Diagnosis Of Breast Disease Research Articles

A multi-level thresholding method for breast thermograms analysis using Dragonfly algorithm

Breast cancer is one of the most common diseases and the second cause of death in women around the world. The presence of a cancerous tumor increase temperature in the region near to it, such heating is then transferred to the skin surface. In this sense, screening seeks to help in cancer diagnostic process before symptoms became evident in a person, different imaging techniques are employed for this purpose (Mammography, Ultrasonography, X-ray, Magnetic Resonance, etc). In the past decade, thermography has shown its major potential to early diagnosis of breast diseases. Thermographic images provide information related to vascular or physiological changes and have some advantages regarding other diagnostic methods; they are non-ionizing, non-invasive, passive, painless and real-time screening. On the other hand, thresholding has been widely used to solve several problems. It is regularly the first step in the process of image analysis that uses histograms to classify the pixels in the image. Segmentation of medical digital images has been stated as an important task for several medical applications. This paper proposes a segmentation technique for thermographic images that consider the spatial information of the pixel contained in the image. This approach employs a novel optimization technique called the Dragonfly Algorithm to compute the best thresholds that segment the image. The experimental results exhibit a well-performance of the proposal in comparison to the other methods over a set of randomly selected thermograms retrieved from the Database for Research Mastology with Infrared Image. The presented proposed approach could provide a highly reliable clinical decision support, which aims to help clinicians in performing a diagnosis using thermography images.

Performance of TL and OSL techniques using CaSO4 and Al2O3 dosimeters for mean glandular dose (MGD) and entrance surface skin dose (ESD) determination in a digital mammographic unit as alternative dosimeters

The mammography is the most important and simple tool in the diagnosis of breast diseases in women. In digital mammography, the process of image acquisition, display and storage are separated which allows optimization of each. Despite the innumerous advantages of this technique, such as an accurate diagnosis for women with dense breast, it was noticed an increase of radiation doses to obtain the images by this system. As with any examination that includes x-rays, there is always a small stochastic risk of inducing cancer, it is therefore important to evaluate the risk from the dose delivered to the patient during the screening process. The mean glandular dose within the breast is the recommended quantity to evaluate the risk from radiation to the breast. To guarantee proper conditions of protection for patients, the radiation dose should be as low as reasonably achievable possible and simultaneously compatible with image quality requirements. Thus, this work proposes the use of the thermoluminescent (TL) CaSO4:Dy sintered discs, produced at IPEN, widely used in individual, environmental and area monitoring in Brazil, and Al2O3:C optically stimulated luminescence (OSL) ‘dot’ dosimeters, manufactured by Landauer® Inc., as application as easy-to-use and low cost alternative dosimeters to evaluate the entrance skin doses (ESD) delivered to patients, the half value layer (HVL) and the mean glandular doses (MGD) in a mammographic digital unit, comparing these two techniques with the results obtained using an All-in-one QC meter. The results obtained demonstrated that the TL and OSL dosimetry systems and the CaSO4 and Al2O3 dosimeters used are able to evaluate the entrance skin dose as well as mean glandular doses in a digital mammographic unit accurately within the requirements, and they can be considered a practical, simple, easy-to-use and low cost tools for verification of these items in a Quality Assurance Program.

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia.

BackgroundLong delays to diagnosis is a major cause of late presentation of breast diseases in sub-Saharan Africa.AimsWe designed and implemented a single-visit breast care algorithm that overcomes health system-related barriers to timely diagnosis of breast diseases.MethodsA multidisciplinary team of Zambian healthcare experts trained a team of mid- and high-level Zambian healthcare practitioners how to evaluate women for breast diseases, and train trainers to do likewise. Working collaboratively, the two teams then designed a clinical platform that provides multiple breast care services within a single visit. The service platform was implemented using a breast outreach camp format, during which breast self-awareness, psychosocial counseling, clinical breast examination, breast ultrasound, ultrasound-guided biopsy, imprint cytology of biopsy specimens and surgical treatment or referral, were offered within a single visit.ResultsEleven hundred and twenty-nine (1129) women attended the camps for breast care. Mean age was 35.9 years. The majority were multiparous (79.4%), breast-fed (76.0%), and reported hormone use (50.4%). Abnormalities were detected on clinical breast examination in 122 (10.8%) women, 114 of whom required ultrasound. Of the 114 who underwent ultrasound, 48 had identifiable lesions and were evaluated with ultrasound-guided core needle biopsy (39) or fine-needle aspiration (9). The concordance between imprint cytology and histopathology was 100%, when breast specimens were classified as either benign or malignant. However, when specimens were classified by histopathologic subtype, the concordance between imprint cytology and histology was 85.7% for benign and 100% for malignant lesions. Six (6) women were diagnosed with invasive cancer. Eighteen (18) women with symptomatic breast lesions had next-day surgery.SignificanceSimilar to its impact on cervical cancer prevention services, a single visit breast care algorithm has the potential to overcome health system-related barriers to timely diagnosis of breast diseases, including cancer, in rural African settings.

