IR was 1.29 (1.20-1.39) for premenopausal women and 1.44 (1.05-1.97) for postmenopausal women. In a large sample of Korean women, MetS and IR were associated with mammographic dense breast, demonstrating that IR, a potentially modifiable risk factor, may increase breast cancer risk, possibly through high mammographic density.

  1. Genetic variation in Transforming Growth Factor beta 1 and mammographic density in Singapore Chinese women

    PubMed Central

    Lee, Eunjung; Van den Berg, David; Hsu, Chris; Ursin, Giske; Koh, Woon-Puay; Yuan, Jian-Min; Stram, Daniel O.; Yu, Mimi C.; Wu, Anna H.

    2013-01-01

    Transforming growth factor-beta (TGF-β) plays a critical role in normal mammary development and morphogenesis. Decreased TGF-β signaling has been associated with increased mammographic density. Percent mammographic density (PMD) adjusted for age and body mass index (BMI) is a strong risk factor and predictor of breast cancer risk. PMD is highly heritable, but few genetic determinants have been identified. We investigated the association between genetic variation in TGFB1 and PMD using a cross-sectional study of 2,038 women who were members of the population-based Singapore Chinese Health Study cohort. We assessed PMD using a computer-assisted method. We used linear regression to examine the association between 9 tagging SNPs of TGFB1 and PMD and their interaction with parity, adjusting for age, BMI, and dialect group. We calculated ‘P-values adjusted for correlated tests’ (PACT) to account for multiple testing. The strongest association was observed for rs2241716. Adjusted PMD was higher by 1.5% per minor allele (PACT =0.04). When stratifying by parity, this association was limited to nulliparous women. For nulliparous women, adjusted PMD was higher by 8.6% per minor allele (PACT=0.003; P for interaction with parity=0.002). Three additional TGFB1 tagging SNPs, which were in linkage disequilibrium with rs2241716, were statistically significantly associated with adjusted PMD (PACT<0.05) for nulliparous women. However, none of these three SNPs showed statistically significant association after adjusting for rs2241716. Our data support that TGFB1 genetic variation may be an important genetic determinant of mammographic density measure that predicts breast cancer risk, particularly in nulliparous women. PMID:23333936

  2. Clinically and mammographically occult breast lesions: detection and classification with high-resolution sonography.

    PubMed

    Buchberger, W; Niehoff, A; Obrist, P; DeKoekkoek-Doll, P; Dünser, M

    2000-08-01

    With recent significant advances in ultrasound technology, the potential of high-resolution sonography to improve the sensitivity of cancer diagnosis in women with dense breasts has become a matter of interest for breast imagers. To determine how often physician-performed high-resolution sonography can detect nonpalpable breast cancers that are not revealed by mammography, 8,970 women with breast density grades 2 through 4 underwent high-resolution sonography as an adjunct to mammography. All sonographically detected, clinically and mammographically occult breast lesions that were not simple cysts were prospectively classified into benign, indeterminate, or malignant categories. Diagnoses were confirmed by ultrasound-guided fine-needle aspiration, core-needle biopsy, or surgical biopsy. In 8,103 women with normal findings at mammography and physical examination, 32 cancers and 330 benign lesions were detected in 273 patients with sonography only. Eight additional cancers were found in 867 patients with a malignant (n = 5) or a benign (n = 3) palpable or mammographically detected index lesion. The overall prevalence of cancers detected with screening sonography was 0.41%, and the proportion of sonographically detected cancers to the total number of nonpalpable cancers was 22%. The mean size of invasive cancers detected only by sonography was 9.1 mm, and was not statistically different from the mean size of invasive cancers detected by mammography. The sensitivity of prospective sonographic classification for malignancy was 100%, and the specificity was 31%. In conclusion, the use of high-resolution sonography as an adjunct to mammography in women with dense breasts may lead to detection of a significant number of otherwise occult cancers that are no different in size from nonpalpable mammographically detected cancers. Prospective classification of these lesions based on sonographic characteristics resulted in an acceptable benign-to-malignant biopsy rate of 6.3:1.

  3. Cost-benefit analysis of biopsy methods for suspicious mammographic lesions; discussion 994-5.

    PubMed

    Fahy, B N; Bold, R J; Schneider, P D; Khatri, V; Goodnight, J E

    2001-09-01

    Stereotactic core biopsy (SCB) is more cost-effective than needle-localized biopsy (NLB) for evaluation and treatment of mammographic lesions. A computer-generated mathematical model was developed based on clinical outcome modeling to estimate costs accrued during evaluation and treatment of suspicious mammographic lesions. Total costs were determined for evaluation and subsequent treatment of cancer when either SCB or NLB was used as the initial biopsy method. Cost was estimated by the cumulative work relative value units accrued. The risk of malignancy based on the Breast Imaging Reporting Data System (BIRADS) score and mammographic suspicion of ductal carcinoma in situ were varied to simulate common clinical scenarios. Total cost accumulated during evaluation and subsequent surgical therapy (if required). Evaluation of BIRADS 5 lesions (highly suggestive, risk of malignancy = 90%) resulted in equivalent relative value units for both techniques (SCB, 15.54; NLB, 15.47). Evaluation of lesions highly suspicious for ductal carcinoma in situ yielded similar total treatment relative value units (SCB, 11.49; NLB, 10.17). Only for evaluation of BIRADS 4 lesions (suspicious abnormality, risk of malignancy = 34%) was SCB more cost-effective than NLB (SCB, 7.65 vs. NLB, 15.66). No difference in cost-benefit was found when lesions highly suggestive of malignancy (BIRADS 5) or those suspicious for ductal carcinoma in situ were evaluated initially with SCB vs. NLB, thereby disproving the hypothesis. Only for intermediate-risk lesions (BIRADS 4) did initial evaluation with SCB yield a greater cost savings than with NLB.

  4. Detection of mammographically occult architectural distortion on digital breast tomosynthesis screening: initial clinical experience.

    PubMed

    Partyka, Luke; Lourenco, Ana P; Mainiero, Martha B

    2014-07-01

    Digital breast tomosynthesis (DBT) has been shown to improve the sensitivity of screening mammography. DBT may have the most potential impact in cases of subtle mammographic findings such as architectural distortion (AD). The objective of our study was to determine whether DBT provides better visualization of AD than digital mammography (DM) and whether sensitivity for cancer detection is increased by the addition of DBT as it relates to cases of mammographically occult AD. Retrospective review of BI-RADS category 0 reports from 9982 screening DM examinations with adjunct DBT were searched for the term "architectural distortion" and were reviewed in consensus by three radiologists. ADs were classified by whether they were seen better on DM or DBT, were seen equally well on both, or were occult on either modality. The electronic medical record was reviewed to identify additional imaging studies, biopsy results, and surgical excision pathology results. Review identified 26 cases of AD, 19 (73%) of which were seen only on the DBT images. Of the remaining seven ADs, six were seen better on DBT than DM. On diagnostic workup, nine lesions were assigned to BI-RADS category 4 or 5. Surgical pathology revealed two invasive carcinomas, two ductal carcinoma in situ lesions, three radial scars, and two lesions showing atypia. The cancer detection rate of DBT in mammographically occult AD was 21% (4/19). The positive predictive value of biopsy was 44%. DBT provides better visualization of AD than DM and identifies a subset of ADs that are occult on DM. Identification of additional ADs on DBT increases the cancer detection rate.

  5. Genetic analysis of mammographic breast density in adult women: evidence of a gene effect.

    PubMed

    Pankow, J S; Vachon, C M; Kuni, C C; King, R A; Arnett, D K; Grabrick, D M; Rich, S S; Anderson, V E; Sellers, T A

    1997-04-16

    The appearance of the female breast viewed by mammography varies considerably from one individual to another because of underlying differences in the relative proportions of fat, connective tissue, and glandular epithelium that combine to create a characteristic pattern of breast density. An association between mammographic patterns and family history of breast cancer has previously been reported. However, this association has not been found in all studies, and few data are available on possible genetic components contributing to mammographic breast density. Our purpose was to estimate familial correlations and perform complex genetic segregation analyses to test the hypothesis that the transmission of a major gene influences mammographic breast density. As part of a cohort study (initiated in 1944) of families with a history of breast cancer, the probands' female relatives who were older than 40 years were asked to obtain a routine mammogram. The mammograms of 1370 women from 258 independent families were analyzed. The fraction of the breast volume occupied by radiographically dense tissue was estimated visually from video displays of left or right mediolateral oblique views by one radiologist experienced in mammography who had no knowledge of individual relationships to the probands. Data on breast cancer risk factors were obtained through telephone interviews and mailed questionnaires. Unadjusted and adjusted familial correlations in breast density were calculated, and complex genetic segregation analyses were performed. Sister-sister correlations in breast density (unadjusted and adjusted for age and either body mass index, menopausal status, hormone replacement therapy, waist-to-hip ratio, number of live births, alcohol consumption, or cigarette smoking status) were all statistically significant (r = .16-.27; all P<.05 [two-sided]). Estimated mother-daughter correlations were smaller in magnitude (r = .01-.17) and not statistically significant. Segregation

  6. Multiple imputation as a means to assess Mammographic vs. Ultrasound technology in Determine Breast Cancer Recurrence

    NASA Astrophysics Data System (ADS)

    Helenowski, Irene B.; Demirtas, Hakan; Khan, Seema; Eladoumikdachi, Firas; Shidfar, Ali

    2014-03-01

    Tumor size based on mammographic and ultrasound data are two methods used in predicting recurrence in breast cancer patients. Which technology offers better determination of diagnosis is an ongoing debate among radiologists, biophysicists, and other clinicians, however. Further complications in assessing the performance of each technology arise from missing data. One approach to remedy this problem may involve multiple imputation. Here, we therefore examine how imputation affects our assessment of the relationship between recurrence and tumor size determined either by mammography of ultrasound technology. We specifically employ the semi-parametric approach for imputing mixed continuous and binary data as presented in Helenowski and Demirtas (2013).

  7. Percent Mammographic Density and Dense Area as Risk Factors for Breast Cancer.

    PubMed

    Rauh, C; Hack, C C; Häberle, L; Hein, A; Engel, A; Schrauder, M G; Fasching, P A; Jud, S M; Ekici, A B; Loehberg, C R; Meier-Meitinger, M; Ozan, S; Schulz-Wendtland, R; Uder, M; Hartmann, A; Wachter, D L; Beckmann, M W; Heusinger, K

    2012-08-01

    Purpose: Mammographic characteristics are known to be correlated to breast cancer risk. Percent mammographic density (PMD), as assessed by computer-assisted methods, is an established risk factor for breast cancer. Along with this assessment the absolute dense area (DA) of the breast is reported as well. Aim of this study was to assess the predictive value of DA concerning breast cancer risk in addition to other risk factors and in addition to PMD. Methods: We conducted a case control study with hospital-based patients with a diagnosis of invasive breast cancer and healthy women as controls. A total of 561 patients and 376 controls with available mammographic density were included into this study. We describe the differences concerning the common risk factors BMI, parital status, use of hormone replacement therapy (HRT) and menopause between cases and controls and estimate the odds ratios for PMD and DA, adjusted for the mentioned risk factors. Furthermore we compare the prediction models with each other to find out whether the addition of DA improves the model. Results: Mammographic density and DA were highly correlated with each other. Both variables were as well correlated to the commonly known risk factors with an expected direction and strength, however PMD (ρ = -0.56) was stronger correlated to BMI than DA (ρ = -0.11). The group of women within the highest quartil of PMD had an OR of 2.12 (95 % CI: 1.25-3.62). This could not be seen for the fourth quartile concerning DA. However the assessment of breast cancer risk could be improved by including DA in a prediction model in addition to common risk factors and PMD. Conclusions: The inclusion of the parameter DA into a prediction model for breast cancer in addition to established risk factors and PMD could improve the breast cancer risk assessment. As DA is measured together with PMD in the process of computer-assisted assessment of PMD it might be considered to include it as one additional breast

  8. Percent Mammographic Density and Dense Area as Risk Factors for Breast Cancer

    PubMed Central

    Rauh, C.; Hack, C. C.; Häberle, L.; Hein, A.; Engel, A.; Schrauder, M. G.; Fasching, P. A.; Jud, S. M.; Ekici, A. B.; Loehberg, C. R.; Meier-Meitinger, M.; Ozan, S.; Schulz-Wendtland, R.; Uder, M.; Hartmann, A.; Wachter, D. L.; Beckmann, M. W.; Heusinger, K.

    2012-01-01

    Purpose: Mammographic characteristics are known to be correlated to breast cancer risk. Percent mammographic density (PMD), as assessed by computer-assisted methods, is an established risk factor for breast cancer. Along with this assessment the absolute dense area (DA) of the breast is reported as well. Aim of this study was to assess the predictive value of DA concerning breast cancer risk in addition to other risk factors and in addition to PMD. Methods: We conducted a case control study with hospital-based patients with a diagnosis of invasive breast cancer and healthy women as controls. A total of 561 patients and 376 controls with available mammographic density were included into this study. We describe the differences concerning the common risk factors BMI, parital status, use of hormone replacement therapy (HRT) and menopause between cases and controls and estimate the odds ratios for PMD and DA, adjusted for the mentioned risk factors. Furthermore we compare the prediction models with each other to find out whether the addition of DA improves the model. Results: Mammographic density and DA were highly correlated with each other. Both variables were as well correlated to the commonly known risk factors with an expected direction and strength, however PMD (ρ = −0.56) was stronger correlated to BMI than DA (ρ = −0.11). The group of women within the highest quartil of PMD had an OR of 2.12 (95 % CI: 1.25–3.62). This could not be seen for the fourth quartile concerning DA. However the assessment of breast cancer risk could be improved by including DA in a prediction model in addition to common risk factors and PMD. Conclusions: The inclusion of the parameter DA into a prediction model for breast cancer in addition to established risk factors and PMD could improve the breast cancer risk assessment. As DA is measured together with PMD in the process of computer-assisted assessment of PMD it might be considered to include it as one additional

  9. Computed tomographic mammography. Diagnosis of mammographically and clinically occult carcinoma of the breast.

    PubMed

    Sibala, J L; Chang, C H; Lin, F; Jewell, W R

    1981-01-01

    If breast cancer can be detected early, while it is still localized and before it can be palpated, the prognosis for cure is excellent. Heretofore, conventional mammography has been the only means available to detect cancer at such an early stage. Two cases of minimal breast carcinoma measuring less than 5 mm in diameter have been detected and correctly diagnosed using computed tomographic mammography (CT/M). Both cases occurred in fatty breasts and were clinically and mammographically occult. These cases demonstrate the value of CT/M in the diagnosis of minimal breast carcinoma that would have been missed otherwise.

  10. [The significance of mammographic symptoms in clinically occult findings].

    PubMed

    de Waal, J C; Steil, B; Baltzer, J; Vaillant, W; Zander, J

    1987-10-01

    The significance of various radiographic signs in 183 patients with clinically occult breast disease is described. 30.6% had a carcinoma of the breast or a carcinoma in situ. The radiological features have varying predictive values and there is variation in the incidence of lymph node metastases. It is considered useful to classify the radiological appearances under the headings of round foci, star-shaped opacities, diffuse opacities, opacities with calcification and groups of micro-calcification. Despite the early diagnosis, 24% of patients already had lymph node metastases.

  11. Analysis of mammographic findings and patient history data with genetic algorithms for the prediction of breast cancer biopsy outcome

    NASA Astrophysics Data System (ADS)

    Frederick, Erik D.; Floyd, Carey E., Jr.

    1998-06-01

    A decision model is presented to increase the specificity of breast biopsy directly optimized on the receiver operating characteristic (ROC) area index. ROC area has higher clinical significance as a performance measure than the traditional metric mean-squared error (MSE). Excisional biopsy as practiced is highly sensitive to cancer but nonspecific; only one in three biopsies is malignant. Data for this study consists of 500 cases randomly selected from patients who underwent excisional biopsy for definitive diagnosis of breast cancer. For each case, inputs to the model consist of mammographic findings and patient history features. Outputs from the model built may be thresholded to correspond to the decision to biopsy a suspicious breast lesion. While clinically relevant, ROC area is a discontinuous function which cannot be optimized directly so a genetic algorithm approach is used to train a nonlinear artificial neural network. Performance using the genetic algorithm method of training was similar to that of a decision model trained using the traditional approach for this data set. ROC areas were obtained after training using three different approaches: genetic algorithm training optimized on ROC area produced an ROC area of 0.845 +/- 0.039, genetic algorithm training optimized on MSE produced an ROC area of 0.845 +/- 0.039, and traditional training using backpropagation produced an ROC area of 0.848 +/- 0.039. Despite the similar performance measures for models trained on this data, it is possible that with different data sets, training on ROC instead of MSE will produce models with significantly different performance. In this case, the genetic algorithm approach will prove useful.

  12. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    SciTech Connect

    Williams, Alex C; Hitt, Austin N; Voisin, Sophie; Tourassi, Georgia

    2013-01-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  13. Combined photoacoustic and acoustic imaging of human breast specimens in the mammographic geometry.

    PubMed

    Xie, Zhixing; Hooi, Fong Ming; Fowlkes, J Brian; Pinsky, Renee W; Wang, Xueding; Carson, Paul L

    2013-11-01

    A photoacoustic volume imaging (PAVI) system was designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3-D ultrasound (AUS). The goal of the work described here was to validate the design and evaluate its performance in human breast tissues for non-invasive imaging of deeply positioned structures covering such geometry. The good penetration of near-infrared light and high receiving sensitivity of a broad-bandwidth, 572-element, 2-D polyvinylidene fluoride (PVDF) array at a low center frequency of 1 MHz were used with 20 channel simultaneous acquisition. Pseudo-lesions filled with dilute blood were imaged in three human breast specimens at various depths up to 49 mm. With near-infrared light illumination and 256-sample averaging, the extrapolated maximum depth in imaging a 2.4-mm blood-rich lesion with a 3-dB contrast-to-noise ratio in a compressed breast was 54 mm. Three-dimensional photoacoustic volume image stacks of the breasts were co-registered with 3-D ultrasound image stacks, suggesting for the first time that PAVI, based on the intrinsic tissue contrast, can visualize tissue interfaces other than those with blood, including the inner skin surface and connective tissue sheets. With the designed system, PAVI revealed satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides in the mammographic geometry with mild compression.

  14. Stereoscopic representation of the breast from two mammographic view with external markers

    NASA Astrophysics Data System (ADS)

    Kallergi, Maria; Manohar, Anand

    2003-05-01

    A new breast imaging technique has been develoepd and tested for the stereoscopic representation of the breast. The method uses markers at specific locations on the breast surface and standard mammographic projections and was tested with an anthropomorphic phantom containing five mass-like objects at locations determined by a CT scan. The phantom was imaged with a GE Senographe 2000D digital system with and without the markers. The algorithm's modules included: 1) Breast area segmentation; 2) Pectoral muscle segmentation; 3) Registration and alignment of the mammographic projections based on selected reference points; 4) Breast volume estimation basdd on volume conservation principle during compression and shape definition using surface points; 5) 3D lesion(s) localization and representation. An interactive, ILD-based, graphical interface was also developed for the stereoscopic display of the breast. The reconstruction algorithm assumed that the breast shrinks and stretches uniformly when compression is applied and removed. The relative movement of the markers after compression allowed more accurate estimation of the shrinking and stretching of the surface offering a relatively simple and practical way to improve volume estimation and surface reconstruction. Such stereoscopic representation of the breast and associated findings may improve radiological interpretation and physical examinations for breast cancer diagnosis.

  15. Reproductive and lifestyle risk factors and mammographic density in Mexican women.

    PubMed

    Rice, Megan S; Bertrand, Kimberly A; Lajous, Martin; Tamimi, Rulla M; Torres, Gabriela; López-Ridaura, Ruy; Romieu, Isabelle

    2015-11-01

    Several breast cancer risk factors have been consistently associated with mammographic density (MD); however, data are limited for Hispanic women. We examined data from 1007 premenopausal and 600 postmenopausal women in the Mexican Teachers' Cohort. Multivariable linear regression was used to estimate associations between risk factors and MD. Among premenopausal women, age, current body mass index (BMI), BMI at age 18 years, and weight change since age 18 years were inversely associated with percent MD, whereas benign breast disease, alcohol intake, and breastfeeding 12 months or more were associated with higher percent MD. Among postmenopausal women, age, current BMI, BMI at age 18 years, weight change since age 18 years, and speaking or having parents who speak an indigenous language were inversely associated with percent MD, whereas benign breast disease and greater age at natural menopause were positively associated with percent MD. Other breast cancer risk factors, such as age at menarche, parity, and age at first pregnancy, were not significantly associated with density in either premenopausal or postmenopausal women. Results from the Mexican Teachers' Cohort are generally consistent with predictors of mammographic density observed in primarily non-Hispanic white populations; however, certain risk factors (e.g., parity) were not significantly associated with MD. Copyright © 2015 Elsevier Inc. All rights reserved.

  16. Bismuth sulfide nanoflowers for detection of X-rays in the mammographic energy range.

    PubMed

    Nambiar, Shruti; Osei, Ernest K; Yeow, John T W

    2015-03-24

    The increased use of diagnostic x-rays, especially in the field of medical radiology, has necessitated a significant demand for high resolution, real-time radiation detectors. In this regard, the photoresponse of bismuth sulfide (Bi2S3), an n-type semiconducting metal chalcogenide, to low energy x-rays has been investigated in this study. In recent years, several types of nanomaterials of Bi2S3 have been widely studied for optoelectronic and thermoelectric applications. However, photoresponse of Bi2S3 nanomaterials for dosimetric applications has not yet been reported. The photosensitivity of Bi2S3 with nanoscale "flower-like" structures was characterized under x-ray tube-potentials typically used in mammographic procedures. Both dark current and photocurrent were measured under varying x-ray doses, field sizes, and bias voltages for each of the tube potentials - 20, 23, 26 and 30 kV. Results show that the Bi2S3 nanoflowers instantaneously responded to even minor changes in the dose delivered. The photoresponse was found to be relatively high (few nA) at bias voltage as low as +1 V, and fairly repeatable for both short and long exposures to mammographic x-rays with minimal or no loss in sensitivity. The overall dose-sensitivity of the Bi2S3 nanoflowers was found to be similar to that of a micro-ionization chamber.

  17. Mammographic surveillance of breast cancer patients: should the mastectomy site be imaged?

    PubMed

    Fajardo, L L; Roberts, C C; Hunt, K R

    1993-11-01

    This study evaluated the usefulness of routine mammography of the mastectomy site in women who have been treated for breast carcinoma. From a retrospective review of medical records and mammographic examinations of 827 patients who had mastectomies, the following information was obtained: demographic data, type of breast reconstruction (if any), length of follow-up after mastectomy, evidence of local recurrence, and results of physical examination of the breast and mammography immediately before diagnosis of local recurrence. Local recurrences of breast cancer were seen in 39 (4.5%) of the 859 breasts in the study group. All patients had a physical examination of the breast and mammography within 3 months of the diagnosis of recurrent breast carcinoma. Mammography of the mastectomy site did not show any recurrences that were not suspected on the basis of physical examination. For two of 20 patients, spot-compression views of palpable abnormalities showed thickening of the surgical scar. In four patients with pain in the chest wall, no abnormalities were found on physical examination or mammograms, but bone scintigrams showed metastasis to the ribs. Our results indicate that mammographic imaging of the mastectomy site does not increase the detection of locally recurrent breast cancer.

