Abstract
Young patients with dense breasts have a relatively low-positive biopsy rate for breast cancer (∼1 in 7). South Korean women have higher breast density than Westerners. We investigated the benefit of using a functional and metabolic imaging technique, diffuse optical spectroscopic imaging (DOSI), to help the standard of care imaging tools to distinguish benign from malignant lesions in premenopausal Korean women. DOSI uses near-infrared light to measure breast tissue composition by quantifying tissue concentrations of water (ctH2O), bulk lipid (ctLipid), deoxygenated (ctHHb), and oxygenated (ctHbO2) hemoglobin. DOSI spectral signatures specific to abnormal tissue and absent in healthy tissue were also used to form a malignancy index. This study included 19 premenopausal subjects (average age 41±9), corresponding to 11 benign and 10 malignant lesions. Elevated lesion to normal ratio of ctH2O, ctHHb, ctHbO2, total hemoglobin (THb=ctHHb+ctHbO2), and tissue optical index (ctHHb×ctH2O/ctLipid) were observed in the malignant lesions compared to the benign lesions (p<0.02). THb and malignancy index were the two best single predictors of malignancy, with >90% sensitivity and specificity. Malignant lesions showed significantly higher metabolism and perfusion than benign lesions. DOSI spectral features showed high discriminatory power for distinguishing malignant and benign lesions in dense breasts of the Korean population.
Highlights
Breast cancer is the second most commonly diagnosed cancer among South Korean women
The diffuse optical spectroscopic imaging (DOSI) probe was placed against the breast tissue and sequential measurements were taken in a rectangular grid pattern using 10-mm spacing
Weighting factors are determined by using computer processing through an iterative process for each wavelength region to determine what combination of values for each wavelength region would best separate the benign from the malignant lesions
Summary
Breast cancer is the second most commonly diagnosed cancer among South Korean women. The incidence of breast cancer has been continuously and rapidly increasing over the past 20 years in South Korea. Leproux et al.: Differential diagnosis of breast masses in South Korean premenopausal women using diffuse. Because of the high occurrence of premenopausal breast cancer patients in South Korea, it is critical to address these limitations in South Korean women. Spectroscopy provides concentrations of the main tissue absorbers (i.e., deoxy-hemoglobin, oxy-hemoglobin, water, and lipid), and informs about tissue perfusion and metabolism.[9] The spectral features of DOSI can reveal additional information about the molecular disposition of these and additional components that have been shown to be linked to the level of malignancy of a lesion.[10] These “specific tumor components (STC)” have been shown to identify tumors in dense breasts,[11] and to differentiate between benign and malignant breast lesions with 91% sensitivity and 94% specificity in a mixed cohort of pre- and postmenopausal women.[12]. The addition of optical spectroscopy may help reduce the need for biopsy in many false-positive cases, especially in young patients
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