Prevalence of breast-related symptoms, health care seeking behaviour and diagnostic needs among women in Burkina Faso

BackgroundThe prevalence of breast cancer has been increasing in sub-Saharan Africa over the last few years. Patients often present with late stage disease, resulting in a high mortality rate. This study aims to estimate the prevalence of breast -related symptoms in the female population of Burkina Faso. The findings can be used to advise on adequate diagnostic health services for breast symptoms to ensure early detection and down-staging of breast cancer.MethodsA cross-sectional, population based study of 996 women was conducted to investigate the proportion of women with breast-related symptoms. A semi-structured questionnaire was used to collect sociodemographic data, information about breast cancer knowledge and details about breast-related symptoms, health care seeking and medical care. Breast-related symptoms were categorised as currently present/not currently present to estimate the current prevalence of women requiring a diagnostic service.ResultsAmong the 996 women, 120 reported having had a breast-related symptom in their life. Only 36 women sought medical advice and eight women had diagnostic confirmation by histological or imaging techniques. Current breast-related symptoms were reported by 33 women (3.3% of the sample). An extrapolation to Burkina Faso’s female population suggests that 184,562 women are in current need of diagnostic services due to any breast-related symptoms.ConclusionsImaging techniques at the community and referral level are needed in order to triage women with breast-related symptoms. Specialised services need to be strengthened to ensure appropriate diagnosis and treatment of breast diseases. Education campaigns among the general population and among health care professionals are required to increase awareness of breast cancer and improve prompt health care seeking and referral.

Breast Mass Segmentation Using a Semi-automatic Procedure Based on Fuzzy C-means Clustering

Mammography is the primary modality that helped in the early detection and diagnosis of women breast diseases. Further, the process of extracting the masses in mammogram represents a challenging task facing the radiologists, due to problems such as fuzzy or speculated borders, low contrast and the presence of intensity inhomogeneities. Aims to help the radiologists in the diagnosis of breast cancer, many approaches have been conducted to automatically segment the masses in mammograms. Towards this aim, in this paper, we present a new approach for extraction of tumors from region-of-interest (ROI) using the algorithm of Fuzzy C-Means (FCM) setting two clusters for semi-automated segmentation. The proposed method meant to select as input data the set of pixels that enable to get the meaningful information required to segment the masses with high accuracy. This could be accomplished through eliminating unnecessary pixels, which influence on this process through separating it outside of the input data using an optimal threshold given by monitoring the change of clusters rate during the process of threshold decrementing. The proposed methodology has successfully segmented the masses, with an average sensitivity of 82.02% and specificity of 98.23%.

Clinicopathological Analysis of Ultrasound-guided Vacuum-assisted Breast Biopsy for the Diagnosis and Treatment of Breast Disease.

To evaluate the usefulness and safety of vacuum-assisted breast biopsy (VABB) for breast lesion diagnosis and treatment. Clinical and histopathological data of 8,748 patients, who underwent 11,221 VABB procedures were analyzed. Most patients (58.2%) were <40 years old. Most lesions (39.6%) were 0.6-1.0 cm in diameter while 3.2% were ≥3.0 cm; fibroadenomas were the most common (46.6%). Eight (14% of 57) cases of atypical ductal hyperplasia were underestimated. The positive predictive values (PPVs) of breast imaging reporting and data system (BI-RADS) ultrasound category were 0.6%, 3.4%, 34.8%, 66.2%, and 93.8% for category 3, 4a, 4b, 4c, and 5 lesions, respectively. The mean number of core specimens was 9.5±8.8; the mean procedure time was 3.4±2.7 min. No residual lesions were found in 94.4% of the 7,480 patients. VABB could replace ultrasound-guided core biopsy and surgical excisional biopsy for the diagnosis of breast disease and the treatment of benign breast lesions.