  18. Mammographic density and intake of selected nutrients and vitamins in Norwegian women.

    PubMed

    Qureshi, Samera Azeem; Couto, Elisabeth; Hilsen, Marit; Hofvind, Solveig; Wu, Anna H; Ursin, Giske

    2011-01-01

    Investigating the association between dietary factors and mammographic density (MD) could shed light on the relationship between diet and breast cancer risk. We took advantage of a national mammographic screening program to study the association between intake of nutrients and MD. In this study, we analyzed data of 2,252 postmenopausal women aged 50-69 yr who participated in the Norwegian Breast Cancer Screening Program in 2004. MD was assessed on digitized mammograms using a computer-assisted method. We used multivariate linear regression models to determine least square means of percent and absolute MD. Overall, we observed no associations between MD and intake of total calories, protein, carbohydrates, cholesterol, and dietary fiber. There was a positive borderline statistically significant association between absolute MD and total fat intake (P = 0.10) and between percent MD and intake of saturated fat (P = 0.06). There was no association between MD and intake of calcium, retinol, vitamins A, B12, C, or D, or combined intake of vitamin D and calcium. This study provides some evidence of an association between MD and dietary intake. Our study highlights the importance of adequate adjustments for BMI in studies of diet and MD.

  19. Radiologists' preferences for digital mammographic display. The International Digital Mammography Development Group.

    PubMed

    Pisano, E D; Cole, E B; Major, S; Zong, S; Hemminger, B M; Muller, K E; Johnston, R E; Walsh, R; Conant, E; Fajardo, L L; Feig, S A; Nishikawa, R M; Yaffe, M J; Williams, M B; Aylward, S R

    2000-09-01

    To determine the preferences of radiologists among eight different image processing algorithms applied to digital mammograms obtained for screening and diagnostic imaging tasks. Twenty-eight images representing histologically proved masses or calcifications were obtained by using three clinically available digital mammographic units. Images were processed and printed on film by using manual intensity windowing, histogram-based intensity windowing, mixture model intensity windowing, peripheral equalization, multiscale image contrast amplification (MUSICA), contrast-limited adaptive histogram equalization, Trex processing, and unsharp masking. Twelve radiologists compared the processed digital images with screen-film mammograms obtained in the same patient for breast cancer screening and breast lesion diagnosis. For the screening task, screen-film mammograms were preferred to all digital presentations, but the acceptability of images processed with Trex and MUSICA algorithms were not significantly different. All printed digital images were preferred to screen-film radiographs in the diagnosis of masses; mammograms processed with unsharp masking were significantly preferred. For the diagnosis of calcifications, no processed digital mammogram was preferred to screen-film mammograms. When digital mammograms were preferred to screen-film mammograms, radiologists selected different digital processing algorithms for each of three mammographic reading tasks and for different lesion types. Soft-copy display will eventually allow radiologists to select among these options more easily.

  20. Effect of dose reduction on the detection of mammographic lesions: A mathematical observer model analysis

    SciTech Connect

    Chawla, Amarpreet S.; Samei, Ehsan; Saunders, Robert; Abbey, Craig; Delong, David

    2007-08-15

    The effect of reduction in dose levels normally used in mammographic screening procedures on the detection of breast lesions were analyzed. Four types of breast lesions were simulated and inserted into clinically-acquired digital mammograms. Dose reduction by 50% and 75% of the original clinically-relevant exposure levels were simulated by adding corresponding simulated noise into the original mammograms. The mammograms were converted into luminance values corresponding to those displayed on a clinical soft-copy display station and subsequently analyzed by Laguerre-Gauss and Gabor channelized Hotelling observer models for differences in detectability performance with reduction in radiation dose. Performance was measured under a signal known exactly but variable detection task paradigm in terms of receiver operating characteristics (ROC) curves and area under the ROC curves. The results suggested that luminance mapping of digital mammograms affects performance of model observers. Reduction in dose levels by 50% lowered the detectability of masses with borderline statistical significance. Dose reduction did not have a statistically significant effect on detection of microcalcifications. The model results indicate that there is room for optimization of dose level in mammographic screening procedures.

  1. Identification of a novel percent mammographic density locus at 12q24

    PubMed Central

    Stevens, Kristen N.; Lindstrom, Sara; Scott, Christopher G.; Thompson, Deborah; Sellers, Thomas A.; Wang, Xianshu; Wang, Alice; Atkinson, Elizabeth; Rider, David N.; Eckel-Passow, Jeanette E.; Varghese, Jajini S.; Audley, Tina; Brown, Judith; Leyland, Jean; Luben, Robert N.; Warren, Ruth M.L.; Loos, Ruth J.F.; Wareham, Nicholas J.; Li, Jingmei; Hall, Per; Liu, Jianjun; Eriksson, Louise; Czene, Kamila; Olson, Janet E.; Shane Pankratz, V.; Fredericksen, Zachary; Diasio, Robert B.; Lee, Adam M.; Heit, John A.; deAndrade, Mariza; Goode, Ellen L.; Vierkant, Robert A.; Cunningham, Julie M.; Armasu, Sebastian M.; Weinshilboum, Richard; Fridley, Brooke L.; Batzler, Anthony; Ingle, James N.; Boyd, Norman F.; Paterson, Andrew D.; Rommens, Johanna; Martin, Lisa J.; Hopper, John L.; Southey, Melissa C.; Stone, Jennifer; Apicella, Carmel; Kraft, Peter; Hankinson, Susan E.; Hazra, Aditi; Hunter, David J.; Easton, Douglas F.; Couch, Fergus J.; Tamimi, Rulla M.; Vachon, Celine M.

    2012-01-01

    Percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer and has a heritable component that remains largely unidentified. We performed a three-stage genome-wide association study (GWAS) of percent mammographic density to identify novel genetic loci associated with this trait. In stage 1, we combined three GWASs of percent density comprised of 1241 women from studies at the Mayo Clinic and identified the top 48 loci (99 single nucleotide polymorphisms). We attempted replication of these loci in 7018 women from seven additional studies (stage 2). The meta-analysis of stage 1 and 2 data identified a novel locus, rs1265507 on 12q24, associated with percent density, adjusting for age and BMI (P = 4.43 × 10−8). We refined the 12q24 locus with 459 additional variants (stage 3) in a combined analysis of all three stages (n = 10 377) and confirmed that rs1265507 has the strongest association in the 12q24 region (P = 1.03 × 10−8). Rs1265507 is located between the genes TBX5 and TBX3, which are members of the phylogenetically conserved T-box gene family and encode transcription factors involved in developmental regulation. Understanding the mechanism underlying this association will provide insight into the genetics of breast tissue composition. PMID:22532574

  2. A multichannel time-domain scanning fluorescence mammograph: Performance assessment and first in vivo results

    NASA Astrophysics Data System (ADS)

    Grosenick, Dirk; Hagen, Axel; Steinkellner, Oliver; Poellinger, Alexander; Burock, Susen; Schlag, Peter M.; Rinneberg, Herbert; Macdonald, Rainer

    2011-02-01

    We present a scanning time-domain fluorescence mammograph capable to image the distribution of a fluorescent contrast agent within a female breast, slightly compressed between two parallel glass plates, with high sensitivity. Fluorescence of the contrast agent is excited using a near infrared picosecond diode laser module. Four additional picosecond diode lasers with emission wavelengths between 660 and 1066 nm allow to measure the intrinsic optical properties of the breast tissue. By synchronously moving a source fiber and seven detection fiber bundles across the breast, distributions of times of flight of photons are recorded simultaneously for selected source-detector combinations in transmission and reflection geometry either at the fluorescence wavelength or at the selected laser wavelengths. To evaluate the performance of the mammograph, we used breastlike rectangular phantoms comprising fluorescent and absorbing objects using the fluorescent dye Omocyanine as contrast agent excited at 735 nm. We compare two-dimensional imaging of the phantom based on transmission and reflection data. Furthermore, we developed an improved tomosynthesis algorithm which permits three-dimensional reconstruction of fluorescence and absorption properties of lesions with good spatial resolution. For illustration, we present fluorescence mammograms of one patient recorded 30 min after administration of the contrast agent indocyanine green showing the carcinoma at high contrast originating from fluorescence of the extravasated dye, excited at 780 nm.

  3. Similar to Adiponectin, Serum Levels of Osteocalcin are Associated with Mammographic Breast Density in Postmenopausal Women.

    PubMed

    Vega, Sara; Basurto, Lourdes; Saucedo, Renata; Barrera, Susana; Reyes-Maldonado, Elba; Garcia-Latorre, Ethel A; Zarate, Arturo

    2017-09-15

    Breast cancer is the most common type of cancer in Canadian women and worldwide. Mammographic density is a well-established breast cancer risk. Recent evidence suggested inverse correlations among adiponectin, osteocalcin, and the risk developing breast cancer. The objective of the study was to evaluate the relationship between breast density and adiponectin and osteocalcin concentrations. A cross-sectional study was performed in 239 women, age range 40 to 60. Mammographic density, serum adiponectin, and osteocalcin levels were measured. According to the Wolfe method, participants were divided into those with low-risk and high-risk pattern mammograms. The study population included 107 premenopausal and 132 postmenopausal women. Parameters were no different between women with low-risk and high-risk patterns. In obese postmenopausal women, the high-risk pattern mammogram group had significantly higher values of adiponectin and osteocalcin compared with the low-risk pattern group. Multiple linear regression analyses showed that adiponectin and osteocalcin levels were associated with high-risk pattern mammograms. Adiponectin and osteocalcin levels were directly associated with high-risk pattern mammograms in obese postmenopausal women. These results do not support the use of adipokines as biomarkers; nevertheless, the most important factor is to assess the risk through breast density. Copyright © 2017 Society of Obstetricians and Gynaecologists of Canada. Published by Elsevier Inc. All rights reserved.

  4. Correlates of mammographic density in B-mode ultrasound and real time elastography.

    PubMed

    Jud, Sebastian Michael; Häberle, Lothar; Fasching, Peter A; Heusinger, Katharina; Hack, Carolin; Faschingbauer, Florian; Uder, Michael; Wittenberg, Thomas; Wagner, Florian; Meier-Meitinger, Martina; Schulz-Wendtland, Rüdiger; Beckmann, Matthias W; Adamietz, Boris R

    2012-07-01

    The aim of our study involved the assessment of B-mode imaging and elastography with regard to their ability to predict mammographic density (MD) without X-rays. Women, who underwent routine mammography, were prospectively examined with additional B-mode ultrasound and elastography. MD was assessed quantitatively with a computer-assisted method (Madena). The B-mode and elastography images were assessed by histograms with equally sized gray-level intervals. Regression models were built and cross validated to examine the ability to predict MD. The results of this study showed that B-mode imaging and elastography were able to predict MD. B-mode seemed to give a more accurate prediction. R for B-mode image and elastography were 0.67 and 0.44, respectively. Areas in the B-mode images that correlated with mammographic dense areas were either dark gray or of intermediate gray levels. Concerning elastography only the gray levels that represent extremely stiff tissue correlated positively with MD. In conclusion, ultrasound seems to be able to predict MD. Easy and cheap utilization of regular breast ultrasound machines encourages the use of ultrasound in larger case-control studies to validate this method as a breast cancer risk predictor. Furthermore, the application of ultrasound for breast tissue characterization could enable comprehensive research concerning breast cancer risk and breast density in young and pregnant women.

  5. Combined photoacoustic and ultrasound imaging of human breast in vivo in the mammographic geometry

    NASA Astrophysics Data System (ADS)

    Xie, Zhixing; Lee, Won-Mean; Hooi, Fong Ming; Fowlkes, J. Brian; Pinsky, Renee W.; Mueller, Dean; Wang, Xueding; Carson, Paul L.

    2013-03-01

    This photoacoustic volume imaging (PAVI) system is designed to study breast cancer detection and diagnosis in the mammographic geometry in combination with automated 3D ultrasound (AUS). The good penetration of near-infrared (NIR) light and high receiving sensitivity of a broad bandwidth, 572 element, 2D PVDF array at a low center-frequency of 1MHz were utilized with 20 channel simultaneous acquisition. The feasibility of this system in imaging optically absorbing objects in deep breast tissues was assessed first through experiments on ex vivo whole breasts. The blood filled pseudo lesions were imaged at depths up to 49 mm in the specimens. In vivo imaging of human breasts has been conducted. 3D PAVI image stacks of human breasts were coregistered and compared with 3D ultrasound image stacks of the same breasts. Using the designed system, PAVI shows satisfactory imaging depth and sensitivity for coverage of the entire breast when imaged from both sides with mild compression in the mammographic geometry. With its unique soft tissue contrast and excellent sensitivity to the tissue hemodynamic properties of fractional blood volume and blood oxygenation, PAVI, as a complement to 3D ultrasound and digital tomosynthesis mammography, might well contribute to detection, diagnosis and prognosis for breast cancer.

  6. Automated assessment of bilateral breast volume asymmetry as a breast cancer biomarker during mammographic screening

    NASA Astrophysics Data System (ADS)

    Williams, Alex C.; Hitt, Austin; Voisin, Sophie; Tourassi, Georgia

    2013-03-01

    The biological concept of bilateral symmetry as a marker of developmental stability and good health is well established. Although most individuals deviate slightly from perfect symmetry, humans are essentially considered bilaterally symmetrical. Consequently, increased fluctuating asymmetry of paired structures could be an indicator of disease. There are several published studies linking bilateral breast size asymmetry with increased breast cancer risk. These studies were based on radiologists' manual measurements of breast size from mammographic images. We aim to develop a computerized technique to assess fluctuating breast volume asymmetry in screening mammograms and investigate whether it correlates with the presence of breast cancer. Using a large database of screening mammograms with known ground truth we applied automated breast region segmentation and automated breast size measurements in CC and MLO views using three well established methods. All three methods confirmed that indeed patients with breast cancer have statistically significantly higher fluctuating asymmetry of their breast volumes. However, statistically significant difference between patients with cancer and benign lesions was observed only for the MLO views. The study suggests that automated assessment of global bilateral asymmetry could serve as a breast cancer risk biomarker for women undergoing mammographic screening. Such biomarker could be used to alert radiologists or computer-assisted detection (CAD) systems to exercise increased vigilance if higher than normal cancer risk is suspected.

  7. Identification of a novel percent mammographic density locus at 12q24.

    PubMed

    Stevens, Kristen N; Lindstrom, Sara; Scott, Christopher G; Thompson, Deborah; Sellers, Thomas A; Wang, Xianshu; Wang, Alice; Atkinson, Elizabeth; Rider, David N; Eckel-Passow, Jeanette E; Varghese, Jajini S; Audley, Tina; Brown, Judith; Leyland, Jean; Luben, Robert N; Warren, Ruth M L; Loos, Ruth J F; Wareham, Nicholas J; Li, Jingmei; Hall, Per; Liu, Jianjun; Eriksson, Louise; Czene, Kamila; Olson, Janet E; Pankratz, V Shane; Fredericksen, Zachary; Diasio, Robert B; Lee, Adam M; Heit, John A; DeAndrade, Mariza; Goode, Ellen L; Vierkant, Robert A; Cunningham, Julie M; Armasu, Sebastian M; Weinshilboum, Richard; Fridley, Brooke L; Batzler, Anthony; Ingle, James N; Boyd, Norman F; Paterson, Andrew D; Rommens, Johanna; Martin, Lisa J; Hopper, John L; Southey, Melissa C; Stone, Jennifer; Apicella, Carmel; Kraft, Peter; Hankinson, Susan E; Hazra, Aditi; Hunter, David J; Easton, Douglas F; Couch, Fergus J; Tamimi, Rulla M; Vachon, Celine M

    2012-07-15

    Percent mammographic density adjusted for age and body mass index (BMI) is one of the strongest risk factors for breast cancer and has a heritable component that remains largely unidentified. We performed a three-stage genome-wide association study (GWAS) of percent mammographic density to identify novel genetic loci associated with this trait. In stage 1, we combined three GWASs of percent density comprised of 1241 women from studies at the Mayo Clinic and identified the top 48 loci (99 single nucleotide polymorphisms). We attempted replication of these loci in 7018 women from seven additional studies (stage 2). The meta-analysis of stage 1 and 2 data identified a novel locus, rs1265507 on 12q24, associated with percent density, adjusting for age and BMI (P = 4.43 × 10(-8)). We refined the 12q24 locus with 459 additional variants (stage 3) in a combined analysis of all three stages (n = 10 377) and confirmed that rs1265507 has the strongest association in the 12q24 region (P = 1.03 × 10(-8)). Rs1265507 is located between the genes TBX5 and TBX3, which are members of the phylogenetically conserved T-box gene family and encode transcription factors involved in developmental regulation. Understanding the mechanism underlying this association will provide insight into the genetics of breast tissue composition.

  8. Bismuth Sulfide Nanoflowers for Detection of X-rays in the Mammographic Energy Range

    PubMed Central

    Nambiar, Shruti; Osei, Ernest K.; Yeow, John T. W.

    2015-01-01

    The increased use of diagnostic x-rays, especially in the field of medical radiology, has necessitated a significant demand for high resolution, real-time radiation detectors. In this regard, the photoresponse of bismuth sulfide (Bi2S3), an n-type semiconducting metal chalcogenide, to low energy x-rays has been investigated in this study. In recent years, several types of nanomaterials of Bi2S3 have been widely studied for optoelectronic and thermoelectric applications. However, photoresponse of Bi2S3 nanomaterials for dosimetric applications has not yet been reported. The photosensitivity of Bi2S3 with nanoscale “flower-like” structures was characterized under x-ray tube-potentials typically used in mammographic procedures. Both dark current and photocurrent were measured under varying x-ray doses, field sizes, and bias voltages for each of the tube potentials – 20, 23, 26 and 30 kV. Results show that the Bi2S3 nanoflowers instantaneously responded to even minor changes in the dose delivered. The photoresponse was found to be relatively high (few nA) at bias voltage as low as +1 V, and fairly repeatable for both short and long exposures to mammographic x-rays with minimal or no loss in sensitivity. The overall dose-sensitivity of the Bi2S3 nanoflowers was found to be similar to that of a micro-ionization chamber. PMID:25801531

  9. Quitting drugs: quantitative and qualitative features.

    PubMed

    Heyman, Gene M

    2013-01-01

    According to the idea that addiction is a chronic relapsing disease, remission is at most a temporary state. Either addicts never stop using drugs, or if they do stop, remission is short lived. However, research on remission reveals a more complex picture. In national epidemiological surveys that recruited representative drug users, remission rates varied widely and were markedly different for legal and illegal drugs and for different racial/ethnic groups. For instance, the half-life for cocaine dependence was four years, but for alcohol dependence it was 16 years, and although most dependent cocaine users remitted before age 30, about 5% remained heavy cocaine users well into their forties. Although varied, the remission results were orderly. An exponential growth curve closely approximated the cumulative frequency of remitting for different drugs and different ethnic/racial groups. Thus, each year a constant proportion of those still addicted remitted, independent of the number of years since the onset of dependence.

  10. Automatic detection of regions of interest in mammographic images

    NASA Astrophysics Data System (ADS)

    Cheng, Erkang; Ling, Haibin; Bakic, Predrag R.; Maidment, Andrew D. A.; Megalooikonomou, Vasileios

    2011-03-01

    This work is a part of our ongoing study aimed at comparing the topology of anatomical branching structures with the underlying image texture. Detection of regions of interest (ROIs) in clinical breast images serves as the first step in development of an automated system for image analysis and breast cancer diagnosis. In this paper, we have investigated machine learning approaches for the task of identifying ROIs with visible breast ductal trees in a given galactographic image. Specifically, we have developed boosting based framework using the AdaBoost algorithm in combination with Haar wavelet features for the ROI detection. Twenty-eight clinical galactograms with expert annotated ROIs were used for training. Positive samples were generated by resampling near the annotated ROIs, and negative samples were generated randomly by image decomposition. Each detected ROI candidate was given a confidences core. Candidate ROIs with spatial overlap were merged and their confidence scores combined. We have compared three strategies for elimination of false positives. The strategies differed in their approach to combining confidence scores by summation, averaging, or selecting the maximum score.. The strategies were compared based upon the spatial overlap with annotated ROIs. Using a 4-fold cross-validation with the annotated clinical galactographic images, the summation strategy showed the best performance with 75% detection rate. When combining the top two candidates, the selection of maximum score showed the best performance with 96% detection rate.

  11. Changes in mammographic density over time in breast cancer cases and women at high risk for breast cancer.

    PubMed

    Work, Meghan E; Reimers, Laura L; Quante, Anne S; Crew, Katherine D; Whiffen, Amy; Terry, Mary Beth

    2014-10-01

    High mammographic breast density is one of the strongest intermediate markers of breast cancer risk, and decreases in density over time have been associated with decreases in breast cancer risk. Using repeated measures of mammographic density in a cohort of high-risk women, the Women at Risk (WAR) cohort at Columbia University Medical Center (N = 2670), we examined whether changes in prediagnostic mammographic density differed among 85 prospectively-ascertained breast cancer cases and 85 age-matched controls, using a nested case-control design. Median age at first mammogram was 51 years (range, 29-77 years), with a median of 4 years between first and second prediagnostic mammogram (range, 1-15 years). Using linear regression with change in percent density as the outcome, we found that in women who did not go on to be diagnosed with breast cancer, change in percent density decreased as time between first and second mammogram increased (β = -1.62% per year, p = 0.004). However, in women who did go on to be diagnosed with breast cancer, there was no overall change in percent density associated with time between first and second mammogram (β = 0.29% per year, p = 0.61); the change over time was statistically significantly different between cases versus controls (p <0.009). If replicated in larger cohorts, these results suggest that within-individual changes in mammographic density as measured by percent density may be a useful biomarker of breast cancer risk. © 2014 UICC.

  12. Tumor characteristics and family history in relation to mammographic density and breast cancer: The French E3N cohort.

    PubMed

    Maskarinec, Gertraud; Dartois, Laureen; Delaloge, Suzette; Hopper, John; Clavel-Chapelon, Françoise; Baglietto, Laura

    2017-08-01

    Mammographic density is a known heritable risk factor for breast cancer, but reports how tumor characteristics and family history may modify this association are inconsistent. Dense and total breast areas were assessed using Cumulus™ from pre-diagnostic mammograms for 820 invasive breast cancer cases and 820 matched controls nested within the French E3N cohort study. To allow comparisons across models, percent mammographic density (PMD) was standardized to the distribution of the controls. Odds ratios (OR) and 95% confidence intervals (CI) of breast cancer risk for mammographic density were estimated by conditional logistic regression while adjusting for age and body mass index. Heterogeneity according to tumor characteristic and family history was assessed using stratified analyses. Overall, the OR per 1 SD for PMD was 1.50 (95% CI, 1.33-1.69). No evidence for significant heterogeneity by tumor size, lymph node status, grade, and hormone receptor status (estrogen, progesterone, and HER2) was detected. However, the association of PMD was stronger for women reporting a family history of breast cancer (OR1SD=2.25; 95% CI, 1.67-3.04) than in women reporting none (OR1SD=1.41; 95% CI, 1.24-1.60; pheterogeneity=0.002). Similarly, effect modification by FHBC was observed using categories of PMD (pheterogeneity=0.02) with respective ORs of 15.16 (95% CI, 4.23-54.28) vs. 3.14 (95% CI, 1.89-5.22) for ≥50% vs. <10% PMD. The stronger association between mammographic density and breast cancer risk with a family history supports the hypothesis of shared genetic factors responsible for familial aggregation of breast cancer and the heritable component of mammographic density. Copyright © 2017 Elsevier Ltd. All rights reserved.

