Abstract
PurposeThe aim of this study was to evaluate the relevance of the three-dimensional (3D) structure of breast microcalcifications (MC) as a predictor of malignancy using highly resolved micro-computed tomography (micro-CT) datasets of biopsy samples.Material and MethodsThe study included 28 women with suspicious MC in their mammogram undergoing vacuum-assisted biopsy. Directly after the intervention, the specimens were scanned in a micro-CT with an isometric spatial resolution of 9 μm. Datasets were analysed regarding the number, volume and morphology of suspicious non-monomorphic MC (fl—fine linear, fp—fine pleomorphic, ch—coarse heterogeneous) and the structure model index (SMI). Histological evaluation was performed according to the B-classification: normal tissue or benign (group A: B1, B2), unclear malignant potential or suspicious of malignancy (group B: B3, B4) and malignant lesions (group C: B5).ResultsIn all groups, suspicious non-monomorphic MC were found: group A exhibited fp MC in 38.5% of samples, no fl/ch; group B: fl 14.3%, fp 28.6%, ch 14.3%; group C always had at least one type of suspicious non-monomorphic MC (fl (57.1%) or fp (57.1%)) in each sample. The different histologic groups showed a similar mean SMI (benign: 2.97 ± 0.31, malignant: 3.02 ± 0.10, unclear: 2.90 ± 0.28). Between the three groups, no significant differences were found regarding number, volume or SMI value of MC.Conclusion3D structure based on the SMI of MC analysed with highest spatial resolution is not significantly associated with the B-classification of breast lesions. Thus, magnification views of MC may be omitted in the analysis of MC detected in mammograms.
Highlights
Breast cancer is the most frequent malignancy in women, with yearly 1.38 million new breast cancer cases worldwide representing 10.9% of all new diagnosed cancer [1]
The World Health Organization (WHO) predicts that the importance of breast cancer is likely to increase in the decades in developing and developed countries due to the increased incidence of breast cancer caused by increased life expectancy [2]
The evaluation of mammograms is standardized according to the American College of Radiology (ACR) Breast Imaging Reporting and Data System (BIRADS) classification
Summary
Breast cancer is the most frequent malignancy in women, with yearly 1.38 million new breast cancer cases worldwide representing 10.9% of all new diagnosed cancer [1]. The World Health Organization (WHO) predicts that the importance of breast cancer is likely to increase in the decades in developing and developed countries due to the increased incidence of breast cancer caused by increased life expectancy [2]. These circumstances urge an improvement in early diagnosis, firstly to improve the outcome of patients and secondly to reduce the healthcare costs related to breast cancer therapy. According to the BIRADS classification, there are three categories of MC including typically benign, MC of intermediate concern and calcification with a high probability of malignancy. Benign calcifications are mostly larger, calcifications of intermediate concern are coarse heterogeneous and typical malignant MC are fine pleomorphic and fine linear [10]
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