Abstract
Histopathology is a well-established standard diagnosis employed for the majority of malignancies, including breast cancer. Nevertheless, despite training and standardization, it is considered operator-dependent and errors are still a concern. Fractal dimension analysis is a computational image processing technique that allows assessing the degree of complexity in patterns. We aimed here at providing a robust and easily attainable method for introducing computer-assisted techniques to histopathology laboratories. Slides from two databases were used: A) Breast Cancer Histopathological; and B) Grand Challenge on Breast Cancer Histology. Set A contained 2480 images from 24 patients with benign alterations, and 5429 images from 58 patients with breast cancer. Set B comprised 100 images of each type: normal tissue, benign alterations, in situ carcinoma, and invasive carcinoma. All images were analyzed with the FracLac algorithm in the ImageJ computational environment to yield the box count fractal dimension (Db) results. Images on set A on 40x magnification were statistically different (p = 0.0003), whereas images on 400x did not present differences in their means. On set B, the mean Db values presented promissing statistical differences when comparing. Normal and/or benign images to in situ and/or invasive carcinoma (all p < 0.0001). Interestingly, there was no difference when comparing normal tissue to benign alterations. These data corroborate with previous work in which fractal analysis allowed differentiating malignancies. Computer-aided diagnosis algorithms may beneficiate from using Db data; specific Db cut-off values may yield ~ 99% specificity in diagnosing breast cancer. Furthermore, the fact that it allows assessing tissue complexity, this tool may be used to understand the progression of the histological alterations in cancer.
Highlights
Breast cancer is the most incident malignancy in women across the world (Cardoso et al 2017)
Histopathology is a powerful tool in the diagnosis of breast cancer, as well as it is the standard diagnosis in the great majority of other malignancies
Characteristics of the datasets Both sets contain an impressive number of images derived from clinical specimens of breast cancer as well as benign alterations
Summary
Breast cancer is the most incident malignancy in women across the world (Cardoso et al 2017). Histopathology is a powerful tool in the diagnosis of breast cancer, as well as it is the standard diagnosis in the great majority of other malignancies. The histopathological diagnosis and further classification of breast cancer are at the core of prognosis and treatment decisions (Sinn and Kreipe 2013). Considering the possibility of interobserver differences when diagnosing malignancies, attempts to automate or employ algorithms to aid diagnosis gain attention. The ability to either fully diagnose or allow excluding images with specific features may be of great interest to improve the final diagnostic made by the pathology professional
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