  13. Explaining variance in the cumulus mammographic measures that predict breast cancer risk: a twins and sisters study.

    PubMed

    Nguyen, Tuong L; Schmidt, Daniel F; Makalic, Enes; Dite, Gillian S; Stone, Jennifer; Apicella, Carmel; Bui, Minh; Macinnis, Robert J; Odefrey, Fabrice; Cawson, Jennifer N; Treloar, Susan A; Southey, Melissa C; Giles, Graham G; Hopper, John L

    2013-12-01

    Mammographic density, the area of the mammographic image that appears white or bright, predicts breast cancer risk. We estimated the proportions of variance explained by questionnaire-measured breast cancer risk factors and by unmeasured residual familial factors. For 544 MZ and 339 DZ twin pairs and 1,558 non-twin sisters from 1,564 families, mammographic density was measured using the computer-assisted method Cumulus. We estimated associations using multilevel mixed-effects linear regression and studied familial aspects using a multivariate normal model. The proportions of variance explained by age, body mass index (BMI), and other risk factors, respectively, were 4%, 1%, and 4% for dense area; 7%, 14%, and 4% for percent dense area; and 7%, 40%, and 1% for nondense area. Associations with dense area and percent dense area were in opposite directions than for nondense area. After adjusting for measured factors, the correlations of dense area with percent dense area and nondense area were 0.84 and -0.46, respectively. The MZ, DZ, and sister pair correlations were 0.59, 0.28, and 0.29 for dense area; 0.57, 0.30, and 0.28 for percent dense area; and 0.56, 0.27, and 0.28 for nondense area (SE = 0.02, 0.04, and 0.03, respectively). Under the classic twin model, 50% to 60% (SE = 5%) of the variance of mammographic density measures that predict breast cancer risk are due to undiscovered genetic factors, and the remainder to as yet unknown individual-specific, nongenetic factors. Much remains to be learnt about the genetic and environmental determinants of mammographic density. ©2013 AACR.

  14. Clinical Utility of Breast MRI in the Diagnosis of Malignancy After Inconclusive or Equivocal Mammographic Diagnostic Evaluation.

    PubMed

    Giess, Catherine S; Chikarmane, Sona A; Sippo, Dorothy A; Birdwell, Robyn L

    2017-06-01

    The purpose of this study was to determine the clinical utility of breast MRI for diagnosing malignancy in women with equivocal mammographic findings but no symptoms. Retrospective review of an institutional MRI database of 7332 contrast-enhanced breast MRI examinations from January 1, 2009, through December 31, 2012, yielded the records of 296 (4.0%) examinations of 294 women without symptoms who underwent MRI for mammographic findings uncertain at diagnostic evaluation. Imaging findings, histopathologic results, and patient demographics were obtained from the electronic medical record. The mean patient age was 55 years (range, 29-83 years). Mammographic lesion type (n = 294) included 89 focal asymmetries, 76 asymmetries, 64 masses, 44 architectural distortions, 17 surgical scar versus lesion, and four miscellaneous lesions. Diagnostic ultrasound, performed on 286 of 294 (97.3%) lesions at mammographic evaluation, showed an ultrasound correlate in 37 (12.9%) lesions, equivocal correlate in 48 (16.8%), and no ultrasound correlate in 201 (70.3%). MRI examination of 294 index lesions showed a correlate in 133 (45.2%) and no correlate in 161 (54.8%). Forty of 294 (13.6%) index lesions were malignant, 37 (92.5%) with an MRI correlate and three (7.5%) without an MRI correlate. Among 250 patients who underwent biopsy or had 2 or more years of imaging stability, the sensitivity, specificity, negative predictive value, and positive predictive value of breast MRI for malignancy were 92.5%, 62.4%, 97.8%, and 31.9%. Forty-four of 294 (15.0%) patients had lesions incidentally found at MRI; 7 of 41 (17.1%) lesions that were biopsied or were stable for at least 1 year were malignant. Problem-solving breast MRI for inconclusive mammographic findings helps identify malignancies with high sensitivity and a high negative predictive value.

  15. Performance analysis of morphological component analysis (MCA) method for mammograms using some statistical features

    NASA Astrophysics Data System (ADS)

    Gardezi, Syed Jamal Safdar; Faye, Ibrahima; Kamel, Nidal; Eltoukhy, Mohamed Meselhy; Hussain, Muhammad

    2014-10-01

    Early detection of breast cancer helps reducing the mortality rates. Mammography is very useful tool in breast cancer detection. But it is very difficult to separate different morphological features in mammographic images. In this study, Morphological Component Analysis (MCA) method is used to extract different morphological aspects of mammographic images by effectively preserving the morphological characteristics of regions. MCA decomposes the mammogram into piecewise smooth part and the texture part using the Local Discrete Cosine Transform (LDCT) and Curvelet Transform via wrapping (CURVwrap). In this study, simple comparison in performance has been done using some statistical features for the original image versus the piecewise smooth part obtained from the MCA decomposition. The results show that MCA suppresses the structural noises and blood vessels from the mammogram and enhances the performance for mass detection.

  16. Qualitative Evaluation.

    ERIC Educational Resources Information Center

    Stone, James C., Ed.; James, Raymond A., Ed.

    1981-01-01

    "Qualitative evaluation" is the theme of this issue of the California Journal of Teacher Education. Ralph Tyler states that evaluation is essentially descriptive, and using numbers does not solve basic problems. Martha Elin Vernazza examines the issue of objectivity in history and its implications for evaluation. She posits that the…

  17. Qualitative Research

    ERIC Educational Resources Information Center

    Roberson, Donald N., Jr.

    2005-01-01

    The purpose of this paper is to describe how a researcher may conduct a basic qualitative research. This paper deals specifically with research of learning, older adults, and in a rural area. This paper became the foundation for the research of my dissertation. I discuss the sample and the criteria for the sample. I also describe the sources of…

  18. A genome-wide linkage study of mammographic density, a risk factor for breast cancer

    PubMed Central

    2011-01-01

    Introduction Mammographic breast density is a highly heritable (h2 > 0.6) and strong risk factor for breast cancer. We conducted a genome-wide linkage study to identify loci influencing mammographic breast density (MD). Methods Epidemiological data were assembled on 1,415 families from the Australia, Northern California and Ontario sites of the Breast Cancer Family Registry, and additional families recruited in Australia and Ontario. Families consisted of sister pairs with age-matched mammograms and data on factors known to influence MD. Single nucleotide polymorphism (SNP) genotyping was performed on 3,952 individuals using the Illumina Infinium 6K linkage panel. Results Using a variance components method, genome-wide linkage analysis was performed using quantitative traits obtained by adjusting MD measurements for known covariates. Our primary trait was formed by fitting a linear model to the square root of the percentage of the breast area that was dense (PMD), adjusting for age at mammogram, number of live births, menopausal status, weight, height, weight squared, and menopausal hormone therapy. The maximum logarithm of odds (LOD) score from the genome-wide scan was on chromosome 7p14.1-p13 (LOD = 2.69; 63.5 cM) for covariate-adjusted PMD, with a 1-LOD interval spanning 8.6 cM. A similar signal was seen for the covariate adjusted area of the breast that was dense (DA) phenotype. Simulations showed that the complete sample had adequate power to detect LOD scores of 3 or 3.5 for a locus accounting for 20% of phenotypic variance. A modest peak initially seen on chromosome 7q32.3-q34 increased in strength when only the 513 families with at least two sisters below 50 years of age were included in the analysis (LOD 3.2; 140.7 cM, 1-LOD interval spanning 9.6 cM). In a subgroup analysis, we also found a LOD score of 3.3 for DA phenotype on chromosome 12.11.22-q13.11 (60.8 cM, 1-LOD interval spanning 9.3 cM), overlapping a region identified in a previous study

  19. Molecular Breast Imaging at Reduced Radiation Dose for Supplemental Screening in Mammographically Dense Breasts

    PubMed Central

    Rhodes, Deborah J.; Hruska, Carrie B.; Conners, Amy Lynn; Tortorelli, Cindy L.; Maxwell, Robert W.; Jones, Katie N.; Toledano, Alicia Y.; O’Connor, Michael K.

    2015-01-01

    OBJECTIVE The purpose of this study was to assess the diagnostic performance of supplemental screening molecular breast imaging (MBI) in women with mammographically dense breasts after system modifications to permit radiation dose reduction. SUBJECTS AND METHODS A total of 1651 asymptomatic women with mammographically dense breasts on prior mammography underwent screening mammography and adjunct MBI performed with 300-MBq 99mTc-sestamibi and a direct-conversion (cadmium zinc telluride) gamma camera, both interpreted independently. The cancer detection rate, sensitivity, specificity, and positive predictive value of biopsies performed (PPV3) were determined. RESULTS In 1585 participants with a complete reference standard, 21 were diagnosed with cancer: two detected by mammography only, 14 by MBI only, three by both modalities, and two by neither. Of 14 participants with cancers detected only by MBI, 11 had invasive disease (median size, 0.9 cm; range, 0.5–4.1 cm). Nine of 11 (82%) were node negative, and two had bilateral cancers. With the addition of MBI to mammography, the overall cancer detection rate (per 1000 screened) increased from 3.2 to 12.0 (p < 0.001) (supplemental yield 8.8). The invasive cancer detection rate increased from 1.9 to 8.8 (p < 0.001) (supplemental yield 6.9), a relative increase of 363%, while the change in DCIS detection was not statistically significant (from 1.3 to 3.2, p =0.250). For mammography alone, sensitivity was 24%; specificity, 89%; and PPV3, 25%. For the combination, sensitivity was 91% (p < 0.001); specificity, 83% (p < 0.001); and PPV3, 28% (p = 0.70). The recall rate increased from 11.0% with mammography alone to 17.6% (p < 0.001) for the combination; the biopsy rate increased from 1.3% for mammography alone to 4.2% (p < 0.001). CONCLUSION When added to screening mammography, MBI performed using a radiopharmaceutical activity acceptable for screening (effective dose 2.4 mSv) yielded a supplemental cancer detection rate of

  20. Case-control study of increased mammographic breast density response to hormone replacement therapy.

    PubMed

    Vachon, Celine M; Sellers, Thomas A; Vierkant, Robert A; Wu, Fang-Fang; Brandt, Kathleen R

    2002-11-01

    Previous studies have demonstrated an association between current hormone replacement therapy (HRT) use and increased mammographic breast density. Many of these studies have also shown that only 20-35% of women initiating HRT respond in this manner. This subgroup of HRT responders may be at an increased risk of breast cancer. We performed a case-control study to investigate how women who experience increased density in response to HRT (cases) differ from women who do not experience an increase in density with HRT use (controls) with regard to breast cancer risk factors, type of HRT, weight change, and baseline breast density. Participants were female residents of Olmsted County, Minnesota who received routine screening mammograms at the Mayo Clinic. Cases included 172 women identified between the years 1998 and 1999 by Mayo radiologists as having a HRT response. Controls were women who did not experience an increase in mammographic density with HRT use and were matched to cases on age (+/-3 years), menopausal status, duration of HRT, month of initiation of HRT, and months between baseline and follow-up mammograms. Mammograms were obtained from cases and controls before and during HRT therapy. Breast density was read as a four-category Bi-Rads density grade measure and as a quantitative percentage estimate, using a computer-assisted method. Risk factor information was obtained from both chart review and a mammography database of patient-provided information. There was no association between HRT response and first-degree family history of breast cancer [odds ratio (OR), 0.8; 95% confidence interval (CI), 0.4-1.5], parity (OR, 0.8; 95% CI, 0.4-1.7), later age at first birth (OR, 0.8 for age >25 years versus nulliparous women; 95% CI, 0.4-1.8), or history of biopsy (OR, 0.9; 95% CI, 0.6-1.5). There was also no association with baseline weight or change in weight between a woman's baseline and follow-up mammograms. However, there was evidence of an association between

  1. A genome-wide linkage study of mammographic density, a risk factor for breast cancer.

    PubMed

    Greenwood, Celia M T; Paterson, Andrew D; Linton, Linda; Andrulis, Irene L; Apicella, Carmel; Dimitromanolakis, Apostolos; Kriukov, Valentina; Martin, Lisa J; Salleh, Ayesha; Samiltchuk, Elena; Parekh, Rashmi V; Southey, Melissa C; John, Esther M; Hopper, John L; Boyd, Norman F; Rommens, Johanna M

    2011-01-01

    Mammographic breast density is a highly heritable (h2 > 0.6) and strong risk factor for breast cancer. We conducted a genome-wide linkage study to identify loci influencing mammographic breast density (MD). Epidemiological data were assembled on 1,415 families from the Australia, Northern California and Ontario sites of the Breast Cancer Family Registry, and additional families recruited in Australia and Ontario. Families consisted of sister pairs with age-matched mammograms and data on factors known to influence MD. Single nucleotide polymorphism (SNP) genotyping was performed on 3,952 individuals using the Illumina Infinium 6K linkage panel. Using a variance components method, genome-wide linkage analysis was performed using quantitative traits obtained by adjusting MD measurements for known covariates. Our primary trait was formed by fitting a linear model to the square root of the percentage of the breast area that was dense (PMD), adjusting for age at mammogram, number of live births, menopausal status, weight, height, weight squared, and menopausal hormone therapy. The maximum logarithm of odds (LOD) score from the genome-wide scan was on chromosome 7p14.1-p13 (LOD = 2.69; 63.5 cM) for covariate-adjusted PMD, with a 1-LOD interval spanning 8.6 cM. A similar signal was seen for the covariate adjusted area of the breast that was dense (DA) phenotype. Simulations showed that the complete sample had adequate power to detect LOD scores of 3 or 3.5 for a locus accounting for 20% of phenotypic variance. A modest peak initially seen on chromosome 7q32.3-q34 increased in strength when only the 513 families with at least two sisters below 50 years of age were included in the analysis (LOD 3.2; 140.7 cM, 1-LOD interval spanning 9.6 cM). In a subgroup analysis, we also found a LOD score of 3.3 for DA phenotype on chromosome 12.11.22-q13.11 (60.8 cM, 1-LOD interval spanning 9.3 cM), overlapping a region identified in a previous study. The suggestive peaks and the larger

  2. Journal club: molecular breast imaging at reduced radiation dose for supplemental screening in mammographically dense breasts.

    PubMed

    Rhodes, Deborah J; Hruska, Carrie B; Conners, Amy Lynn; Tortorelli, Cindy L; Maxwell, Robert W; Jones, Katie N; Toledano, Alicia Y; O'Connor, Michael K

    2015-02-01

    OBJECTIVE. The purpose of this study was to assess the diagnostic performance of supplemental screening molecular breast imaging (MBI) in women with mammographically dense breasts after system modifications to permit radiation dose reduction. SUBJECTS AND METHODS. A total of 1651 asymptomatic women with mammographically dense breasts on prior mammography underwent screening mammography and adjunct MBI performed with 300-MBq (99m)Tc-sestamibi and a direct-conversion (cadmium zinc telluride) gamma camera, both interpreted independently. The cancer detection rate, sensitivity, specificity, and positive predictive value of biopsies performed (PPV3) were determined. RESULTS. In 1585 participants with a complete reference standard, 21 were diagnosed with cancer: two detected by mammography only, 14 by MBI only, three by both modalities, and two by neither. Of 14 participants with cancers detected only by MBI, 11 had invasive disease (median size, 0.9 cm; range, 0.5-4.1 cm). Nine of 11 (82%) were node negative, and two had bilateral cancers. With the addition of MBI to mammography, the overall cancer detection rate (per 1000 screened) increased from 3.2 to 12.0 (p < 0.001) (supplemental yield 8.8). The invasive cancer detection rate increased from 1.9 to 8.8 (p < 0.001) (supplemental yield 6.9), a relative increase of 363%, while the change in DCIS detection was not statistically significant (from 1.3 to 3.2, p =0.250). For mammography alone, sensitivity was 24%; specificity, 89%; and PPV3, 25%. For the combination, sensitivity was 91% (p < 0.001); specificity, 83% (p < 0.001); and PPV3, 28% (p = 0.70). The recall rate increased from 11.0% with mammography alone to 17.6% (p < 0.001) for the combination; the biopsy rate increased from 1.3% for mammography alone to 4.2% (p < 0.001). CONCLUSION. When added to screening mammography, MBI performed using a radiopharmaceutical activity acceptable for screening (effective dose 2.4 mSv) yielded a supplemental cancer detection rate

  3. Increased COX-2 expression in epithelial and stromal cells of high mammographic density tissues and in a xenograft model of mammographic density.

    PubMed

    Chew, G L; Huo, C W; Huang, D; Hill, P; Cawson, J; Frazer, H; Hopper, J L; Haviv, I; Henderson, M A; Britt, K; Thompson, E W

    2015-08-01

    Mammographic density (MD) adjusted for age and body mass index is one of the strongest known risk factors for breast cancer. Given the high attributable risk of MD for breast cancer, chemoprevention with a safe and available agent that reduces MD and breast cancer risk would be beneficial. Cox-2 has been implicated in MD-related breast cancer risk, and was increased in stromal cells in high MD tissues in one study. Our study assessed differential Cox-2 expression in epithelial and stromal cells in paired samples of high and low MD human breast tissue, and in a validated xenograft biochamber model of MD. We also examined the effects of endocrine treatment upon Cox-2 expression in high and low MD tissues in the MD xenograft model. Paired high and low MD human breast tissue samples were immunostained for Cox-2, then assessed for differential expression and staining intensity in epithelial and stromal cells. High and low MD human breast tissues were separately maintained in biochambers in mice treated with Tamoxifen, oestrogen or placebo implants, then assessed for percentage Cox-2 staining in epithelial and stromal cells. Percentage Cox-2 staining was greater for both epithelial (p = 0.01) and stromal cells (p < 0.0001) of high compared with low MD breast tissues. In high MD biochamber tissues, percentage Cox-2 staining was greater in stromal cells of oestrogen-treated versus placebo-treated tissues (p = 0.05).

  4. Correlative feature analysis on FFDM

    SciTech Connect

    Yuan Yading; Giger, Maryellen L.; Li Hui; Sennett, Charlene

    2008-12-15

    Identifying the corresponding images of a lesion in different views is an essential step in improving the diagnostic ability of both radiologists and computer-aided diagnosis (CAD) systems. Because of the nonrigidity of the breasts and the 2D projective property of mammograms, this task is not trivial. In this pilot study, we present a computerized framework that differentiates between corresponding images of the same lesion in different views and noncorresponding images, i.e., images of different lesions. A dual-stage segmentation method, which employs an initial radial gradient index (RGI) based segmentation and an active contour model, is applied to extract mass lesions from the surrounding parenchyma. Then various lesion features are automatically extracted from each of the two views of each lesion to quantify the characteristics of density, size, texture and the neighborhood of the lesion, as well as its distance to the nipple. A two-step scheme is employed to estimate the probability that the two lesion images from different mammographic views are of the same physical lesion. In the first step, a correspondence metric for each pairwise feature is estimated by a Bayesian artificial neural network (BANN). Then, these pairwise correspondence metrics are combined using another BANN to yield an overall probability of correspondence. Receiver operating characteristic (ROC) analysis was used to evaluate the performance of the individual features and the selected feature subset in the task of distinguishing corresponding pairs from noncorresponding pairs. Using a FFDM database with 123 corresponding image pairs and 82 noncorresponding pairs, the distance feature yielded an area under the ROC curve (AUC) of 0.81{+-}0.02 with leave-one-out (by physical lesion) evaluation, and the feature metric subset, which included distance, gradient texture, and ROI-based correlation, yielded an AUC of 0.87{+-}0.02. The improvement by using multiple feature metrics was statistically

  5. Common Breast Cancer Susceptibility Variants in LSP1 and RAD51L1 Are Associated with Mammographic Density Measures that Predict Breast Cancer Risk

    PubMed Central

    Vachon, Celine M.; Scott, Christopher G.; Fasching, Peter A.; Hall, Per; Tamimi, Rulla M.; Li, Jingmei; Stone, Jennifer; Apicella, Carmel; Odefrey, Fabrice; Gierach, Gretchen L.; Jud, Sebastian M.; Heusinger, Katharina; Beckmann, Matthias W.; Pollan, Marina; Fernández-Navarro, Pablo; González-Neira, Anna; Benítez, Javier; van Gils, Carla H.; Lokate, Mariëtte; Onland-Moret, N. Charlotte; Peeters, Petra H.M.; Brown, Judith; Leyland, Jean; Varghese, Jajini S.; Easton, Douglas F.; Thompson, Deborah J.; Luben, Robert N.; Warren, Ruth ML; Wareham, Nicholas J.; Loos, Ruth JF; Khaw, Kay-Tee; Ursin, Giske; Lee, Eunjung; Gayther, Simon A.; Ramus, Susan J.; Eeles, Rosalind A.; Leach, Martin O.; Kwan-Lim, Gek; Couch, Fergus J.; Giles, Graham G.; Baglietto, Laura; Krishnan, Kavitha; Southey, Melissa C.; Le Marchand, Loic; Kolonel, Laurence N.; Woolcott, Christy; Maskarinec, Gertraud; Haiman, Christopher A; Walker, Kate; Johnson, Nichola; McCormack, Valerie A.; Biong, Margarethe; Alnæs, Grethe I.G.; Gram, Inger Torhild; Kristensen, Vessela N.; Børresen-Dale, Anne-Lise; Lindström, Sara; Hankinson, Susan E.; Hunter, David J.; Andrulis, Irene L.; Knight, Julia A.; Boyd, Norman F.; Figueroa, Jonine D.; Lissowska, Jolanta; Wesolowska, Ewa; Peplonska, Beata; Bukowska, Agnieszka; Reszka, Edyta; Liu, JianJun; Eriksson, Louise; Czene, Kamila; Audley, Tina; Wu, Anna H.; Pankratz, V. Shane; Hopper, John L.; dos-Santos-Silva, Isabel

    2013-01-01

    Background Mammographic density adjusted for age and body mass index (BMI) is a heritable marker of breast cancer susceptibility. Little is known about the biological mechanisms underlying the association between mammographic density and breast cancer risk. We examined whether common low-penetrance breast cancer susceptibility variants contribute to inter-individual differences in mammographic density measures. Methods We established an international consortium (DENSNP) of 19 studies from 10 countries, comprising 16,895 Caucasian women, to conduct a pooled cross-sectional analysis of common breast cancer susceptibility variants in 14 independent loci and mammographic density measures. Dense and non-dense areas, and percent density, were measured using interactive-thresholding techniques. Mixed linear models were used to assess the association between genetic variants and the square roots of mammographic density measures adjusted for study, age, case status, body mass index (BMI) and menopausal status. Results Consistent with their breast cancer associations, the C-allele of rs3817198 in LSP1 was positively associated with both adjusted dense area (p=0.00005) and adjusted percent density (p=0.001) whereas the A-allele of rs10483813 in RAD51L1 was inversely associated with adjusted percent density (p=0.003), but not with adjusted dense area (p=0.07). Conclusion We identified two common breast cancer susceptibility variants associated with mammographic measures of radio-dense tissue in the breast gland. Impact We examined the association of 14 established breast cancer susceptibility loci with mammographic density phenotypes within a large genetic consortium and identified two breast cancer susceptibility variants, LSP1-rs3817198 and RAD51L1-rs10483813, associated with mammographic measures and in the same direction as the breast cancer association. PMID:22454379

  6. Mammographic density, parity and age at first birth, and risk of breast cancer: an analysis of four case-control studies.

