Computer-aided-detection marker value and breast density in the detection of invasive lobular carcinoma

Abstract

Invasive Lobular Carcinoma (ILC) is frequently a mammographic and diagnostic dilemma; thus any additional information that CAD (Computer-Aided Detection) systems can give radiologists may be helpful. Our study was to evaluate the role of CAD numeric values as indicators of malignancy and the effect of breast density in the diagnosis of ILC. Eighty consecutive biopsy-proven ILC cases with CAD (ImageChecker®, Hologic | R2, Santa Clara, CA, versions 2.3, 3.1, 3.2, 5.0, 5.2) diagnosed between June 2002 and December 2004 were retrospectively reviewed. Data included: BIRADS® breast density, whether CAD marked the cancer at diagnosis year or years prior, and lesion type. Study mammograms underwent additional CAD scans (Image Checker® V5.3, V8.0, V8.1) to obtain a numeric value associated with each marker, low values represent increasingly suspicious features. CAD correctly marked 65% (52/80) of ILC cases, detection was found to decrease with increased breast density. Numeric values of CAD marks at sites of carcinoma showed median score of 171 (range 0 – 1121). The CAD marker may potentially be used as an additional indicator of suspicious lesion features in all breast densities and higher likelihood that an area on the mammogram requires further investigation.