    PubMed

    Woolcott, Christy G; Koga, Karin; Conroy, Shannon M; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Vachon, Celine M; Yaffe, Martin J; Pagano, Ian; Maskarinec, Gertraud

    2012-04-01

    Mammographic density is strongly and consistently associated with breast cancer risk. To determine if this association was modified by reproductive factors (parity and age at first birth), data were combined from four case-control studies conducted in the United States and Japan. To overcome the issue of variation in mammographic density assessment among the studies, a single observer re-read all the mammograms using one type of interactive thresholding software. Logistic regression was used to estimate odds ratios (OR) while adjusting for other known breast cancer risk factors. Included were 1,699 breast cancer cases and 2,422 controls, 74% of whom were postmenopausal. A positive association between mammographic density and breast cancer risk was evident in every group defined by parity and age at first birth (OR per doubling of percent mammographic density ranged between 1.20 and 1.39). Nonetheless, the association appeared to be stronger among nulliparous than parous women (OR per doubling of percent mammographic density = 1.39 vs. 1.24; P interaction = 0.054). However, when examined by study location, the effect modification by parity was apparent only in women from Hawaii and when examined by menopausal status, it was apparent in postmenopausal, but not premenopausal, women. Effect modification by parity was not significant in subgroups defined by body mass index or ethnicity. Adjusting for mammographic density did not attenuate the OR for the association between parity and breast cancer risk by more than 16.4%, suggesting that mammographic density explains only a small proportion of the reduction in breast cancer risk associated with parity. In conclusion, this study did not support the hypothesis that parity modifies the breast cancer risk attributed to mammographic density. Even though an effect modification was found in Hawaiian women, no such thing was found in women from the other three locations.

  7. Mammographic Imaging Studies Using the Monte Carlo Image Simulation-Differential Sampling (MCMIS-DS) Code

    SciTech Connect

    Kuruvilla Verghese

    2002-04-05

    This report summarizes the highlights of the research performed under the 1-year NEER grant from the Department of Energy. The primary goal of this study was to investigate the effects of certain design changes in the Fisher Senoscan mammography system and in the degree of breast compression on the discernability of microcalcifications in calcification clusters often observed in mammograms with tumor lesions. The most important design change that one can contemplate in a digital mammography system to improve resolution of calcifications is the reduction of pixel dimensions of the digital detector. Breast compression is painful to the patient and is though to be a deterrent to women to get routine mammographic screening. Calcification clusters often serve as markers (indicators ) of breast cancer.

  8. Mammographic screening debate on study design: a need to move the field forward.

    PubMed

    Ursin, Giske

    2012-12-12

    The mammographic screening debate has been running for decades. The temperature of this debate is unusually high, and all participants, regardless of viewpoint, seem to have a conflict of interest. Another unusual aspect of this debate is the focus on study design, and in particular on designs that some think exceeded their usefulness decades ago. What are the questions that remain to be answered in this debate? Are there methodological issues that have not been adequately addressed? Do we have the right tools to provide up-to-date answers to how women can best protect themselves against dying from breast cancer? This commentary discusses some of the current issues.See related Opinion articles http://www.biomedcentral.com/1741-7015/10/106 and http://www.biomedcentral.com/1741-7015/10/163.

  9. Use of magnetic resonance imaging for detecting clinically and mammographically occult ductal carcinoma in situ.

    PubMed

    Lo, G; Cheung, Polly S Y

    2008-06-01

    We report on two cases where breast magnetic resonance imaging examination changed clinical management. Breast magnetic resonance imaging is now recognised as an indispensable adjunctive examination to mammography and ultrasound. In each of the two cases described, breast magnetic resonance imaging revealed unsuspected, extensive, and mammographically and ultrasonologically occult, ductal carcinoma in situ. In each of these cases, planned breast conserving surgery was changed to mastectomy. The success of breast conservation treatment depends on removal of all tumour with clear margins at the time of surgery. Magnetic resonance imaging is now considered the most sensitive method for evaluating the extent of breast cancer. Breast magnetic resonance imaging has a very high sensitivity for invasive carcinoma (near 100%), and recent studies show its specificity in high-risk patients is between 93 and 99%. Magnetic resonance imaging may well be proven an important adjunctive examination in patients who have dense breasts or extensive fibrocystic change.

  10. The Shrinking Breast: An Unusual Mammographic Finding of Invasive Lobular Carcinoma.

    PubMed

    Jafri, Nazia F; Slanetz, Priscilla J

    2007-01-01

    We report two cases of invasive lobular carcinoma of the breast that were initially missed on first mammographic interpretation because of an uncommon, easily overlooked, and unreported imaging presentation. The abnormality in the cases manifested as an apparent decrease in breast glandular tissue volume when compared with the patients' previous mammograms, observed as "shrinking" of the breast on mammography. Invasive lobular carcinoma is considered one of the most difficult subtypes of breast cancer to identify on mammography because the changes that occur are often nonspecific and subtle. Microcalcifications that are usually associated with breast masses on imaging are rarely seen in this subtype of breast cancer. Although magnetic resonance imaging and computer-aided detection have somewhat improved the detection of invasive lobular carcinoma, radiologic and clinical detection remains a challenge.

  11. Using Qualitative Metasummary to Synthesize Qualitative and Quantitative Descriptive Findings

    PubMed Central

    Sandelowski, Margarete; Barroso, Julie; Voils, Corrine I.

    2008-01-01

    The new imperative in the health disciplines to be more methodologically inclusive has generated a growing interest in mixed research synthesis, or the integration of qualitative and quantitative research findings. Qualitative metasummary is a quantitatively oriented aggregation of qualitative findings originally developed to accommodate the distinctive features of qualitative surveys. Yet these findings are similar in form and mode of production to the descriptive findings researchers often present in addition to the results of bivariate and multivariable analyses. Qualitative metasummary, which includes the extraction, grouping, and formatting of findings, and the calculation of frequency and intensity effect sizes, can be used to produce mixed research syntheses and to conduct a posteriori analyses of the relationship between reports and findings. PMID:17243111

  12. Assessment of change in breast density: reader performance using synthetic mammographic images

    NASA Astrophysics Data System (ADS)

    Astley, Sue; Swayamprakasam, Chitra; Berks, Michael; Sergeant, Jamie; Morris, Julie; Wilson, Mary; Barr, Nicky; Boggis, Caroline

    2012-02-01

    A recent study has shown that breast cancer risk can be reduced by taking Tamoxifen, but only if this results in at least a 10% point reduction in mammographic density. When mammographic density is quantified visually, it is impossible to assess reader accuracy using clinical images as the ground truth is unknown. Our aim was to compare three models of assessing density change and to determine reader accuracy in identifying reductions of 10% points or more. We created 100 synthetic, mammogram-like images comprising 50 pairs designed to simulate natural reduction in density within each pair. Model I: individual images were presented to readers and density assessed. Model II: pairs of images were displayed together, with readers assessing density for each image. Model III: pairs of images were displayed together, and readers asked whether there was at least a 10% point reduction in density. Ten expert readers participated. Readers' estimates of percentage density were significantly closer to the truth (6.8%-26.4%) when images were assessed individually rather than in pairs (9.6%-29.8%). Measurement of change was significantly more accurate in Model II than Model I (p<0.005). Detecting density changes of at least 10% points in image pairs, mean accuracy was significantly (p<0.005) lower (58%-88%) when change was calculated from density assessments than in Model III (74%-92%). Our results suggest that where readers need to identify change in density, images should be displayed alongside one another. In our study, less accurate assessors performed better when asked directly about the magnitude of the change.

  13. Direct measurement of clinical mammographic x-ray spectra using a CdTe spectrometer.

    PubMed

    Santos, Josilene C; Tomal, Alessandra; Furquim, Tânia A; Fausto, Agnes M F; Nogueira, Maria S; Costa, Paulo R

    2017-07-01

    To introduce and evaluate a method developed for the direct measurement of mammographic x-ray spectra using a CdTe spectrometer. The assembly of a positioning system and the design of a simple and customized alignment device for this application is described. A positioning system was developed to easily and accurately locate the CdTe detector in the x-ray beam. Additionally, an alignment device to line up the detector with the central axis of the radiation beam was designed. Direct x-ray spectra measurements were performed in two different clinical mammography units and the measured x-ray spectra were compared with computer-generated spectra. In addition, the spectrometer misalignment effect was evaluated by comparing the measured spectra when this device is aligned relatively to when it is misaligned. The positioning and alignment of the spectrometer have allowed the measurements of direct mammographic x-ray spectra in agreement with computer-generated spectra. The most accurate x-ray spectral shape, related with the minimal HVL value, and high photon fluence for measured spectra was found with the spectrometer aligned according to the proposed method. The HVL values derived from both simulated and measured x-ray spectra differ at most 1.3 and 4.5% for two mammography devices evaluated in this study. The experimental method developed in this work allows simple positioning and alignment of a spectrometer for x-ray spectra measurements given the geometrical constraints and maintenance of the original configurations of mammography machines. © 2017 American Association of Physicists in Medicine.

  14. An assessment of reference exposure in analogic and digital mammographic units

    NASA Astrophysics Data System (ADS)

    Tilly, J. G.; Miguel, C.; Schelin, H. R.; Porto, L. E.; Paschuk, S.; Denyak, V.; Kmiecik, C.

    2014-11-01

    In this study, the incident air kerma (Ki,a), half-value layer (HVL), output and voltage accuracy for 28 mammography services were evaluated. All mammographs had high frequency rectification, a focus-film distance greater than 60 cm, automatic exposure control, a Mo-Mo anode-filter combination, and compression system. Twenty-three evaluations were made of analogic imaging systems and 21 of digital imaging systems, two of which were full field digital mammography units. The Ki,a was measured in the beam radiation with a 6 cm3 ionization chamber, calibrated for a mammography range of energy. A standard American College of Radiology mammographic phantom simulated a skull caudal incidence. The average, minimum, and maximum Ki,a values were 10.13 mGy, 3.92 mGy, and 30.41 mGy, respectively. However, when the analogic and digital systems are analyzed separately in two subsets, the values were 8.13 mGy, 3.92 mGy, and 11.78 mGy for the analogic systems and 12.33 mGy, 5.21 mGy, and 30.41 mGy for the digital systems, respectively. The results show that the Ki,a values found in digital systems were higher than those in analogic systems, highlighting the differences between these acquisition systems. All HVL values, measured in the primary beam at 28 kV were found between 0.33 mm Al and 0.43 mm Al. Although the manufacture time of the equipment was approximately 146 months (~12 years) prior, the variation in output was between 0.071 mGy/mAs and 0.164 mGy/mAs for the entire sample.

  15. RELATIONSHIP OF MAMMOGRAPHIC DENSITY AND GENE EXPRESSION: ANALYSIS OF NORMAL BREAST TISSUE SURROUNDING BREAST CANCER

    PubMed Central

    Sandhu, Rupninder; Williams, Tyisha; Midkiff, Bentley R.; Lissowska, Jolanta; Wesolowska, Ewa; Boyd, Norman F.; Johnson, Nicole B.; Figueroa, Jonine D.; Sherman, Mark E.; Troester, Melissa A.

    2014-01-01

    Purpose Previous studies of breast tissue gene expression have demonstrated that the extratumoral microenvironment has substantial variability across individuals, some of which can be attributed to epidemiologic factors. To evaluate how mammographic density (MD) and breast tissue composition relate to extratumoral microenvironment gene expression, we used data on 121 breast cancer patients from the population-based Polish Women's Breast Cancer Study. Design Breast cancer cases were classified based on a previously reported, biologically-defined extratumoral gene expression signature with two subtypes: an Active subtype, which is associated with high expression of genes related to fibrosis and wound response, and an Inactive subtype, which has high expression of cellular adhesion genes. MD of the contralateral breast was assessed using pre-treatment mammograms and a quantitative, reliable computer-assisted thresholding method. Breast tissue composition was evaluated based on digital image analysis of tissue sections. Results The Inactive extratumoral subtype was associated with significantly higher percentage mammographic density (PD) and dense area (DA) in univariate analysis (PD: p=0.001; DA: p=0.049) and in multivariable analyses adjusted for age and body mass index (PD: p=0.004; DA: p=0.049). Inactive/higher MD tissue was characterized by a significantly higher percentage of stroma and a significantly lower percentage of adipose tissue, with no significant change in epithelial content. Analysis of published gene expression signatures suggested that Inactive/higher MD tissue expressed increased estrogen response and decreased TGF-β signaling. Conclusions By linking novel molecular phenotypes with MD, our results indicate that MD reflects broad transcriptional changes, including changes in both epithelia- and stroma-derived signaling. PMID:23918601

  16. Childhood body size and pubertal timing in relation to adult mammographic density phenotype.

    PubMed

    Schoemaker, Minouk J; Jones, Michael E; Allen, Steven; Hoare, Jean; Ashworth, Alan; Dowsett, Mitch; Swerdlow, Anthony J

    2017-02-07

    An earlier age at onset of breast development and longer time between pubertal stages has been implicated in breast cancer risk. It is not clear whether associations of breast cancer risk with puberty or predictors of onset of puberty, such as weight and height, are mediated via mammographic density, an important risk factor for breast cancer. We investigated whether childhood body size and pubertal timing and tempo, collected by questionnaire, are associated with percentage and absolute area mammographic density at ages 47-73 years in 1105 women recruited to a prospective study. After controlling for adult adiposity, weight at ages 7 and 11 years was strongly significantly inversely associated with percentage and absolute dense area (p trend <0.001), and positively associated with absolute non-dense area. Greater height at age 7, but not age 11, was associated with lower percentage density (p trend = 0.016). Later age at menarche and age at when regular periods were established was associated with increased density, but additional adjustment for childhood weight attenuated the association. A longer interval between thelarche and menarche, and between thelarche and regular periods, was associated with increased dense area, even after adjusting for childhood weight (p trend = 0.013 and 0.028, respectively), and was independent of age at pubertal onset. Greater prepubertal weight and earlier pubertal onset are associated with lower adult breast density, but age at pubertal onset does not appear to have an independent effect on adult density after controlling for childhood adiposity. A possible effect of pubertal tempo on density needs further investigation.

  17. Variation in mammographic appearance between projections of small breast cancers compared with radial scars.

    PubMed

    Cawson, Jennifer N; Nickson, Carolyn; Evans, Jill; Kavanagh, Anne M

    2010-10-01

    The study aims to assess variation in appearance between mammographic projections (conspicuity variation) for invasive breast cancers (IBCs) compared with radial scars (RS). Conspicuity variation has been previously described as characteristic of RS. The lesions were also compared with respect to breast density and the proportion of cases detected by one of two readers and required a third (consensus) read. The study was approved by the BreastScreen Victoria research committee. Mammograms of 75 randomly selected invasive breast cancers, with histological diameter ≤10 mm (IBC), were mixed with 67 consecutively detected RS, all from a double-reading population-based breast cancer screening programme. On blinded review, these 142 lesions were classified for mammographic findings and assessed for marked or minor conspicuity variation between views. We assessed the associations between lesion type, lesion spicules and centres, breast density, conspicuity variation and proportion detected by one reader only. Marked conspicuity variation was common, but not statistically different for IBC and RS (64% vs. 66%, χ(2) = 0.8, P = 0.04). Conspicuity variation did not correlate with spiculation type (long, fine or short, broad based) or lesion centres (lucent or dense) (ρ < 0.05, P = 0.5), and showed no significant change with increasing Breast Imaging Reporting and Data System breast density (IBC, χ(2) = 2.3, P = 0.5; RS, χ(2) = 0.95, P = 0.6). Density did not vary by lesion type. In the screening programme, 29% of IBC (125 of 431) versus 43% of RS (32 of 75) had been detected by one of two readers (χ(2) = 2.7, P = 0.098). Two-thirds of small IBCs displayed marked conspicuity variation, similar to RS. Therefore, conspicuity variation does not discriminate between IBC and RS. © 2010 The Authors. Journal of Medical Imaging and Radiation Oncology © 2010 The Royal Australian and New Zealand College of Radiologists.

  18. Identification of two novel mammographic density loci at 6Q25.1.

    PubMed

    Brand, Judith S; Li, Jingmei; Humphreys, Keith; Karlsson, Robert; Eriksson, Mikael; Ivansson, Emma; Hall, Per; Czene, Kamila

    2015-06-03

    Mammographic density (MD) is a strong heritable and intermediate phenotype for breast cancer, but much of its genetic variation remains unexplained. We performed a large-scale genetic association study including 8,419 women of European ancestry to identify MD loci. Participants of three Swedish studies were genotyped on a custom Illumina iSelect genotyping array and percent and absolute mammographic density were ascertained using semiautomated and fully automated methods from film and digital mammograms. Linear regression analysis was used to test for SNP-MD associations, adjusting for age, body mass index, menopausal status and six principal components. Meta-analyses were performed by combining P values taking sample size, study-specific inflation factor and direction of effect into account. Genome-wide significant associations were observed for two previously identified loci: ZNF365 (rs10995194, P = 2.3 × 10(-8) for percent MD and P = 8.7 × 10(-9) for absolute MD) and AREG (rs10034692, P = 6.7 × 10(-9) for absolute MD). In addition, we found evidence of association for two variants at 6q25.1, both of which are known breast cancer susceptibility loci: rs9485370 in the TAB2 gene (P = 4.8 × 10(-9) for percent MD and P = 2.5 × 10(-8) for absolute MD) and rs60705924 in the CCDC170/ESR1 region (P = 2.2 × 10(-8) for absolute MD). Both regions have been implicated in estrogen receptor signaling with TAB2 being a potential regulator of tamoxifen response. We identified two novel MD loci at 6q25.1. These findings underscore the importance of 6q25.1 as a susceptibility region and provide more insight into the mechanisms through which MD influences breast cancer risk.

  19. Glycemic index, glycemic load and mammographic breast density: the EPIC Florence longitudinal study.

    PubMed

    Masala, Giovanna; Assedi, Melania; Bendinelli, Benedetta; Ermini, Ilaria; Occhini, Daniela; Sieri, Sabina; Brighenti, Furio; Del Turco, Marco Rosselli; Ambrogetti, Daniela; Palli, Domenico

    2013-01-01

    A few studies have evaluated the association between diet and mammographic breast density (MBD) and results are inconsistent. MBD, a well-recognized risk factor for breast cancer, has been proposed as a marker of cumulative exposure to hormones and growth factors. Diets with a high glycemic index (GI) or glycemic load (GL) may increase breast cancer risk, via an effect on the insulin-like growth factor axis. We have investigated the association between carbohydrate intake, GI, GL and MBD in a prospective study. We identified a large series of women, in the frame of the EPIC-Florence cohort, with a mammogram taken five years after enrolment, when detailed information on dietary and lifestyle habits and anthropometric measurements had been collected. Mammograms have been retrieved (1,668, 83%) and MBD assessed according to Wolfe's classification. We compared women with high MBD (P2+DY Wolfe's categories) with those with low MBD (N1+P1) through logistic models adjusted for age, education, body mass index, menopause, number of children, breast feeding, physical activity, non-alcohol energy, fibers, saturated fat and alcohol. A direct association between GL and high MBD emerged in the highest quintile of intake in comparison with the lowest quintile (OR = 1.73, 95%CI 1.13-2.67, p for trend = 0.048) while no association with glycemic index was evident. These results were confirmed after exclusion of women reporting to be on a diet or affected with diabetes, and when Hormone Replacement Therapy at the date of mammographic examination used to assess MBD was considered. The effect was particularly evident among leaner women, although no interaction was found. A positive association was suggested for increasing simple sugar and total carbohydrates intakes limited to the highest quintiles. In this Italian population we observed an association between glycemic load, total and rapidly absorbed carbohydrates and high MBD. These novel results warrant further investigations.

  20. Evaluation and correlation of mammographically suspicious lesions with histopathology at Addington Hospital, Durban.

    PubMed

    Cupido, B D; Vawda, F; Sabri, A; Sikwila, C T

    2013-03-04

    Stereotactic core-needle biopsies (SCNBs) are a reliable alternative to surgical biopsy for microcalcifications. The positive predictive value (PPV) of SCNB has been shown to be reproducible in several studies using the Breast Imaging Reporting and Data System (BIRADS) classification, which is the current gold standard in mammographic reporting. At this stage, no study has been done in KwaZulu-Natal to assess local outcomes against BIRADS. The current standard of care utilises vacuum-assisted breast biopsy, but is not available in a resource-constrained environment such as ours. The need, therefore, is for constant evaluation of existing practice to ensure that it is optimised for the challenges and limitations facing local radiologists. To assess the PPV of SCNB in Addington Hospital, and to compare it with that of BIRADS. Material and methods. Mammographically detected lesions were assigned to 3 categories: benign, indeterminate and suspicious. A retrospective review of 67 SCNBs was performed for lesions falling within the suspicious category, and the PPV and rates of ductal carcinoma in situ (DCIS) were determined. Our study demonstrated a PPV of 20.9%. This correlated well with international studies for BIRADS 4 and 5 lesions. DCIS accounted for 21.4% of detected malignancies, which is in keeping with current literature. Despite resource limitations, local outcomes were comparable to those of BIRADS. Given our fairly general categorisation of lesions, however, it should be emphasised that BIRADS allows better organisation, consistency and clarity in breast imaging reporting, as well as accurate data comparison between centres facing limitations similar to our own.

  1. Analysis of mammographic breast density in a group of screening chinese women and breast cancer patients.

    PubMed

    Liu, Jing; Liu, Pei-Fang; Li, Jun-Nan; Qing, Chun; Ji, Yu; Hao, Xi-Shan; Zhang, Xue-Ning

    2014-01-01

    A dense breast not only reduces the sensitivity of mammography but also is a moderate independent risk factor for breast cancer. The percentage of Western women with fat breast tissue is higher aged 40 years or older. To a certain extent, mammography as a first choice of screening imaging method for Western women of this group is reasonable. Hitherto, the frequency and age distribution of mammographic breast density patterns among Chinese women had not been characterized. The purpose of this study was to investigate the frequency and age distribution of mammographic breast density patterns among a group of Chinese screening women and breast cancer patients in order to provide useful information for age-specific guidelines for breast cancer screening in Chinese women. A retrospective review of a total of 3,394 screening women between August and December 2009 and 2,527 breast cancer patients between July 2011 and June 2012 was conducted. Descriptive analyses were used to examine the association between age and breast density. The significance of differences of breast density between the screening women and the breast cancer patients was examined using nonparametric tests. There was a significant inverse relationship between age and breast density overall (r=-0.37, p<0.01). Breast density of the breast cancer patients in the subgroups of 40-49 years old was greater compared with that of the screening women, the same in those aged 50-54 years and in those 55 years old or older, less than in the screening group. With regard to the Chinese women younger than 55 years old, the diagnostic efficiency of breast cancer screening imaging examinations may be potentially improved by combining screening mammography with ultrasound.

  2. Distribution of mammographic density and its influential factors among Chinese women

    PubMed Central

    Wang, Peishan; Liu, Peifang; Cao, Yali; Xiong, Li; Luo, Yahong; Pan, Tie; Ma, Xiangjun; Wang, Jie; Yang, Zhenhua; Liu, Xueou; Chen, Chuan; Huang, Yubei; Li, Yi; Wang, Yaogang; Hao, Xishan; Ye, Zhaoxiang; Chen, Kexin

    2014-01-01

    Background: Mammographic density (MD) has not been systematically investigated among Chinese women. Breast cancer screening programmes provided detailed information on MD in a large number of asymptomatic women. Methods: In the Multi-modality Independent Screening Trial (MIST), we estimated the association between MD and its influential factors using logistic regression, adjusting for age, body mass index (BMI) and study area. Differences between Chinese and other ethnic groups with respect to MD were also explored with adjustment for age and BMI. Results: A total of 28 388 women aged 45 to 65 years, who had been screened by mammography, were enrolled in the study. Of these, 49.2% were categorized as having dense breasts (BI-RADS density 3 and 4) and 50.8% as fatty breasts (BI-RADS density 1 and 2). Postmenopausal status [odds ratio (OR) = 0.66; 95% confidence interval (CI): 0.62–0.70] and higher number of live births (OR = 0.56; 95% CI: 0.46–0.68) were inversely associated with MD, whereas prior benign breast disease (OR = 1.48; 95% CI: 1.40–1.56) and later age at first birth (OR = 1.17; 95% CI: 1.08–1.27) were positively associated with MD. In comparison with the data from the Breast Cancer Surveillance Consortium, we found that women in MIST were more likely to have fatty breasts than Americans (from the Breast Cancer Surveillance Consortium) in the older age group (≥50 years) but more likely to have dense breasts in the younger age group (<50 years). Conclusions: This study suggests that several risk factors for breast cancer were associated with breast density in Chinese women. Information on the determinants of mammographic density may provide valuable insights into breast cancer aetiology. PMID:24639441

  3. Mammographic density measurement: a comparison of automated volumetric density measurement to BIRADS

    NASA Astrophysics Data System (ADS)

    McEntee, Mark F.; Damases, Christine N.

    2014-03-01

    The aim of this study is to compare mammographic breast density assessment with automated volumetric software with Breast Imaging Reporting and Data System (BIRADS) categorization by radiologists on two imaging systems. A data set of 120 mammograms was classified by twenty American Board of Radiology (ABR) Examiners. The mammograms were of 20 women (mean age, 60 years; range, 42-89 years). These women were image twice once with GE system and the following year with Hologic system. These images also had their volumetric density classified by using Volpara Density Grade (VDG). The radiologists were asked to estimate the mammographic density according to BIRADS categories (1- 4). There was a moderate agreement between VDG classification and radiologist BIRADS density shown with Cohen's Kappa (K=0.45; p<0.001). Radiologists estimated percentage density to be lower by an average of 0.37, the radiologist's BIRADS having a mean of 2.13 and the mean VDG higher at 2.50 (t = -11.99; p<0.001). VDG and radiologist's BIRADS showed a positive strong correlation (r=0.84; p<0.001). Radiologist BIRADS and VDG AvBD% also showed a strong positive correlation (r=0.86; p<0.001). There was a large spread of radiologist's BIRADS categories for each of the VDG AvBD% classifications. Using Volpara, the Hologic system showed a higher meanAvBD% (10.02 vs. 9.97). However using BIRADS the Hologic systems showed a lower mean (2.05 vs. 2.21). Automated systems demonstrated higher internal validity. The results demonstrated a moderate agreement and a strong correlation between VDG classification and radiologist BIRADS density assessment.

  4. The role of mammographic calcification in the neoadjuvant therapy of breast cancer imaging evaluation.

    PubMed

    Li, Jun-jie; Chen, Canming; Gu, Yajia; Di, Genhong; Wu, Jiong; Liu, Guangyu; Shao, ZhiMin

    2014-01-01

    Investigate the patterns of mammographically detected calcifications before and after neoadjuvant chemotherapy (NACT) to determine their value for efficacy evaluation and surgical decision making. 187 patients with malignant mammographic calcifications were followed to record the appearances and changes in the calcifications and to analyze their responses to NACT. Patients with calcifications had higher rates of hormonal receptor (HR) positive tumors (74.3% versus 64.6%) and HER2 positive tumors (51.3% versus 33.4%, p = 0.004) and a similar pathologic complete response (pCR) rate compared to patients without calcifications (35.4% versus 29.8%). After NACT, the range of calcification decreased in 40% of patients, increased in 7.5% and remained stable in 52.5%; the calcification density decreased in 15% of patients, increased in 7.5% and remained stable in 77.5%; none of these change patterns were related to tumor response rate. No significant correlation was observed between the calcification appearance (morphology, distribution, range, diameter or density) and tumor subtypes or pCR rates. Among patients with malignant calcifications, 54 showed calcifications alone, 40 occurred with an architectural distortion (AD) and 93 with a mass. Calcifications were observed inside the tumor in 44% of patients and outside in 56%, with similar pCR rates and patterns of change. Calcification appearance did not clearly change after NACT, and calcification patterns were not related to pCR rate, suggesting that mammogram may not accurate to evaluate tumor response changes. Microcalcifications visible after NACT is essential for determining the extent of excision, patients with calcifications that occurred outside of the mass still had the opportunity for breast conservation.

  5. Uncertainties of exposure-related quantities in mammographic x-ray unit quality control.

    PubMed

    Gregory, Kent J; Pattison, John E; Bibbo, Giovanni

    2006-03-01

    Breast screening programs operate in many countries with mammographic x-ray units subject to stringent quality control tests. These tests include the evaluation of quantities based on exposure measurements, such as half value layer, automatic exposure control reproducibility, average glandular dose, and radiation output rate. There are numerous error sources that contribute to the uncertainty of these exposure-related quantities, some of which are unique to the low energy x-ray spectrum produced by mammographic x-ray units. For each of these exposure-related quantities, the applicable error sources and their magnitudes vary, depending on the test equipment used to make the measurement, and whether or not relevant corrections have been applied. This study has identified and quantified a range of error sources that may be used to estimate the combined uncertainty of these exposure-related quantities, given the test equipment used and corrections applied. The uncertainty analysis uses methods described by the International Standards Organization's Guide to the Expression of Uncertainty in Measurement. Examples of how these error sources combine to give the uncertainty of the exposure-related quantities are presented. Using the best test equipment evaluated in this study, uncertainties of the four exposure-related quantities at the 95% confidence interval were found to be +/-1.6% (half value layer), +/-0.0008 (automatic exposure control reproducibility), +/-2.3% (average glandular dose), and +/-2.1% (radiation output rate). In some cases, using less precise test equipment or failing to apply corrections, resulted in uncertainties more than double in magnitude.

  6. Qualitative research.

    PubMed

    Maher, Lisa; Dertadian, George

    2017-08-07

    This narrative review aims to highlight key insights from qualitative research on drug use and drug users by profiling a selection of classic works. Consensus methods were used to identify and select four papers published in 1938, 1969, 1973 and 1984 considered to be classics. These landmark qualitative studies included the first account of addiction as a social process, demonstrating that people have meaningful responses to drug use that cannot be reduced to their pharmacological effects; the portrayal of inner-city heroin users as exacting, energetic and engaged social agents; identification of the interactive social learning processes involved in becoming a drug user; the application of the 'career' concept to understanding transitions and trajectories of drug use over time; and the articulation of a framework for understanding drug use that incorporates the interaction between pharmacology, psychology and social environments. These classic sociological and anthropological studies deployed qualitative research methods to show how drug use is shaped by complex sets of factors situated within social contexts, viewing drug users as agents engaged actively in social processes and worlds. Their findings have been used to challenge stereotypes about drug use and drug users, develop a deeper understanding of drug use among hidden, hard-to-research and under-studied populations, and provide the foundations for significant developments in scientific knowledge about the nature of drug use. They continue to retain their relevance, providing important correctives to biomedical and behaviourist paradigms, reminding us that drug use is a social process, and demonstrating how the inductive approach of qualitative research can strengthen the way we understand and respond to drug use and related harms. © 2017 Society for the Study of Addiction.

  7. The association between mammographic calcifications and breast cancer prognostic factors in a population-based registry cohort.

    PubMed

    Nyante, Sarah J; Lee, Sheila S; Benefield, Thad S; Hoots, Tiffany N; Henderson, Louise M

    2017-01-01

    Mammographic calcifications can be a marker of malignancy, but their association with prognosis is less well established. In the current study, the authors examined the relationship between calcifications and breast cancer prognostic factors in the population-based Carolina Mammography Registry. The current study included 8472 invasive breast cancers diagnosed in the Carolina Mammography Registry between 1996 and 2011 for which information regarding calcifications occurring within 2 years of diagnosis was reported. Calcification-specific Breast Imaging Reporting and Data System (BI-RADS) assessments were reported prospectively by a radiologist. Tumor characteristic data were obtained from the North Carolina Central Cancer Registry and/or pathology reports. Multivariable-adjusted associations between the presence of calcifications in the breast affected by cancer and tumor characteristics were estimated using logistic regression. Statistical tests were 2-sided. The presence of calcifications was found to be positively associated with tumors that were high grade (vs low grade: odds ratio [OR], 1.43; 95% confidence interval [95% CI], 1.10-1.88) or had an in situ component (vs without: OR, 2.15; 95% CI, 1.81-2.55). Calcifications were found to be inversely associated with hormone receptor-negative status (vs positive status: OR, 0.73; 95% CI, 0.57-0.93), size >35 mm (vs ≤8 mm: OR, 0.47; 95% CI, 0.37-0.61), and lobular tumors (vs ductal: OR, 0.39; 95% CI, 0.22-0.69). The association between the presence of calcifications and an in situ component was limited to BI-RADS category 4 and 5 calcifications and was absent for BI-RADS category 2 or 3 calcifications (P for heterogeneity <.01). The association with tumor size was found to be strongest for BI-RADS categories 3 and 4 (P for heterogeneity <.01). Calcifications were found to be associated with both unfavorable (high grade) and favorable (small size, hormone receptor positivity) prognostic factors

  8. A method for 3D electron density imaging using single scattered x-rays with application to mammographic screening.

    PubMed

    Van Uytven, Eric; Pistorius, Stephen; Gordon, Richard

    2008-10-07

    Screening mammography is the current standard in detecting breast cancer. However, its fundamental disadvantage is that it projects a 3D object into a 2D image. Small lesions are difficult to detect when superimposed over layers of normal, heterogeneous tissue. In this work, we examine the potential of single scattered photon electron density imaging in a mammographic environment. Simulating a low-energy (<20 keV) scanning pencil beam, we have developed an algorithm capable of producing 3D electron density images from a single projection. We have tested the algorithm by imaging parts of a simulated mammographic accreditation phantom containing lesions of various sizes. The results indicate that the group of imaged lesions differ significantly from background breast tissue (p<0.005), confirming that electron density imaging may be a useful diagnostic test for the presence of breast cancer.

  9. HCG blood test - qualitative

    MedlinePlus

    ... qualitative; Serum HCG - qualitative; HCG in blood serum - qualitative ... Henry's Clinical Diagnosis and Management by Laboratory Methods. 22nd ed. Philadelphia, PA: Elsevier Saunders; 2011:chap ...

  10. Digital versus screen-film mammography: impact of mammographic density and hormone therapy on breast cancer detection.

    PubMed

    Chiarelli, Anna M; Prummel, Maegan V; Muradali, Derek; Shumak, Rene S; Majpruz, Vicky; Brown, Patrick; Jiang, Hedy; Done, Susan J; Yaffe, Martin J

    2015-11-01

    Most studies that have examined the effects of mammographic density and hormone therapy use on breast cancer detection have included screen-film mammography. This study further examines this association in post-menopausal women screened by digital mammography. Approved by the University of Toronto Research Ethics Board, this study identified 688,418 women of age 50-74 years screened with digital or screen-film mammography from 2008 to 2009 within the Ontario Breast Screening Program. Of 2993 eligible women with invasive breast cancer, 2450 were contacted and 1421 participated (847 screen-film mammography, 574 digital direct radiography). Mammographic density was measured by study radiologists using the standard BI-RADS classification system and by a computer-assisted method. Information on hormone therapy use was collected by a telephone-administered questionnaire. Logistic regression and two-tailed tests for significance evaluated associations between factors and detection method by mammography type. Women with >75 % radiologist-measured mammographic density compared to those with <25 % were more likely to be diagnosed with an interval than screen-detected cancer, with the difference being greater for those screened with screen-film (OR = 6.40, 95 % CI 2.30-17.85) than digital mammography (OR = 2.41, 95 % CI 0.67-8.58) and aged 50-64 years screened with screen-film mammography (OR = 10.86, 95 % CI 2.96-39.57). Recent former hormone therapy users were also at an increased risk of having an interval cancer with the association being significant for women screened with digital mammography (OR = 2.08, 95 % CI 1.17-3.71). Breast screening using digital mammography lowers the risk of having an interval cancer for post-menopausal women aged 50-64 with greater mammographic density.

  11. Breast-Specific γ-Imaging for the Detection of Mammographically Occult Breast Cancer in Women at Increased Risk.

    PubMed

    Brem, Rachel F; Ruda, Rachel C; Yang, Jialu L; Coffey, Caitrín M; Rapelyea, Jocelyn A

    2016-05-01

    Breast-specific γ-imaging (BSGI) is a physiologic imaging modality that can detect subcentimeter and mammographically occult breast cancer, with a sensitivity and specificity comparable to MRI. The purpose of this study was to determine the incremental increase in breast cancer detection when BSGI is used as an adjunct to mammography in women at increased risk for breast cancer. All patients undergoing BSGI from April 2010 through January 2014 were retrospectively reviewed. Eligible patients were identified as women at increased risk for breast cancer and whose most recent mammogram was benign. Examinations exhibiting focally increased radiotracer uptake were considered positive. Incremental increase in cancer detection was calculated as the percentage of mammographically occult BSGI-detected breast cancer and the number of mammographically occult breast cancers detected per 1,000 women screened. Included in this study were 849 patients in whom 14 BSGI examinations detected mammographically occult breast cancer. Patients ranged in age from 26 to 83 y, with a mean age of 57 y. Eleven of 14 cancers were detected in women with dense breasts. The addition of BSGI to the annual breast screen of asymptomatic women at increased risk for breast cancer yields 16.5 cancers per 1,000 women screened. When high-risk lesions and cancers were combined, BSGI detected 33.0 high-risk lesions and cancers per 1,000 women screened. BSGI is a reliable adjunct modality to screening mammography that increases breast cancer detection by 1.7% (14/849) in women at increased risk for breast cancer, comparable to results reported for breast MRI. BSGI is beneficial in breast cancer detection in women at increased risk, particularly in those with dense breasts. © 2016 by the Society of Nuclear Medicine and Molecular Imaging, Inc.

  12. Association between mammographic density and pregnancies relative to age and BMI: a breast cancer case-only analysis.

    PubMed

    Hack, Carolin C; Emons, Julius; Jud, Sebastian M; Heusinger, Katharina; Adler, Werner; Gass, Paul; Haeberle, Lothar; Heindl, Felix; Hein, Alexander; Schulz-Wendtland, Rüdiger; Uder, Michael; Hartmann, Arndt; Beckmann, Matthias W; Fasching, Peter A; Pöhls, Uwe G

    2017-08-21

    Percentage mammographic density (PMD) is a major risk factor for breast cancer (BC). It is strongly associated with body mass index (BMI) and age, which are themselves risk factors for breast cancer. This analysis investigated the association between the number of full-term pregnancies and PMD in different subgroups relative to age and BMI. Patients were identified in the breast cancer database of the University Breast Center for Franconia. A total of 2410 patients were identified, for whom information on parity, age, and BMI, and a mammogram from the time of first diagnosis were available for assessing PMD. Linear regression analyses were conducted to investigate the influence on PMD of the number of full-term pregnancies (FTPs), age, BMI, and interaction terms between them. As in previous studies, age, number of FTPs, and BMI were found to be associated with PMD in the expected direction. However, including the respective interaction terms improved the prediction of PMD even further. Specifically, the association between PMD and the number of FTPs differed in young patients under the age of 45 (mean decrease of 0.37 PMD units per pregnancy) from the association in older age groups (mean decrease between 2.29 and 2.39 PMD units). BMI did not alter the association between PMD and the number of FTPs. The effect of pregnancies on mammographic density does not appear to become apparent before the age of menopause. The mechanism that drives the effect of pregnancies on mammographic density appears to be counter-regulated by other influences on mammographic density in younger patients.

  13. Predicted image quality of a CMOS APS X-ray detector across a range of mammographic beam qualities

    NASA Astrophysics Data System (ADS)

    Konstantinidis, A.

    2015-09-01

    Digital X-ray detectors based on Complementary Metal-Oxide- Semiconductor (CMOS) Active Pixel Sensor (APS) technology have been introduced in the early 2000s in medical imaging applications. In a previous study the X-ray performance (i.e. presampling Modulation Transfer Function (pMTF), Normalized Noise Power Spectrum (NNPS), Signal-to-Noise Ratio (SNR) and Detective Quantum Efficiency (DQE)) of the Dexela 2923MAM CMOS APS X-ray detector was evaluated within the mammographic energy range using monochromatic synchrotron radiation (i.e. 17-35 keV). In this study image simulation was used to predict how the mammographic beam quality affects image quality. In particular, the experimentally measured monochromatic pMTF, NNPS and SNR parameters were combined with various mammographic spectral shapes (i.e. Molybdenum/Molybdenum (Mo/Mo), Rhodium/Rhodium (Rh/Rh), Tungsten/Aluminium (W/Al) and Tungsten/Rhodium (W/Rh) anode/filtration combinations at 28 kV). The image quality was measured in terms of Contrast-to-Noise Ratio (CNR) using a synthetic breast phantom (4 cm thick with 50% glandularity). The results can be used to optimize the imaging conditions in order to minimize patient's Mean Glandular Dose (MGD).

  14. Similarity of fibroglandular breast tissue content measured from magnetic resonance and mammographic images and by a mathematical algorithm.

    PubMed

    Nayeem, Fatima; Ju, Hyunsu; Brunder, Donald G; Nagamani, Manubai; Anderson, Karl E; Khamapirad, Tuenchit; Lu, Lee-Jane W

    2014-01-01

    Women with high breast density (BD) have a 4- to 6-fold greater risk for breast cancer than women with low BD. We found that BD can be easily computed from a mathematical algorithm using routine mammographic imaging data or by a curve-fitting algorithm using fat and nonfat suppression magnetic resonance imaging (MRI) data. These BD measures in a strictly defined group of premenopausal women providing both mammographic and breast MRI images were predicted as well by the same set of strong predictor variables as were measures from a published laborious histogram segmentation method and a full field digital mammographic unit in multivariate regression models. We also found that the number of completed pregnancies, C-reactive protein, aspartate aminotransferase, and progesterone were more strongly associated with amounts of glandular tissue than adipose tissue, while fat body mass, alanine aminotransferase, and insulin like growth factor-II appear to be more associated with the amount of breast adipose tissue. Our results show that methods of breast imaging and modalities for estimating the amount of glandular tissue have no effects on the strength of these predictors of BD. Thus, the more convenient mathematical algorithm and the safer MRI protocols may facilitate prospective measurements of BD.

  15. Genome-wide association study identifies multiple loci associated with both mammographic density and breast cancer risk.

    PubMed

    Lindström, Sara; Thompson, Deborah J; Paterson, Andrew D; Li, Jingmei; Gierach, Gretchen L; Scott, Christopher; Stone, Jennifer; Douglas, Julie A; dos-Santos-Silva, Isabel; Fernandez-Navarro, Pablo; Verghase, Jajini; Smith, Paula; Brown, Judith; Luben, Robert; Wareham, Nicholas J; Loos, Ruth J F; Heit, John A; Pankratz, V Shane; Norman, Aaron; Goode, Ellen L; Cunningham, Julie M; deAndrade, Mariza; Vierkant, Robert A; Czene, Kamila; Fasching, Peter A; Baglietto, Laura; Southey, Melissa C; Giles, Graham G; Shah, Kaanan P; Chan, Heang-Ping; Helvie, Mark A; Beck, Andrew H; Knoblauch, Nicholas W; Hazra, Aditi; Hunter, David J; Kraft, Peter; Pollan, Marina; Figueroa, Jonine D; Couch, Fergus J; Hopper, John L; Hall, Per; Easton, Douglas F; Boyd, Norman F; Vachon, Celine M; Tamimi, Rulla M

    2014-10-24

    Mammographic density reflects the amount of stromal and epithelial tissues in relation to adipose tissue in the breast and is a strong risk factor for breast cancer. Here we report the results from meta-analysis of genome-wide association studies (GWAS) of three mammographic density phenotypes: dense area, non-dense area and percent density in up to 7,916 women in stage 1 and an additional 10,379 women in stage 2. We identify genome-wide significant (P<5 × 10(-8)) loci for dense area (AREG, ESR1, ZNF365, LSP1/TNNT3, IGF1, TMEM184B and SGSM3/MKL1), non-dense area (8p11.23) and percent density (PRDM6, 8p11.23 and TMEM184B). Four of these regions are known breast cancer susceptibility loci, and four additional regions were found to be associated with breast cancer (P<0.05) in a large meta-analysis. These results provide further evidence of a shared genetic basis between mammographic density and breast cancer and illustrate the power of studying intermediate quantitative phenotypes to identify putative disease-susceptibility loci.

  16. Genome-wide association study identifies multiple loci associated with both mammographic density and breast cancer risk

    PubMed Central

    Lindström, Sara; Thompson, Deborah J.; Paterson, Andrew D.; Li, Jingmei; Gierach, Gretchen L.; Scott, Christopher; Stone, Jennifer; Douglas, Julie A.; dos-Santos-Silva, Isabel; Fernandez-Navarro, Pablo; Verghase, Jajini; Smith, Paula; Brown, Judith; Luben, Robert; Wareham, Nicholas J.; Loos, Ruth J.F.; Heit, John A.; Pankratz, V. Shane; Norman, Aaron; Goode, Ellen L.; Cunningham, Julie M.; deAndrade, Mariza; Vierkant, Robert A.; Czene, Kamila; Fasching, Peter A.; Baglietto, Laura; Southey, Melissa C.; Giles, Graham G.; Shah, Kaanan P.; Chan, Heang-Ping; Helvie, Mark A.; Beck, Andrew H.; Knoblauch, Nicholas W.; Hazra, Aditi; Hunter, David J.; Kraft, Peter; Pollan, Marina; Figueroa, Jonine D.; Couch, Fergus J.; Hopper, John L.; Hall, Per; Easton, Douglas F.; Boyd, Norman F.; Vachon, Celine M.; Tamimi, Rulla M.

    2015-01-01

    Mammographic density reflects the amount of stromal and epithelial tissues in relation to adipose tissue in the breast and is a strong risk factor for breast cancer. Here we report the results from meta-analysis of genome-wide association studies (GWAS) of three mammographic density phenotypes: dense area, non-dense area and percent density in up to 7,916 women in stage 1 and an additional 10,379 women in stage 2. We identify genome-wide significant (P<5×10−8) loci for dense area (AREG, ESR1, ZNF365, LSP1/TNNT3, IGF1, TMEM184B, SGSM3/MKL1), non-dense area (8p11.23) and percent density (PRDM6, 8p11.23, TMEM184B). Four of these regions are known breast cancer susceptibility loci, and four additional regions were found to be associated with breast cancer (P<0.05) in a large meta-analysis. These results provide further evidence of a shared genetic basis between mammographic density and breast cancer and illustrate the power of studying intermediate quantitative phenotypes to identify putative disease susceptibility loci. PMID:25342443

  17. Autologous breast reconstruction with endoscopic latissimus dorsi musculosubcutaneous flaps in patients choosing breast-conserving therapy: mammographic appearance.

    PubMed

    Monticciolo, D L; Ross, D; Bostwick, J; Eaves, F; Styblo, T

    1996-08-01

    The objective of this study was to define and evaluate mammographic changes in patients treated with breast-conserving therapy and a new reconstructive technique that uses autologous tissue from a latissimus dorsi musculosubcutaneous flap. Of 20 patients who underwent either immediate or delayed endoscopic latissimus dorsi muscle flap reconstruction after lumpectomy, 13 also had postsurgery mammograms available for review. Radiographic findings assessed included skin thickening, density or radiolucency at the reconstruction site, density around the flap, fat necrosis, calcifications, and the presence of surgical clips. Mammograms for three patients (23%) revealed thickening that we believed was attributable to radiation therapy. No patient had increased density in the flap itself; all flaps were relatively radiolucent centrally (13/13; 100%). Mammograms revealed density around the rim of the flap in four patients (31%). This density was most likely secondary to latissimus dorsi muscle fibers and did not limit radiographic evaluation. One patient had calcifications, probably secondary to fat necrosis. No oil cysts were seen. In the majority of patients (11/13; 85%), surgical clips were visible. Endoscopic latissimus dorsi muscle flap reconstruction, previously used only for mastectomy patients, is now being used for improved esthetic outcome in selected patients who desire breast conservation. Our results indicate that the mammographic findings are predictable. The most common findings are relative radiolucency centrally, with or without density from muscle fibers around the edges of the area of tissue transfer. The transplanted musculosubcutaneous flap does not interfere with mammographic evaluation.

  18. Impact of luminance distribution in the visual field on foveal contrast sensitivity in the context of mammographic softcopy reading

    NASA Astrophysics Data System (ADS)

    Apelt, Dörte; Rascher-Friesenhausen, Richard; Klein, Jan; Strasburger, Hans; Preim, Bernhard; Peitgen, Heinz-Otto

    2009-02-01

    For quality control in mammographic softcopy reading (SCR) a number of recommendations exists. Among them is a room illuminance of 10 lx. Moreover, the use of masks on the image seems to be advantageous, due to a reduction of scattered light in the focus of view. Room illuminance affects the global luminance adaptation and the maximal monitor contrast; masking decreases the luminance in the central and near-peripheral region. We investigated the effects of masking and illuminance on foveal contrast sensitivity. A study with eight observers was conducted in the context of mammographic softcopy reading. Using Gabor patterns with varying spatial frequencies, orientations and contrast levels as stimuli and an orientation discrimination task, the intraobserver contrast sensitivity was determined for foveal vision. Tested illuminances for a non-masked image were 10, 30, 50 and 90 lx, and for a masked image 10 lx. Major findings are: (1) Masking does not lead to improved contrast sensitivity. Instead, all observers reported a strong fatigue effect during the presentation of the masked image. (2) Among the illuminances tested, only half of the observers showed the best contrast sensitivity at 10 lx. For the other observers best results were achieved at illuminance levels of 50 or 90 lx, respectively. The results can be used to appraise the effects of viewing conditions with the aim of drawing conclusions for mammographic SCR, and to initiate further studies.

  19. Application of computer-extracted breast tissue texture features in predicting false-positive recalls from screening mammography

    NASA Astrophysics Data System (ADS)

    Ray, Shonket; Choi, Jae Y.; Keller, Brad M.; Chen, Jinbo; Conant, Emily F.; Kontos, Despina

    2014-03-01

    Mammographic texture features have been shown to have value in breast cancer risk assessment. Previous models have also been developed that use computer-extracted mammographic features of breast tissue complexity to predict the risk of false-positive (FP) recall from breast cancer screening with digital mammography. This work details a novel locallyadaptive parenchymal texture analysis algorithm that identifies and extracts mammographic features of local parenchymal tissue complexity potentially relevant for false-positive biopsy prediction. This algorithm has two important aspects: (1) the adaptive nature of automatically determining an optimal number of region-of-interests (ROIs) in the image and each ROI's corresponding size based on the parenchymal tissue distribution over the whole breast region and (2) characterizing both the local and global mammographic appearances of the parenchymal tissue that could provide more discriminative information for FP biopsy risk prediction. Preliminary results show that this locallyadaptive texture analysis algorithm, in conjunction with logistic regression, can predict the likelihood of false-positive biopsy with an ROC performance value of AUC=0.92 (p<0.001) with a 95% confidence interval [0.77, 0.94]. Significant texture feature predictors (p<0.05) included contrast, sum variance and difference average. Sensitivity for false-positives was 51% at the 100% cancer detection operating point. Although preliminary, clinical implications of using prediction models incorporating these texture features may include the future development of better tools and guidelines regarding personalized breast cancer screening recommendations. Further studies are warranted to prospectively validate our findings in larger screening populations and evaluate their clinical utility.

  20. Understanding Participatory Action Research: A Qualitative Research Methodology Option

    ERIC Educational Resources Information Center

    MacDonald, Cathy

    2012-01-01

    Participatory Action Research (PAR) is a qualitative research methodology option that requires further understanding and consideration. PAR is considered democratic, equitable, liberating, and life-enhancing qualitative inquiry that remains distinct from other qualitative methodologies (Kach & Kralik, 2006). Using PAR, qualitative features of an…

  1. Understanding Participatory Action Research: A Qualitative Research Methodology Option

    ERIC Educational Resources Information Center

    MacDonald, Cathy

    2012-01-01

    Participatory Action Research (PAR) is a qualitative research methodology option that requires further understanding and consideration. PAR is considered democratic, equitable, liberating, and life-enhancing qualitative inquiry that remains distinct from other qualitative methodologies (Kach & Kralik, 2006). Using PAR, qualitative features of an…

  2. Mammographic Density and Vitamin D Levels - A Cross-sectional Study.

    PubMed

    Straub, Loreen; Riedel, Johanna; Luppa, Peter B; Wissing, Johanna; Artmann, Almut; Kiechle, Marion; Seifert-Klauss, Vanadin Regina

    2017-03-01

    Background Some studies have already proposed an inverse association between vitamin D levels and breast density. As breast density is already considered an established risk factor for breast cancer, such a connection could offer a new starting point for the prevention of breast cancer. Material and Methods To investigate this suggested connection, a total of 412 pre- and 572 post-menopausal women for whom mammography was indicated were recruited into this cross-sectional study. In addition to a questionnaire-based interview on the patient's general and gynecological medical history, her eating habits and lifestyle, serum levels of 25-hydroxyvitamin D [25(OH)D], calcium, phosphate and creatinine were determined. Breast density was determined by mammography and categorized as 1 to 4 according to the ACR classification. In addition to performing descriptive analysis to get a better overview of the data, a number of multivariate regression models were developed to determine the impact of confounders and the connection between vitamin D and mammographic density. Results More than half of all participants had low levels of 25(OH)D (< 20 ng/ml) and only a small minority of women (5.7 %) had what are currently considered to be optimal serum levels of 25(OH)D of at least 30 ng/ml. The significant majority of the cohort had a medium mammographic density (n = 463 had ACR 2; n = 343 had ACR 3). Logistic regression analysis showed that lower 25(OH)D serum levels were associated significantly more often with high rather than medium breast density. This association remained, even after adjusting for other factors which influence breast density such as age, BMI and menopausal status (p = 0.032 for ACR 4 vs. ACR 2; p = 0.028 for ACR 4 vs. ACR 3). When the same analysis was done separately for pre-menopausal and post-menopausal women, BMI in both groups was found to be inversely correlated with breast density and this inverse correlation was highly

  3. Polymorphisms in genes involved in the estrogen pathway and mammographic density

    PubMed Central

    2010-01-01

    Background Single nucleotide polymorphisms (SNPs) in genes involved in the estrogen pathway appear to be associated with breast cancer risk and possibly with mammographic density (MD), but little is known of these associations among premenopausal women. This study examines the association of 11 polymorphisms in five estrogen-related genes (estrogen receptors alpha and beta (ERα, ERβ), 17β-hydroxysteroid dehydrogenase 1 (HSD17B1), catechol-O-methyltransferase (COMT), cytochrome P450 1B1 (CYP1B1)) with premenopausal MD. Effect modification of four estrogen-related factors (parity, age at menarche, hormonal derivatives use and body mass index (BMI)) on this relation is also assessed. Methods Polymorphisms were genotyped in 741 premenopausal Caucasian women whose MD was measured in absolute density (AD, cm2) and percent density using a computer-assisted method. Multivariate linear models were used to examine the associations (Ptrend) and interactions (Pi). Results None of the SNPs showed a statistically significant association with AD. However, each additional rare allele of rs1056836 CYP1B1 was associated with a reduction in AD among nulliparous women (Ptrend = 0.004), while no association was observed among parous women (Ptrend = 0.62; Pi = 0.02). An increase in the number of rare alleles of the HSD17B1 SNP (rs598126 and rs2010750) was associated with an increase in AD among women who never used hormonal derivatives (Ptrend = 0.06 and Ptrend = 0.04, respectively), but with a decrease in AD among past hormonal derivatives users (Ptrend = 0.04; Pi = 0.02 and Ptrend = 0.08; Pi = 0.01, respectively). Moreover, a negative association of rs598126 HSD17B1 SNP with AD was observed among women with higher BMI (>median) (Ptrend = 0.01; Pi = 0.02). A negative association between an increased number of rare alleles of COMT rs4680 SNP and AD was limited to women who never used hormonal derivatives (Ptrend = 0.02; Pi = 0.03) or with late age at menarche (>median) (Ptrend = 0

  4. A Novel Automated Mammographic Density Measure and Breast 
Cancer Risk

    PubMed Central

    2012-01-01

    Background Mammographic breast density is a strong breast cancer risk factor but is not used in the clinical setting, partly because of a lack of standardization and automation. We developed an automated and objective measurement of the grayscale value variation within a mammogram, evaluated its association with breast cancer, and compared its performance with that of percent density (PD). Methods Three clinic-based studies were included: a case–cohort study of 217 breast cancer case subjects and 2094 non-case subjects and two case–control studies comprising 928 case subjects and 1039 control subjects and 246 case subjects and 516 control subjects, respectively. Percent density was estimated from digitized mammograms using the computer-assisted Cumulus thresholding program, and variation was estimated from an automated algorithm. We estimated hazards ratios (HRs), odds ratios (ORs), the area under the receiver operating characteristic curve (AUC), and 95% confidence intervals (CIs) using Cox proportional hazards models for the cohort and logistic regression for case–control studies, with adjustment for age and body mass index. We performed a meta-analysis using random study effects to obtain pooled estimates of the associations between the two mammographic measures and breast cancer. All statistical tests were two-sided. Results The variation measure was statistically significantly associated with the risk of breast cancer in all three studies (highest vs lowest quartile: HR = 7.0 [95% CI = 4.6 to 10.4]; OR = 10.7 [95% CI = 7.5 to 15.3]; OR = 2.6 [95% CI = 1.6 to 4.2]; all P trend < .001). In two studies, the risk estimates and AUCs for the variation measure were greater than those for percent density (AUCs for variation = 0.71 and 0.76; AUCs for percent density = 0.65 and 0.65), whereas in the third study, these estimates were similar (AUC for variation = 0.60 and AUC for percent density = 0.61). A meta-analysis of the three studies demonstrated a stronger

  5. Digital Breast Tomosynthesis versus Supplemental Diagnostic Mammographic Views for Evaluation of Noncalcified Breast Lesions

    PubMed Central

    Bandos, Andriy I.; Ganott, Marie A.; Sumkin, Jules H.; Kelly, Amy E.; Catullo, Victor J.; Rathfon, Grace Y.; Lu, Amy H.; Gur, David

    2013-01-01

    Purpose: To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Materials and Methods: Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31–60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS–based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy–based area under the receiver operating characteristic (ROC) curve. Results: Average probability-of-malignancy–based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of

  6. Mammographic x-ray unit kilovoltage test tool based on k-edge absorption effect.

    PubMed

    Napolitano, Mary E; Trueblood, Jon H; Hertel, Nolan E; David, George

    2002-09-01

    A simple tool to determine the peak kilovoltage (kVp) of a mammographic x-ray unit has been designed. Tool design is based on comparing the effect of k-edge discontinuity of the attenuation coefficient for a series of element filters. Compatibility with the mammography accreditation phantom (MAP) to obtain a single quality control film is a second design objective. When the attenuation of a series of sequential elements is studied simultaneously, differences in the absorption characteristics due to the k-edge discontinuities are more evident. Specifically, when the incident photon energy is higher than the k-edge energy of a number of the elements and lower than the remainder, an inflection may be seen in the resulting attenuation data. The maximum energy of the incident photon spectra may be determined based on this inflection point for a series of element filters. Monte Carlo photon transport analysis was used to estimate the photon transmission probabilities for each of the sequential k-edge filter elements. The photon transmission corresponds directly to optical density recorded on mammographic x-ray film. To observe the inflection, the element filters chosen must have k-edge energies that span a range greater than the expected range of the end point energies to be determined. For the design, incident x-ray spectra ranging from 25 to 40 kVp were assumed to be from a molybdenum target. Over this range, the k-edge energy changes by approximately 1.5 keV between sequential elements. For this design 21 elements spanning an energy range from 20 to 50 keV were chosen. Optimum filter element thicknesses were calculated to maximize attenuation differences at the k-edge while maintaining optical densities between 0.10 and 3.00. Calculated relative transmission data show that the kVp could be determined to within +/-1 kV. To obtain experimental data, a phantom was constructed containing 21 different elements placed in an acrylic holder. MAP images were used to determine

  7. Mammographic breast density: Predictive value for pathological response to neoadjuvant chemotherapy in breast cancer patients.

    PubMed

    Elsamany, S; Alzahrani, A; Abozeed, W N; Rasmy, A; Farooq, M U; Elbiomy, M A; Rawah, E; Alsaleh, K; Abdel-Aziz, N M

    2015-10-01

    This study aims to evaluate the relation between mammographic breast density (BD) and pathological response to neoadjuvant chemotherapy. In this retrospective study, 241 breast cancer patients who received neoadjuvant chemotherapy were included. BD was assessed in mammograms already performed at diagnosis. Pathological complete response (pCR) and pathological stage were correlated with BD, tumour phenotype and other clinico-pathological factors. Patients with low BD had better pCR compared to those with high density (30.5% vs 19.5% respectively, OR = 1.8, 95% CI = 0.98-3.3, p = 0.056) which was more pronounced after adjustment with body mass index (BMI) (OR = 2.4, 95% CI = 1.2-4.8, p = 0.011). HER2-positive disease (32.5% vs. 18.4%, OR = 2.2, 95% = 1.2-4.0, p = 0.01), lower BMI (OR = 1.1, 95% CI = 1.03-1.15, p = 0.004) and lower clinical stage (p = 0.002) were significant predictors of pCR in univariate analysis. In multivariate analysis, low BD (OR = 2.7, 95% CI = 1.3-5.5, p = 0.006) and lower BMI (OR = 1.1, 95% CI = 1.03-1.17, p = 0.003) were independent predictors of better pCR, while early clinical stage (I, II) was of borderline significance (OR = 2.6, 95% CI = 0.99-6.7, p = 0.052). High BD (OR = 1.8, 95% CI = 1.1-3.2, p = 0.03), advanced clinical stage (III) (OR = 1.5, 95% CI = 1.03-2.1, p = 0.03) and higher BMI (OR = 1.06, 95% CI = 1.02-1.11, p = 0.006) were significant predictors of advanced pathological stage. Low mammographic BD, low BMI and early clinical stage were associated with improved pCR rate and lower pathological stage after neoadjuvant chemotherapy. BD had more pronounced association with response to chemotherapy after adjustment with BMI. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. Digital breast tomosynthesis versus supplemental diagnostic mammographic views for evaluation of noncalcified breast lesions.

    PubMed

    Zuley, Margarita L; Bandos, Andriy I; Ganott, Marie A; Sumkin, Jules H; Kelly, Amy E; Catullo, Victor J; Rathfon, Grace Y; Lu, Amy H; Gur, David

    2013-01-01

    To compare the diagnostic performance of breast tomosynthesis versus supplemental mammography views in classification of masses, distortions, and asymmetries. Eight radiologists who specialized in breast imaging retrospectively reviewed 217 consecutively accrued lesions by using protocols that were HIPAA compliant and institutional review board approved in 182 patients aged 31-60 years (mean, 50 years) who underwent diagnostic mammography and tomosynthesis. The lesions in the cohort included 33% (72 of 217) cancers and 67% (145 of 217) benign lesions. Eighty-four percent (182 of 217) of the lesions were masses, 11% (25 of 217) were asymmetries, and 5% (10 of 217) were distortions that were initially detected at clinical examination in 8% (17 of 217), at mammography in 80% (173 of 217), at ultrasonography (US) in 11% (25 of 217), or at magnetic resonance imaging in 1% (2 of 217). Histopathologic examination established truth in 191 lesions, US revealed a cyst in 12 lesions, and 14 lesions had a normal follow-up. Each lesion was interpreted once with tomosynthesis and once with supplemental mammographic views; both modes included the mediolateral oblique and craniocaudal views in a fully crossed and balanced design by using a five-category Breast Imaging Reporting and Data System (BI-RADS) assessment and a probability-of-malignancy score. Differences between modes were analyzed with a generalized linear mixed model for BI-RADS-based sensitivity and specificity and with modified Obuchowski-Rockette approach for probability-of-malignancy-based area under the receiver operating characteristic (ROC) curve. Average probability-of-malignancy-based area under the ROC curve was 0.87 for tomosynthesis versus 0.83 for supplemental views (P < .001). With tomosynthesis, the false-positive rate decreased from 85% (989 of 1160) to 74% (864 of 1160) (P < .01) for cases that were rated BI-RADS category 3 or higher and from 57% (663 of 1160) to 48% (559 of 1160) for cases rated BI

  9. Association between air pollution and mammographic breast density in the Breast Cancer Surveilance Consortium.

    PubMed

    Yaghjyan, Lusine; Arao, Robert; Brokamp, Cole; O'Meara, Ellen S; Sprague, Brian L; Ghita, Gabriela; Ryan, Patrick

    2017-04-06

    Mammographic breast density is a well-established strong risk factor for breast cancer. The environmental contributors to geographic variation in breast density in urban and rural areas are poorly understood. We examined the association between breast density and exposure to ambient air pollutants (particulate matter <2.5 μm in diameter (PM2.5) and ozone (O3)) in a large population-based screening registry. Participants included women undergoing mammography screening at imaging facilities within the Breast Cancer Surveillance Consortium (2001-2009). We included women aged ≥40 years with known residential zip codes before the index mammogram (n = 279,967). Breast density was assessed using the American College of Radiology's Breast Imaging-Reporting and Data System (BI-RADS) four-category breast density classification. PM2.5 and O3 estimates for grids across the USA (2001-2008) were obtained from the US Environmental Protection Agency Hierarchical Bayesian Model (HBM). For the majority of women (94%), these estimates were available for the year preceding the mammogram date. Association between exposure to air pollutants and density was estimated using polytomous logistic regression, adjusting for potential confounders. Women with extremely dense breasts had higher mean PM2.5 and lower O3 exposures than women with fatty breasts (8.97 vs. 8.66 ug/m(3) and 33.70 vs. 35.82 parts per billion (ppb), respectively). In regression analysis, women with heterogeneously dense vs. scattered fibroglandular breasts were more likely to have higher exposure to PM2.5 (fourth vs. first quartile odds ratio (OR) = 1.19, 95% confidence interval (CI) 1.16 - 1.23). Women with extremely dense vs. scattered fibroglandular breasts were less likely to have higher levels of ozone exposure (fourth vs. first quartile OR = 0.80, 95% CI 0.73-0.87). Exposure to PM2.5 and O3 may in part explain geographical variation in mammographic density. Further studies are warranted to

  10. The vitamin D pathway and mammographic breast density among postmenopausal women

    PubMed Central

    Sprague, Brian L.; Trentham-Dietz, Amy; Gangnon, Ronald E.; Buist, Diana S. M.; Burnside, Elizabeth S.; Aiello Bowles, Erin J.; Stanczyk, Frank Z.; Sisney, Gale S.; Skinner, Halcyon G.

    2011-01-01

    Laboratory studies have demonstrated that vitamin D has a number of chemopreventive properties, and that these properties may be mediated or modified by other molecules in the vitamin D pathway, such as parathyroid hormone (PTH) or calcium. However, there is little epidemiologic data exploring the effects of vitamin D on breast cancer risk in the context of these other molecules. We examined a panel of molecules in the vitamin D pathway in relation to mammographic breast density, a marker of breast cancer risk, in the Wisconsin Breast Density Study. A total of 238 postmenopausal women (ages 55-70, with no history of postmenopausal hormone use) were enrolled from mammography clinics in Madison, Wisconsin. Subjects provided blood samples that were analyzed for levels of 25-hydroxy vitamin D [25(OH)D], PTH, insulin-like growth factor-1 (IGF1), IGF-binding protein 3 (IGFBP3), retinol, and calcium. Percent breast density was measured using Cumulus software. In age-adjusted analyses there was a positive association between 25(OH)D and percent breast density (P=0.05; mean percent density=11.3% vs. 15.6% for 1st vs. 4th quartile of 25(OH)D). Breast density was inversely associated with PTH (P=0.05; 16.0% vs. 11.4% for Q1 vs. Q4) and positively associated with the IGF-1:IGFBP-3 molar ratio (P=0.02; 11.9% vs. 15.6% for Q1 vs. Q4). However, these associations were all null after further adjustment for body mass index (BMI; P>0.25). The independent relation between 25(OH)D and breast density remained null among subgroups defined by BMI and serum levels of retinol, calcium, and estradiol. These results suggest no strong independent associations between the circulating molecules of the vitamin D pathway and mammographic breast density in postmenopausal women. While it remains possible that vitamin D could influence breast cancer risk, our results suggest that such an effect would be mediated through pathways other than breast density. PMID:21847642

  11. Cigarette smoking and mammographic density in the Danish Diet, Cancer and Health cohort.

    PubMed

    Jacobsen, Katja Kemp; Lynge, Elsebeth; Vejborg, Ilse; Tjønneland, Anne; von Euler-Chelpin, My; Andersen, Zorana J

    2016-02-01

    Smoking before first childbirth increases breast cancer risk, but the biological mechanism remains unknown and may involve mammographic density (MD), one of the strongest biomarkers of breast cancer risk. We aimed to examine whether active smoking and passive smoking were associated with MD. For the 5,356 women (4,489 postmenopausal) from the Danish Diet, Cancer and Health cohort (1993-1997) who attended mammographic screening in Copenhagen (1993-2001), we used MD (mixed/dense or fatty) assessed at the first screening after cohort entry. Active smoking (status, duration, and intensity) and passive smoking were assessed at cohort baseline (1993-1997) via questionnaire, together with other breast cancer risk factors. Logistic regression was used to estimate associations (odds ratios, 95 % confidence intervals) between smoking and MD, adjusting for confounders. Two thousand and twenty-six (56.5 %) women had mixed/dense MD, 2,214 (41.4 %) were current, and 1,175 (21.9 %) former smokers. Current smokers had significantly lower odds (0.86, 0.75-0.99) of having mixed/dense MD compared to never smokers, while former smoking was not associated with MD. Inverse association between smoking and MD was strongest in women who initiated smoking before age of 16 years (0.79, 0.64-0.96), smoked ≥15 cigarettes/day (0.83, 0.71-0.98), smoked ≥5 pack-years (0.62, 0.43-0.89), smoked >30 years (0.86, 0.75-0.99), and smoked ≥11 years before first childbirth (0.70, 0.51-0.96). Association between smoking and MD diminished after smoking cessation, with increased odds of having mixed/dense breasts in women who quit smoking >20 years ago as compared to current smokers (1.37, 1.01-1.67). There was no association between passive smoking and MD. We found an inverse association between active smoking and MD.

  12. Higher alcohol intake may modify the association between mammographic density and breast cancer: an analysis of three case-control studies.

    PubMed

    Conroy, Shannon M; Koga, Karin; Woolcott, Christy G; Dahl, Timothy; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Yaffe, Martin J; Vachon, Celine M; Maskarinec, Gertraud

    2012-10-01

    Alcohol consumption and mammographic density are established risk factors for breast cancer. This study examined whether the association of mammographic density with breast cancer varies by alcohol intake. Mammographic density was assessed in digitized images for 1207 cases and 1663 controls from three populations (Japan, Hawaii, California) using a computer-assisted method. Associations were estimated by logistic regression. When comparing ever to never drinking, mean density was similar and consumption was not associated with breast cancer risk. However, within the Hawaii/Japan subset, women consuming >1 drink/day had a non-significantly elevated relative risk compared to never drinkers. Also in the Hawaii/Japan population, alcohol intake only modified the association between mammographic density and breast cancer in women consuming >1 drink/day (p(interaction)=0.05) with significant risk estimates of 3.65 and 6.58 for the 2nd and 3rd density tertiles as compared to 1.57 and 1.61 for never drinkers in Hawaii/Japan. Although these findings suggest a stronger association between mammographic density and breast cancer risk for alcohol consumers, the small number of cases requires caution in interpreting the results.

  13. Application of Localization and Needle Placement Guided by Mammographic, Ultrasound and Fiberoptic Ductoscopy for Resection of Non-palpable Breast Lesions.

    PubMed

    Yuan, Zhu; Qu, Xiang; Zhang, Zhong-Tao; Jiang, Wen G

    2017-08-01

    To evaluate the usefulness of localization needles under mammographic, ultrasound or fiberoptic ductoscopy guidance for non-palpable breast lesions. Eighty-three patients undergoing needle localization and biopsy of non-palpable breast lesions under mammographic, ultrasound or fiberoptic ductoscopy guidance from June 2013 to December 2014 in Beijing Friendship Hospital were included in the study. The preoperative imaging assessment, application of localization needles, surgical operation and pathological examination were recorded and analyzed retrospectively. A total of 83 localization and biopsies were carried out, of which 27 were performed under mammographic guidance, 32 under ultrasound guidance and 24 under fiberoptic ductoscopy guidance. Twenty-seven cases of breast microcalcifications were localized under mammographic guidance and surgically removed, of which eight cases were pathologically diagnosed as malignant. Thirty-two cases of non-palpable breast lesions were localized under ultrasound guidance and 30 pathologically diagnosed, of these, four cases were pathologically diagnosed as malignant. Twenty-four cases of intraductal space-occupying lesions were localized under ductoscopy guidance and surgically removed, of which five cases were pathologically diagnosed as malignant. Utilization of localization needles under mammographic, ultrasound or fiberoptic ductoscopy guidance for non-palpable breast lesions is a safe and effective procedure, and is helpful in the diagnosis of breast cancer. With the help of this procedure, more malignant lesions can be localized and surgically removed. Copyright© 2017, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.

  14. Deep learning of symmetrical discrepancies for computer-aided detection of mammographic masses

    NASA Astrophysics Data System (ADS)

    Kooi, Thijs; Karssemeijer, Nico

    2017-03-01

    When humans identify objects in images, context is an important cue; a cheetah is more likely to be a domestic cat when a television set is recognised in the background. Similar principles apply to the analysis of medical images. The detection of diseases that manifest unilaterally in symmetrical organs or organ pairs can in part be facilitated by a search for symmetrical discrepancies in or between the organs in question. During a mammographic exam, images are recorded of each breast and absence of a certain structure around the same location in the contralateral image will render the area under scrutiny more suspicious and conversely, the presence of similar tissue less so. In this paper, we present a fusion scheme for a deep Convolutional Neural Network (CNN) architecture with the goal to optimally capture such asymmetries. The method is applied to the domain of mammography CAD, but can be relevant to other medical image analysis tasks where symmetry is important such as lung, prostate or brain images.

  15. Increased vitamin D and calcium intake associated with reduced mammographic breast density among premenopausal women.

    PubMed

    Fair, Alecia Malin; Lewis, Toni J; Sanderson, Maureen; Dupont, William D; Fletcher, Sarah; Egan, Kathleen M; Disher, Anthony C

    2015-10-01

    Vitamin D has been identified as a weak protective factor for postmenopausal breast cancer (relative risk, ~0.9), whereas high breast density has been identified as a strong risk factor (relative risk, ~4-6). To test the hypothesis that there is an association between vitamin D intake, but not circulating vitamin D levels, and mammographic breast density among women in our study, we conducted a cross-sectional study of 165 screening mammography patients at Nashville General Hospital's Breast Health Center, a public facility serving medically indigent and underserved women. Dietary and total (dietary plus supplements) vitamin D and calcium intakes were estimated by the Harvard African American Food Frequency Questionnaire, and blood samples were analyzed for 25-hydroxyvitamin D. Average percent breast density for the left and right breasts combined was estimated from digitized films using an interactive thresholding method available through Cumulus software. After statistical adjustment for age, race, and body mass index, the results revealed that there were significant trends of decreasing breast density with increasing vitamin D and calcium intake among premenopausal but not among postmenopausal women. There was no association between serum vitamin D and breast density in premenopausal or postmenopausal women. Confirmation of our findings in larger studies may assist in clarifying the role of vitamin D in breast density.

  16. The effect of skin thickness determined using breast CT on mammographic dosimetry

    SciTech Connect

    Huang Shihying; Boone, John M.; Yang, Kai; Kwan, Alexander L. C.; Packard, Nathan J.

    2008-04-15

    The effect of breast skin thickness on dosimetry in mammography was investigated. Breast computed tomography (CT) acquisition techniques, combined with algorithms designed for determining specific breast metrics, were useful for estimating skin thickness. A radial-geometry edge detection scheme was implemented on coronal reconstructed breast CT (bCT) images to measure the breast skin thickness. Skin thickness of bilateral bCT volume data from 49 women and unilateral bCT volume data from 2 women (10 healthy women and 41 women with BIRADS 4 and 5 diagnoses) was robustly measured with the edge detection scheme. The mean breast skin thickness ({+-}inter-breast standard deviation) was found to be 1.45{+-}0.30 mm. Since most current published normalized glandular dose (D{sub gN}) coefficients are based on the assumption of a 4-mm breast skin thickness, the D{sub gN} values computed with Monte Carlo techniques will increase up to 18% due to the thinner skin layers (e.g., 6-cm 50% glandular breast, 28 kVp Mo-Mo spectrum). The thinner skin dimensions found in this study suggest that the current D{sub gN} values used for mammographic dosimetry lead to a slight underestimate in glandular dose.

  17. Mammographic findings after breast cancer treatment with local excision and definitive irradiation

    SciTech Connect

    Dershaw, D.D.; Shank, B.; Reisinger, S.

    1987-08-01

    Following local excision and definitive irradiation of 163 breast cancers in 160 women, alterations in mammographic patterns were observed for up to 7 years. Skin thickening was observed in 96% of mammograms obtained within 1 year of completing therapy and was most pronounced in women treated with iridium implant, chemotherapy, or axillary dissection. In 76% of mammograms, alterations in the parenchymal pattern, including coarsening of stroma and increased breast density, were seen at 1 year. Neither skin nor parenchymal changes progressed after 1 year. Within 3 years of treatment the parenchymal density, which usually regressed, did not change in all patients. At 3 years skin thickness and the parenchymal pattern had returned to normal in less than 50% of the breasts of these women. Scars developed in approximately one-quarter of women. They were present on the initial post-treatment mammogram and remained unchanged on serial studies. Coarse, benign calcifications also developed in the breasts of about one-quarter of women. Microcalcifications developed in 11 breasts; biopsy specimens of six were benign. Benign microcalcifications may be related to therapy.

  18. Identification of corresponding lesions in multiple mammographic views using star-shaped iso-contours

    NASA Astrophysics Data System (ADS)

    Wiemker, Rafael; Kutra, Dominik; Heese, Harald; Buelow, Thomas

    2014-03-01

    It is common practice to assess lesions in two different mammographic views of each breast: medio-lateral oblique (MLO) and cranio-caudal (CC). We investigate methods that aim at automatic identification of a lesion which was indicated by the user in one view in the other view of the same breast. Automated matching of user indicated lesions has slightly different objectives than lesion segmentation or matching for improved computer aided detection, leading to different algorithmic choices. A novel computationally efficient algorithm is presented which is based on detection of star-shaped iso-contours with high sphericity and local consistency. The lesion likelihood is derived from a purely geometry based figure of merit and thus is invariant against monotonous intensity transformations (e.g. non-linear LUTs).Validation was carried out by virtue of FROC curves on a public database consisting of entirely digital mammograms with expert-delineated match pairs, showing superior performance as compared to gradient-based minimum cost path algorithms, with computation times faster by an order of magnitude and the potential of being fully parallelizable for GPU implementations.

  19. Evolution of mammographic image quality in the state of Rio de Janeiro*

    PubMed Central

    Villar, Vanessa Cristina Felippe Lopes; Seta, Marismary Horsth De; de Andrade, Carla Lourenço Tavares; Delamarque, Elizabete Vianna; de Azevedo, Ana Cecília Pedrosa

    2015-01-01

    Objective To evaluate the evolution of mammographic image quality in the state of Rio de Janeiro on the basis of parameters measured and analyzed during health surveillance inspections in the period from 2006 to 2011. Materials and Methods Descriptive study analyzing parameters connected with imaging quality of 52 mammography apparatuses inspected at least twice with a one-year interval. Results Amongst the 16 analyzed parameters, 7 presented more than 70% of conformity, namely: compression paddle pressure intensity (85.1%), films development (72.7%), film response (72.7%), low contrast fine detail (92.2%), tumor mass visualization (76.5%), absence of image artifacts (94.1%), mammography-specific developers availability (88.2%). On the other hand, relevant parameters were below 50% conformity, namely: monthly image quality control testing (28.8%) and high contrast details with respect to microcalcifications visualization (47.1%). Conclusion The analysis revealed critical situations in terms of compliance with the health surveillance standards. Priority should be given to those mammography apparatuses that remained non-compliant at the second inspection performed within the one-year interval. PMID:25987749

  20. Basic physics and doubts about relationship between mammographically determined tissue density and breast cancer risk.

    PubMed

    Kopans, Daniel B

    2008-02-01

    Numerous studies have suggested a link between breast tissue patterns, as defined with mammography, and risk for breast cancer. There may be a relationship, but the author believes all of these studies have methodological flaws. It is impossible, with the parameters used in these studies, to accurately measure the percentage of tissues by volume when two-dimensional x-ray mammographic images are used. Without exposure values, half-value layer information, and knowledge of the compressed thickness of the breast, an accurate volume of tissue cannot be calculated. The great variability in positioning the breast for a mammogram is also an uncontrollable factor in measuring tissue density. Computerized segmentation algorithms can accurately assess the percentage of the x-ray image that is "dense," but this does not accurately measure the true volume of tissue. Since the percentage of dense tissue is ultimately measured in relation to the complete volume of the breast, defining the true boundaries of the breast is also a problem. Studies that purport to show small percentage differences between groups are likely inaccurate. Future investigations need to use three-dimensional information. (c) RSNA, 2008.

  1. Hemodynamic signature of breast cancer under fractional mammographic compression using a dynamic diffuse optical tomography system

    PubMed Central

    Carp, Stefan A.; Sajjadi, Amir Y.; Wanyo, Christy M.; Fang, Qianqian; Specht, Michelle C.; Schapira, Lidia; Moy, Beverly; Bardia, Aditya; Boas, David A.; Isakoff, Steven J.

    2013-01-01

    Near infrared dynamic diffuse optical tomography measurements of breast hemodynamics during fractional mammographic compression offer a novel contrast mechanism for detecting breast cancer and monitoring chemotherapy. Tissue viscoelastic relaxation during the compression period leads to a slow reduction in the compression force and reveals biomechanical and metabolic differences between healthy and lesion tissue. We measured both the absolute values and the temporal evolution of hemoglobin concentration during 25-35 N of compression for 22 stage II and III breast cancer patients scheduled to undergo neoadjuvant chemotherapy. 17 patients were included in the group analysis (average tumor size 3.2 cm, range: 1.3-5.7 cm). We observed a statistically significant differential decrease in total and oxy-hemoglobin, as well as in hemoglobin oxygen saturation in tumor areas vs. healthy tissue, as early as 30 seconds into the compression period. The hemodynamic contrast is likely driven by the higher tumor stiffness and different viscoelastic relaxation rate, as well as the higher tumor oxygen metabolism rate. PMID:24409390

  2. ACR Appropriateness Criteria® on nonpalpable mammographic findings (excluding calcifications).

    PubMed

    Newell, Mary S; Birdwell, Robyn L; D'Orsi, Carl J; Bassett, Lawrence W; Mahoney, Mary C; Bailey, Lisa; Berg, Wendie A; Harvey, Jennifer A; Herman, Cheryl R; Kaplan, Stuart S; Liberman, Laura; Mendelson, Ellen B; Parikh, Jay R; Rabinovitch, Rachel; Rosen, Eric L; Sutherland, M Linda

    2010-12-01

    Screening mammography can detect breast cancer before it becomes clinically apparent. However, the screening process identifies many false-positive findings for each cancer eventually confirmed. Additional tools are available to help differentiate spurious findings from real ones and to help determine when tissue sampling is required, when short-term follow-up will suffice, or whether the finding can be dismissed as benign. These tools include additional diagnostic mammographic views, breast ultrasound, breast MRI, and, when histologic evaluation is required, percutaneous biopsy. The imaging evaluation of a finding detected at screening mammography proceeds most efficiently, cost-effectively, and with minimization of radiation dose when approached in an evidence-based manner. The appropriateness of the above-referenced tools is presented here as they apply to a variety of findings often encountered on screening mammography; an algorithmic approach to workup of these potential scenarios is also included. The recommendations put forth represent a compilation of evidence-based data and expert opinion of the ACR Appropriateness Criteria(®) Expert Panel on Breast Imaging. Copyright © 2010 American College of Radiology. Published by Elsevier Inc. All rights reserved.

  3. Pixelated CdTe detectors to overcome intrinsic limitations of crystal based positron emission mammographs

    NASA Astrophysics Data System (ADS)

    De Lorenzo, G.; Chmeissani, M.; Uzun, D.; Kolstein, M.; Ozsahin, I.; Mikhaylova, E.; Arce, P.; Cañadas, M.; Ariño, G.; Calderón, Y.

    2013-01-01

    A positron emission mammograph (PEM) is an organ dedicated positron emission tomography (PET) scanner for breast cancer detection. State-of-the-art PEMs employing scintillating crystals as detection medium can provide metabolic images of the breast with significantly higher sensitivity and specificity with respect to standard whole body PET scanners. Over the past few years, crystal PEMs have dramatically increased their importance in the diagnosis and treatment of early stage breast cancer. Nevertheless, designs based on scintillators are characterized by an intrinsic deficiency of the depth of interaction (DOI) information from relatively thick crystals constraining the size of the smallest detectable tumor. This work shows how to overcome such intrinsic limitation by substituting scintillating crystals with pixelated CdTe detectors. The proposed novel design is developed within the Voxel Imaging PET (VIP) Pathfinder project and evaluated via Monte Carlo simulation. The volumetric spatial resolution of the VIP-PEM is expected to be up to 6 times better than standard commercial devices with a point spread function of 1 mm full width at half maximum (FWHM) in all directions. Pixelated CdTe detectors can also provide an energy resolution as low as 1.5% FWHM at 511 keV for a virtually pure signal with negligible contribution from scattered events.

  4. Pixelated CdTe detectors to overcome intrinsic limitations of crystal based positron emission mammographs.

    PubMed

    De Lorenzo, G; Chmeissani, M; Uzun, D; Kolstein, M; Ozsahin, I; Mikhaylova, E; Arce, P; Cañadas, M; Ariño, G; Calderón, Y

    2013-01-01

    A positron emission mammograph (PEM) is an organ dedicated positron emission tomography (PET) scanner for breast cancer detection. State-of-the-art PEMs employing scintillating crystals as detection medium can provide metabolic images of the breast with significantly higher sensitivity and specificity with respect to standard whole body PET scanners. Over the past few years, crystal PEMs have dramatically increased their importance in the diagnosis and treatment of early stage breast cancer. Nevertheless, designs based on scintillators are characterized by an intrinsic deficiency of the depth of interaction (DOI) information from relatively thick crystals constraining the size of the smallest detectable tumor. This work shows how to overcome such intrinsic limitation by substituting scintillating crystals with pixelated CdTe detectors. The proposed novel design is developed within the Voxel Imaging PET (VIP) Pathfinder project and evaluated via Monte Carlo simulation. The volumetric spatial resolution of the VIP-PEM is expected to be up to 6 times better than standard commercial devices with a point spread function of 1 mm full width at half maximum (FWHM) in all directions. Pixelated CdTe detectors can also provide an energy resolution as low as 1.5% FWHM at 511 keV for a virtually pure signal with negligible contribution from scattered events.

  5. Pixelated CdTe detectors to overcome intrinsic limitations of crystal based positron emission mammographs

    PubMed Central

    De Lorenzo, G.; Chmeissani, M.; Uzun, D.; Kolstein, M.; Ozsahin, I.; Mikhaylova, E.; Arce, P.; Cañadas, M.; Ariño, G.; Calderón, Y.

    2013-01-01

    A positron emission mammograph (PEM) is an organ dedicated positron emission tomography (PET) scanner for breast cancer detection. State-of-the-art PEMs employing scintillating crystals as detection medium can provide metabolic images of the breast with significantly higher sensitivity and specificity with respect to standard whole body PET scanners. Over the past few years, crystal PEMs have dramatically increased their importance in the diagnosis and treatment of early stage breast cancer. Nevertheless, designs based on scintillators are characterized by an intrinsic deficiency of the depth of interaction (DOI) information from relatively thick crystals constraining the size of the smallest detectable tumor. This work shows how to overcome such intrinsic limitation by substituting scintillating crystals with pixelated CdTe detectors. The proposed novel design is developed within the Voxel Imaging PET (VIP) Pathfinder project and evaluated via Monte Carlo simulation. The volumetric spatial resolution of the VIP-PEM is expected to be up to 6 times better than standard commercial devices with a point spread function of 1 mm full width at half maximum (FWHM) in all directions. Pixelated CdTe detectors can also provide an energy resolution as low as 1.5% FWHM at 511 keV for a virtually pure signal with negligible contribution from scattered events. PMID:23750176

  6. Consumption of sweet foods and mammographic breast density: a cross-sectional study

    PubMed Central

    2014-01-01

    Background The increasing consumption of sugar worldwide seems to lead to several health problems, including some types of cancer. While some studies reported a positive association between sweet foods intake and breast cancer risk, little is known about their relation to mammographic density (MD), a strong breast cancer risk factor. This study examined the association of sweet foods and drinks intake with MD among 776 premenopausal and 779 postmenopausal women recruited at mammography. Methods A food-frequency questionnaire was used to assess intake of sweet foods, sugar-sweetened beverages and spoonsful of sugar added. Percent and absolute breast density were estimated using a computer-assisted method. Multivariate generalized linear models were used to evaluate associations. All models were adjusted for potential confounders, including age and body mass index. Results For increasing quartiles of sugar-sweetened beverages intake, adjusted-mean absolute density was respectively 32, 34, 32 and 36 cm2 among all women (Ptrend = 0.040) and 43, 46, 44 and 51 cm2 among premenopausal women (Ptrend = 0.007). For increasing quartiles of sweet foods intake, adjusted-mean percent density was respectively 16, 16, 17 and 19% among postmenopausal women (Ptrend = 0.036). No association was shown between intake of spoonsful of sugar added and MD. Conclusion Our results suggest that an increase in sweet foods or sugar-sweetened beverage intake is associated with higher MD. PMID:24969543

  7. Results of a pilot programme of mammographic breast cancer screening in the Western Cape.

    PubMed

    Apffelstaedt, J P; Hattingh, R; Baatjes, K; Wessels, N

    2014-04-01

    Mammographic screening programmes are now established in developing countries. We present an analysis of the first screening programme in sub-Saharan Africa. Women aged > or = 40 years were identified at three primary healthcare centres in the Western Cape Province, South Africa, and after giving informed consent underwent mammography at a mobile unit. After a single reading, patients with American College of Radiology Breast Imaging Reporting and Data System (BIRADS) 3 - 5 lesions were referred to a tertiary centre for further management. Between 1 February 2011 and 31 August 2012, 2 712 screening mammograms were performed. A total of 261 screening mammograms were reported as BIRADS 3 - 5 (recall rate 9.6%). Upon review of the 250 available screening mammograms, 58 (23%) were rated benign or no abnormalities (BIRADS 1 and 2) and no further action was taken. In 32 women, tissue was acquired (biopsy rate for the series 1.2%); 10 cancers were diagnosed (biopsy malignancy rate 31%). For the entire series of 2 712 screening mammograms, the cancer diagnosis rate was 3.7/1 000 examinations. Of 10 cancers diagnosed at screening, 5 were TNM clinical stage 0, 2 stage I and 3 stage II. The low cancer detection rate achieved, and the technical and multiple administrative problems experienced do not justify installation of a screening programme using the model utilised in this series.

  8. Increased vitamin D and calcium intake associated with reduced mammographic breast density among premenopausal women

    PubMed Central

    Fair, Alecia Malin; Lewis, Toni J.; Sanderson, Maureen; Dupont, William D.; Fletcher, Sarah; Egan, Kathleen M.; Disher, Anthony C.

    2015-01-01

    Vitamin D has been identified as a weak protective factor for postmenopausal breast cancer (relative risk [RR]~0.9), while high breast density has been identified as a strong risk factor (RR~4–6). To test the hypothesis that there is an association between vitamin D intake, but not circulating vitamin D levels, and mammographic breast density among women in our study we conducted a cross-sectional study of 165 screening mammography patients at Nashville General Hospital’s Breast Health Center (NGH-BHC), a public facility serving medically indigent and underserved women. Dietary and total (dietary plus supplements) vitamin D, calcium intakes were estimated by the AAFQ and blood samples were analyzed for 25-Hydroxyvitamin D [25(OH)D3]. Average percent breast density for the left and right breasts combined was estimated from digitized films using an interactive-thresholding method available through Cumulus software. After statistical adjustment for age, race and body mass index, the results revealed there were significant trends of decreasing breast density with increasing vitamin D and calcium intake among premenopausal, but not among postmenopausal women. There was no association between serum vitamin D and breast density in pre- or postmenopausal women. Confirmation of our findings in larger studies may assist in clarifying the role of vitamin D in breast density. PMID:26321093

  9. Inter-observer variability within BI-RADS and RANZCR mammographic density assessment schemes

    NASA Astrophysics Data System (ADS)

    Damases, Christine N.; Mello-Thoms, Claudia; McEntee, Mark F.

    2016-03-01

    This study compares variability associated with two visual mammographic density (MD) assessment methods using two separate samples of radiologists. The image test-set comprised of images obtained from 20 women (age 42-89 years). The images were assessed for their MD by twenty American Board of Radiology (ABR) examiners and twenty-six radiologists registered with the Royal Australian and New Zealand College of Radiologists (RANZCR). Images were assessed using the same technology and conditions, however the ABR radiologists used the BI-RADS and the RANZCR radiologists used the RANZCR breast density synoptic. Both scales use a 4-point assessment. The images were then grouped as low- and high-density; low including BIRADS 1 and 2 or RANZCR 1 and 2 and high including BI-RADS 3 and 4 or RANZCR 3 and 4. Four-point BI-RADS and RANZCR showed no or negligible correlation (ρ=-0.029 p<0.859). The average inter-observer agreement on the BI-RADS scale had a Kappa of 0.565; [95% CI = 0.519 - 0.610], and ranged between 0.328-0.669 while the inter-observer agreement using the RANZCR scale had a Kappa of 0.360; [95% CI = 0.308 - 0.412] and a range of 0.078-0.499. Our findings show a wider range of inter-observer variability among RANZCR registered radiologists than the ABR examiners.

  10. Mammographic density is the main correlate of tumors detected on ultrasound but not on mammography.

    PubMed

    Häberle, Lothar; Fasching, Peter A; Brehm, Barbara; Heusinger, Katharina; Jud, Sebastian M; Loehberg, Christian R; Hack, Carolin C; Preuss, Caroline; Lux, Michael P; Hartmann, Arndt; Vachon, Celine M; Meier-Meitinger, Martina; Uder, Michael; Beckmann, Matthias W; Schulz-Wendtland, Rüdiger

    2016-11-01

    Although mammography screening programs do not include ultrasound examinations, some diagnostic units do provide women with both mammography and ultrasonography. This article is concerned with estimating the risk of a breast cancer patient diagnosed in a hospital-based mammography unit having a tumor that is visible on ultrasound but not on mammography. A total of 1,399 women with invasive breast cancer from a hospital-based diagnostic mammography unit were included in this retrospective study. For inclusion, mammograms from the time of the primary diagnosis had to be available for computer-assisted assessment of percentage mammographic density (PMD), as well as Breast Imaging Reporting and Data System (BIRADS) assessment of mammography. In addition, ultrasound findings were available for the complete cohort as part of routine diagnostic procedures, regardless of any patient or imaging characteristics. Logistic regression analyses were conducted to identify predictors of mammography failure, defined as BIRADS assessment 1 or 2. The probability that the visibility of a tumor might be masked at diagnosis was estimated using a regression model with the identified predictors. Tumors were only visible on ultrasound in 107 cases (7.6%). PMD was the strongest predictor for mammography failure, but age, body mass index and previous breast surgery also influenced the risk, independently of the PMD. Risk probabilities ranged from 1% for a defined low-risk group up to 40% for a high-risk group. These findings might help identify women who should be offered ultrasound examinations in addition to mammography.

  11. Talking and Thinking about Qualitative Research

    ERIC Educational Resources Information Center

    Ellis, Carolyn; Bochner, Arthur; Denzin, Norman; Lincoln, Yvonna; Morse, Janice; Pelias, Ronald; Richardson, Laurel

    2008-01-01

    This script comes from an edited transcript of a session titled "Talking and Thinking About Qualitative Research," which was part of the 2006 International Congress of Qualitative Inquiry, held at the University of Illinois at Urbana-Champaign on May 4-6, 2006. This special session featured scholars informally responding to questions about their…

  12. Talking and Thinking about Qualitative Research

    ERIC Educational Resources Information Center

    Ellis, Carolyn; Bochner, Arthur; Denzin, Norman; Lincoln, Yvonna; Morse, Janice; Pelias, Ronald; Richardson, Laurel

    2008-01-01

    This script comes from an edited transcript of a session titled "Talking and Thinking About Qualitative Research," which was part of the 2006 International Congress of Qualitative Inquiry, held at the University of Illinois at Urbana-Champaign on May 4-6, 2006. This special session featured scholars informally responding to questions about their…

  13. Insulin-like growth factor-1, insulin-like growth factor-binding protein-3, growth hormone, and mammographic density in the Nurses' Health Studies.

    PubMed

    Rice, Megan S; Tworoger, Shelley S; Rosner, Bernard A; Pollak, Michael N; Hankinson, Susan E; Tamimi, Rulla M

    2012-12-01

    Higher circulating insulin-like growth factor I (IGF-1) levels have been associated with higher mammographic density among women in some, but not all studies. Also, few studies have examined the association between mammographic density and circulating growth hormone (GH) in premenopausal women. We conducted a cross-sectional study among 783 premenopausal women and 436 postmenopausal women who were controls in breast cancer case-control studies nested in the Nurses' Health Study (NHS) and NHSII. Participants provided blood samples in 1989-1990 (NHS) or in 1996-1999 (NHSII), and mammograms were obtained near the time of blood draw. Generalized linear models were used to assess the associations of IGF-1, IGF-binding protein-3 (IGFBP-3), IGF-1:IGFBP-3 ratio, and GH with percent mammographic density, total dense area, and total non-dense area. Models were adjusted for potential confounders including age and body mass index (BMI), among others. We also assessed whether the associations varied by age or BMI. In both pre- and postmenopausal women, percent mammographic density was not associated with plasma levels of IGF-1, IGFBP-3, or the IGF-1:IGFBP-3 ratio. In addition, GH was not associated with percent density among premenopausal women in the NHSII. Similarly, total dense area and non-dense area were not significantly associated with any of these analytes. In postmenopausal women, IGF-1 was associated with higher percent mammographic density among women with BMI <25 kg/m(2), but not among overweight/obese women. Overall, plasma IGF-1, IGFBP-3, and GH levels were not associated with mammographic density in a sample of premenopausal and postmenopausal women.

  14. Digitized assessment of mammographic breast density--effects of continuous combined hormone therapy, tibolone and black cohosh compared to placebo.

    PubMed

    Lundström, E; Hirschberg, A L; Söderqvist, G

    2011-12-01

    To determine the effects of continuous combined hormone therapy, tibolone, black cohosh, and placebo on digitized mammographic breast density in postmenopausal women. A prospective, double-blind, placebo-controlled study of 154 postmenopausal women randomized to estradiol 2 mg/norethisterone acetate 1 mg (E2/NETA), tibolone 2.5 mg or placebo and a prospective, open, uncontrolled drug safety study, of which 65 postmenopausal women were treated with black cohosh. Mammograms, at baseline and after six months of treatment, were previously classified according to visual quantification scales. Reanalysis of assessable mammograms by digitized quantification of breast density. Treatment groups were comparable at baseline. During treatment, both E2/NETA and tibolone significantly increased breast density (mean increase 14.3%, p<0.001 and 2.3%, p<0.001, respectively), while black cohosh and placebo did not. Twenty-four out of the 43 women on E2/NETA had an increase in density exceeding 10% and 6 women had an increase of 30% or more. In the tibolone group, only one woman had an increase in density of more than 10%. The difference in increase in breast density between E2/NETA on the one hand and tibolone, black cohosh and placebo on the other was highly significant (p<0.0001). Digitized mammographic breast density is a highly sensitive method confirming significant increase in density by standard E2/NETA treatment and to a lesser extent by tibolone, whereas black cohosh does not influence mammographic breast density during six months treatment. Digitized assessment also yields data on individual variation and small increases left undetectable by visual classification. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  15. Management of Clinically and Mammographically Occult Benign Papillary Lesions Diagnosed at Ultrasound-Guided 14-Gauge Breast Core Needle Biopsy.

    PubMed

    Moon, Sung Mo; Jung, Hae Kyoung; Ko, Kyung Hee; Kim, Youdong; Lee, Kyong Sik

    2016-11-01

    To determine how to manage clinically and mammographically occult benign papillary lesions diagnosed at ultrasound (US)-guided 14-gauge breast core needle biopsy (CNB) by evaluating their upgrade rates. From our pathologic database of US-guided 14-gauge breast CNB, 69 benign papillomas and 9 atypical papillomas with available subsequent excisional findings (surgery or vacuum-assisted removal with additional US follow-up for ≥2 years) or US follow-up alone (≥2 years) were included in this study. We analyzed their upgrade rates by using excisional or US follow-up findings, with no change at 2 years as the reference standard. Patient age, lesion size, lesion distance from the nipple, multiplicity, imaging-histologic concordance, and histologic findings were compared between groups with and without upgrades by statistical analysis. Surgical excision was performed in 53 (67.9%) of 78 benign papillary lesions and revealed 5 upgrades (11.4%) to atypical papillomas in 44 benign papillomas and 2 upgrades (22.2%) to ductal carcinomas in situ in 9 atypical papillomas. Among 12 benign papillomas (15.4%) with vacuum-assisted removal and US follow-up (≥2 years), 1 (8.3%) was upgraded to atypical papilloma. The remaining 13 benign papillomas (16.7%) were followed with US and were stable after a 2-year follow-up period. There were no significant differences in the variables between the groups. Uniform surgical excision is not a reasonable management strategy for clinically and mammographically occult benign papillary lesions diagnosed at US-guided 14-gauge breast CNB. Clinically and mammographically occult benign papillary lesions may be subsequently managed by vacuum-assisted removal or imaging follow-up if atypia is not found. © 2016 by the American Institute of Ultrasound in Medicine.

  16. Mammographic density and risk of breast cancer by adiposity: an analysis of four case-control studies.

    PubMed

    Conroy, Shannon M; Woolcott, Christy G; Koga, Karin R; Byrne, Celia; Nagata, Chisato; Ursin, Giske; Vachon, Celine M; Yaffe, Martin J; Pagano, Ian; Maskarinec, Gertraud

    2012-04-15

    The association of mammographic breast density with breast cancer risk may vary by adiposity. To examine effect modification by body mass index (BMI), the authors standardized mammographic density data from four case-control studies (1994-2002) conducted in California, Hawaii and Minnesota and Gifu, Japan. The 1,699 cases and 2,422 controls included 45% Caucasians, 40% Asians and 9% African-Americans. Using ethnic-specific BMI cut points, 34% were classified as overweight and 19% as obese. A single reader assessed density from mammographic images using a computer-assisted method. Logistic regression was used to estimate odds ratios (OR) and 95% confidence intervals (95% CI) while adjusting for potential confounders. Modest heterogeneity in the relation between percent density and breast cancer risk across studies was observed (p(heterogeneity) = 0.08). Cases had a greater age-adjusted mean percent density than controls: 31.7% versus 28.5%, respectively (p <0.001). Relative to <20 percent density, the ORs for >35 were similar across BMI groups whereas the OR for 20-35 was slightly higher in overweight (OR = 1.69, 95% CI: 1.28, 2.24) and obese (OR = 1.62, 95% CI: 1.12, 2.33) than in normal weight women (OR = 1.49, 95% CI: 1.11, 2.01). Furthermore, limited evidence of effect modification by BMI of the OR per 10% increase in percent density (p(interaction) = 0.06) was observed, including subgroup analyses by menopausal status and in analyses that excluded women at the extremes of the BMI scale. Our findings indicate little, if any, modification by BMI of the effects of breast density on breast cancer risk. Copyright © 2011 UICC.

  17. Effect of a low-fat, high-carbohydrate dietary intervention on change in mammographic density over menopause.

    PubMed

    Martin, Lisa J; Greenberg, Carolyn V; Kriukov, Valentina; Minkin, Salomon; Jenkins, David J A; Yaffe, Martin; Hislop, Gregory; Boyd, Norman F

    2009-01-01

    We have previously shown that a low-fat dietary intervention for 2 years in women with extensive mammographic density decreased mammographic density to a greater extent than in the control group. Post-hoc analysis indicated that this effect was strongest in women who became postmenopausal during the follow-up period. The purpose of the present study was to determine if this potentially important finding could be confirmed in a new and larger group of subjects with a longer follow-up time. Participants in a low-fat dietary intervention trial who were premenopausal at entry and became postmenopausal during follow-up were examined. Total breast, dense, and non-dense area and percent density were measured in baseline and postmenopause mammograms using a computer-assisted method. Total breast and non dense area increased more in the control group compared to the intervention group (for breast area 2.6 and 0.2 cm(2), respectively; P=0.05, and for non-dense area 10.9 and 8.1 cm(2), respectively; P=0.06). Dense area decreased to a similar degree in both groups (-8.2 and -8.0 cm(2), respectively; P=0.84). Percent density decreased to a slightly greater degree in the control compared to intervention group (-9.4 and -7.8%, respectively, P=0.11). There were no significant differences between study groups after adjustment for weight change. Menopause reduced density to a similar extent in the low-fat diet and control groups. If a low-fat diet reduces breast cancer risk, the effect is unlikely to be through changes in mammographic density at menopause.

  18. Significance of MPEG-7 textural features for improved mass detection in mammography.

    PubMed

    Eltonsy, Nevine H; Tourassi, Georgia D; Fadeev, Aleksey; Elmaghraby, Adel S

    2006-01-01

    The purpose of the study is to investigate the significance of MPEG-7 textural features for improving the detection of masses in screening mammograms. The detection scheme was originally based on morphological directional neighborhood features extracted from mammographic regions of interest (ROIs). Receiver Operating Characteristics (ROC) was performed to evaluate the performance of each set of features independently and merged into a back-propagation artificial neural network (BPANN) using the leave-one-out sampling scheme (LOOSS). The study was based on a database of 668 mammographic ROIs (340 depicting cancer regions and 328 depicting normal parenchyma). Overall, the ROC area index of the BPANN using the directional morphological features was Az=0.85+/-0.01. The MPEG-7 edge histogram descriptor-based BPNN showed an ROC area index of Az=0.71+/-0.01 while homogeneous textural descriptors using 30 and 120 channels helped the BPNN achieve similar ROC area indexes of Az=0.882+/-0.02 and Az=0.877+/-0.01 respectively. After merging the MPEG-7 homogeneous textural features with the directional neighborhood features the performance of the BPANN increased providing an ROC area index of Az=0.91+/-0.01. MPEG-7 homogeneous textural descriptor significantly improved the morphology-based detection scheme.

  19. Vision 20/20: Mammographic breast density and its clinical applications

    SciTech Connect

    Ng, Kwan-Hoong Lau, Susie

    2015-12-15

    Breast density is a strong predictor of the failure of mammography screening to detect breast cancer and is a strong predictor of the risk of developing breast cancer. The many imaging options that are now available for imaging dense breasts show great promise, but there is still the question of determining which women are “dense” and what imaging modality is suitable for individual women. To date, mammographic breast density has been classified according to the Breast Imaging-Reporting and Data System (BI-RADS) categories from visual assessment, but this is known to be very subjective. Despite many research reports, the authors believe there has been a lack of physics-led and evidence-based arguments about what breast density actually is, how it should be measured, and how it should be used. In this paper, the authors attempt to start correcting this situation by reviewing the history of breast density research and the debates generated by the advocacy movement. The authors review the development of breast density estimation from pattern analysis to area-based analysis, and the current automated volumetric breast density (VBD) analysis. This is followed by a discussion on seeking the ground truth of VBD and mapping volumetric methods to BI-RADS density categories. The authors expect great improvement in VBD measurements that will satisfy the needs of radiologists, epidemiologists, surgeons, and physicists. The authors believe that they are now witnessing a paradigm shift toward personalized breast screening, which is going to see many more cancers being detected early, with the use of automated density measurement tools as an important component.

  20. Mammographic Density and Prediction of Nodal Status in Breast Cancer Patients

    PubMed Central

    Hack, C. C.; Häberle, L.; Geisler, K.; Schulz-Wendtland, R.; Hartmann, A.; Fasching, P. A.; Uder, M.; Wachter, D. L.; Jud, S. M.; Loehberg, C. R.; Lux, M. P.; Rauh, C.; Beckmann, M. W.; Heusinger, K.

    2013-01-01

    Aim: Nodal status remains one of the most important prognostic factors in breast cancer. The cellular and molecular reasons for the spread of tumor cells to the lymph nodes are not well understood and there are only few predictors in addition to tumor size and multifocality that give an insight into additional mechanisms of lymphatic spread. Aim of our study was therefore to investigate whether breast characteristics such as mammographic density (MD) add to the predictive value of the presence of lymph node metastases in patients with primary breast cancer. Methods: In this retrospective study we analyzed primary, metastasis-free breast cancer patients from one breast center for whom data on MD and staging information were available. A total of 1831 patients were included into this study. MD was assessed as percentage MD (PMD) using a semiautomated method and two readers for every patient. Multiple logistic regression analyses with nodal status as outcome were used to investigate the predictive value of PMD in addition to age, tumor size, Ki-67, estrogen receptor (ER), progesterone receptor (PR), grading, histology, and multi-focality. Results: Multifocality, tumor size, Ki-67 and grading were relevant predictors for nodal status. Adding PMD to a prediction model which included these factors did not significantly improve the prediction of nodal status (p = 0.24, likelihood ratio test). Conclusion: Nodal status could be predicted quite well with the factors multifocality, tumor size, Ki-67 and grading. PMD does not seem to play a role in the lymphatic spread of tumor cells. It could be concluded that the amount of extracellular matrix and stromal cell content of the breast which is reflected by MD does not influence the probability of malignant breast cells spreading from the primary tumor to the lymph nodes. PMID:24771910

  1. Mammographic Breast Density and Subsequent Risk of Breast Cancer in Postmenopausal Women According to Tumor Characteristics

    PubMed Central

    Yaghjyan, Lusine; Colditz, Graham A.; Collins, Laura C.; Schnitt, Stuart J.; Rosner, Bernard; Vachon, Celine

    2011-01-01

    The findings suggest that higher mammographic density is associated with more aggressive tumor characteristics and also with in situ tumors. PMID:21795664

  2. Does surgical closure technique affect early mammographic detection of tumor recurrence after breast-conserving therapy?

    PubMed

    Newlin, Heather E; Indelicato, Daniel J; Abbitt, Patricia; Marshall, Julia; Wymer, David; Grobmyer, Stephen; Haigh, Linda; Copeland, Edward; Morris, Christopher G; Mendenhall, Nancy P

    2009-10-01

    Scarring in the tumor bed may mask or mimic local recurrence of tumor on surveillance mammography. Type of surgical closure technique used during lumpectomy may impact the pattern or density of scar tissue apparent in the tumor bed on mammography. This study sought to determine whether surgical closure type affects tumor-bed scar formation and impacts interpretation of surveillance mammography in women treated with breast-conserving therapy for early-stage breast cancer. One hundred women who received breast-conserving therapy were selected; 99 of them had 2-year post-treatment mammograms for the treated breast. Craniocaudal and mediolateral oblique views were reviewed by 3 subspecialty radiologists who routinely read mammograms. The mammograms were scored on 5-point scales for overall breast density and scarring within the tumor bed. The analyses did not demonstrate greater scarring or density in breast status post superficial closure compared with breast status post full-thickness closure, or vice versa (P > 0.05 for scarring and density). There were no detectable differences between the 2 closure techniques either within the data from individual reviewers, within the composite data for the entire group of reviewers, or in instances where 2 of 3 reviewers agreed (P > 0.05). There was significant interobserver variability in scoring among the mammographers for both scarring (P = 0.001) and density (P < 0.0001). Based on our study of the 2-year post-treatment mammograms, there was no evidence that closure technique impacts degree of scarring in the tumor bed. However, striking interobserver variability in scoring density and scarring was noted.

  3. Associated factors with mammographic changes in women undergoing breast cancer screening

    PubMed Central

    de Sant'Ana, Ricardo Soares; Mattos, Jacó Saraiva de Castro; da Silva, Anderson Soares; de Mello, Luanes Marques; Nunes, Altacílio Aparecido

    2016-01-01

    ABSTRACT Objective: To evaluate association of sociodemographic, anthropometric, and epidemiological factors with result of mammogram in women undergoing breast cancer screening. Methods: This is a cross-sectional study with data obtained through interviews, anthropometric measurements, and mammography of 600 women aged 40 to 69 years at the Preventive Medicine Department of Hospital de Câncer de Barretos, Brazil, in 2014. The results of these examinations in the BI-RADS categories 1 and 2 were grouped and classified in this study as normal mammogram outcome, and those of BI-RADS categories 3, 4A, 4B, 4C, and 5 were grouped and classified as altered mammogram outcome. The statistical analysis included the Student's t-test to compare means, as well as odds ratios (OR), with their corresponding 95% confidence intervals (95%CI), to verify an association by means of the multivariate analysis. Results: Of 600 women evaluated, 45% belonged to the age group of 40–49 years-old and 60.2% were classified as BI-RADS category 2. The multivariate analysis showed that women with blood hypertension (OR: 2.64; 95%CI: 1.07–6.49; p<0.05) were more likely to present changes in the mammography, while physical activity was associated with lower chances (OR: 0.30; 95%CI: 0.11–0.81; p<0.05). Conclusion: Hypertensive women undergoing screening mammography are more likely to present mammographic changes, whereas women practicing physical activity have lower chances (70%) of presenting changes in the breast compared with sedentary individuals. PMID:27759819

  4. Outcomes of Preoperative MRI-Guided Needle Localization of Nonpalpable Mammographically Occult Breast Lesions.

    PubMed

    Gao, Yiming; Bagadiya, Neeti R; Jardon, Meghan L; Heller, Samantha L; Melsaether, Amy N; Toth, Hildegard B; Moy, Linda

    2016-09-01

    MRI-guided needle localization allows access to MRI-detected mammographically occult breast lesions that are not amenable to MRI-guided biopsy. The purpose of this study was to examine the safety and outcomes of MRI-guided needle localization. Ninety-nine consecutive breast lesions that underwent preoperative MRI-guided needle localization were identified. Clinical indications for breast MRI, reasons for performing MRI-guided needle localization, and surgical pathology results were recorded. Lesion characteristics, procedure time, and complications were assessed. Of 99 lesions, 60 (60.6%) were in a location inaccessible for MRI biopsy, necessitating MRI-guided needle localization. Histologic evaluation revealed 38 (38.4%) carcinomas, 31 (31.3%) high-risk lesions, and 30 (30.3%) benign lesions. Carcinoma was more likely to be found in women with known cancer (31/61 [50.8%]; p = 0.003) than in women undergoing imaging for high-risk screening (2/18 [11.1%]) or problem solving (6/20 [30%]). Masses (p = 0.013) and foci (p < 0.001) were more likely to be malignant than were lesions with nonmass enhancement. Foci were significantly more often malignant compared with all other lesion types (9/10 [90%]; p < 0.001). The mean (± SD) procedure time was 32.9 ± 9.39 minutes. All lesions were occult on specimen radiographs. There were no procedure-related complications. The positive predictive value of MRI-guided needle localization (38.4%) is comparable to that of mammography- and tomosynthesis-guided localizations and is highest in women with a known diagnosis of cancer. It is highly accurate in targeting small enhancing lesions, thereby improving surgical management. MRI-guided needle localization is a safe, accurate, and time-efficient procedure.

  5. Longitudinal Change in Mammographic Density among ER-Positive Breast Cancer Patients Using Tamoxifen.

    PubMed

    Nyante, Sarah J; Sherman, Mark E; Pfeiffer, Ruth M; Berrington de Gonzalez, Amy; Brinton, Louise A; Bowles, Erin J Aiello; Hoover, Robert N; Glass, Andrew; Gierach, Gretchen L

    2016-01-01

    Tamoxifen-associated mammographic density (MD) reductions are linked to improved breast cancer survival. We evaluated MD at six time points to determine the timing of greatest reduction following tamoxifen initiation. We sampled 40 Kaiser Permanente Northwest estrogen receptor (ER)-positive breast cancer patients from a prior study of MD change, according to tamoxifen use duration and age at diagnosis: <4 years tamoxifen and ≤50 years (N = 6) or >50 years (N = 10) old; ≥4 years tamoxifen and ≤50 years (N = 13) or >50 years (N = 11) old. A single reader evaluated percent MD in the contralateral breast on baseline (pre-diagnosis) and five approximately yearly post-diagnostic (T1 to T5) mammograms. Mean MD change was calculated. Interactions with age (≤50 and >50 years), tamoxifen duration (<4 and ≥4 years), and baseline MD (tertiles) were tested in linear regression models. Overall, the largest MD decline occurred by T1 (mean 4.5%) with little additional decline by T5. Declines differed by tertile of baseline MD (Pinteraction < 0.01). In the highest tertile, the largest reduction occurred by T1 (mean 14.9%), with an additional reduction of 3.6% by T5. Changes were smaller in the middle and lowest baseline MD tertiles, with cumulative reductions of 3.0% and 0.4% from baseline to T5, respectively. There were no differences by age (Pinteraction = 0.36) or tamoxifen duration (Pinteraction = 0.42). Among ER-positive patients treated with tamoxifen and surviving ≥5 years, most of the MD reduction occurred within approximately 12 months of tamoxifen initiation, suggesting that MD measurement at a single time point following tamoxifen initiation can identify patients with substantial density declines.

  6. Clinical comparison of a novel breast DXA technique to mammographic density

    SciTech Connect

    Shepherd, John A.; Herve, Lionel; Landau, Jessie; Fan Bo; Kerlikowske, Karla; Cummings, Steve R.

    2006-05-15

    We compare mammography breast density (BD{sub MD}) to the measure of breast composition using a clinical dual energy absorptiometry (DXA) system (BD{sub DXA}) calibrated to measure breast density. A DXA scanning protocol was dev