Clinical and histologic characteristics of breast cancers in women with previous pathologic diagnosis of benign breast disease in Spain.

Women with a benign breast disease (BBD) have an increased risk of subsequent breast carcinoma. Information is scarce regarding the characteristics of breast carcinomas diagnosed after a BBD. Our aim was to point out the differences in clinical and histologic characteristics of breast carcinomas diagnosed in women with and without a previous pathologic diagnosis of BBD in the context of population-based mammography screening. Retrospective cohort study of all women aged 50-69years who were screened at least once in a population-based screening program in Spain, between 1994 and 2011 and followed up until December 2012. The mean follow-up was 6.1years. We analyzed 6645 breast carcinomas, of whom 238 had a previous pathologic diagnosis of BBD. Information on clinical and histologic characteristics was collected from pathology reports. Logistic regression was used to estimate the odds ratio (OR) and 95% confidence intervals (95%CI) of occurrence of selected histologic characteristics of breast carcinomas in women with and without a previous BBD. Women with a previous BBD had a higher proportion of ductal carcinoma insitu (DCIS) compared with women without a BBD (22.1% and 13.6%, respectively). Among those diagnosed with an invasive breast carcinoma, women with previous BBD were more likely to be diagnosed with carcinomas sized >2cm (OR=1.46; 95%CI=1.03-2.08), metastatic positive (OR=2.66; 95%CI=1.21-5.86), and with a high Ki-67 proliferation rate (OR=1.93; 95%CI=1.24-2.99). No differences were found across histologic subtypes of BBD. Screening participants with a previous pathologic diagnosis of BBD had a higher proportion of DCIS. However, invasive carcinomas detected in women with a BBD were associated with clinical and histologic characteristics conferring a worst prognosis.

P3 Breast Magnetic Resonance Imaging outcomes and utility of multidisciplinary discussion

Background & purpose: Breast Magnetic Resonance Imaging (MRI) has a role in diagnosis and treatment of breast disease, which may be limited by reduced sensitivity, high false positive rate and high cost(1). A multidisciplinary meeting (MDM) discussion around complex cases requiring MRI may have a positive impact as it does for breast cancer cases(2).

Ultrasonographic assessment of male breast diseases.

Although rare and accounting for less than 1% of all breast cancers, the incidence of breast cancer in men has increased by 26% over the past few decades. Very little has been reported on the sonographic appearance of benign and malignant male breast conditions. The aim of this study was to describe the ultrasonographic features of male breast disease and the value of ultrasound in the evaluation of male breast disease. Between December 2006 and October 2014, ultrasound examinations were performed in 560 male patients presenting with enlargement of, pain in, and/or a lump in the breast. One hundred and thirty-six patients (24.3%) underwent surgical excision, and 424 patients (75.7%) were diagnosed by ultrasound. Their ultrasonographic features were retrospectively evaluated. The final diagnoses were gynecomastia (n=537), primary breast cancer (n=9), lipoma (n=7), chronic mastitis (n=6), and fibroadenoma (n=1). Of the 560 lesions, 356 (63.6%) were classified as Breast Imaging Reporting and Data System (BI-RADS) category 2, 191 (34.1%) were classified as BI-RADS category 3, and 13 (2.3%) were classified as BI-RADS 4 or 5. The sensitivity, specificity, PPV, NPV, and accuracy of the detection of malignant breast masses according to ultrasound were 100%, 99.3%, 69.2%, 100%, and 97.7% respectively. The sonographic patterns of gynecomastia were nodular (n=131, 24.4%), dendritic (n=50, 9.3%), and diffuse glandular (n=356, 66.3%). Color Doppler flow imaging revealed hypervascularity in five of these malignant masses, moderate vascularity in two of the masses, and mild vascularity in the remaining two masses. Other diseases included in the study are also described. Ultrasonography (US) is useful in the diagnosis of male breast diseases, especially in differentiating cancer from benign lesions.

Efficiency of Imaging Modalities in Male Breast Disease: Can Ultrasound Give Additional Information for Assessment of Gynecomastia Evolution?

The purpose of this study is to present mammography and ultrasound findings of male breast lesions and to investigate the ability of diagnostic modalities in estimating the evolution of gynecomastia. Sixty-nine male patients who admitted to Taksim and Bakirkoy Education and Research Hospitals and underwent mammography (MG) and ultrasonography (US) imaging were retrospectively evaluated. Duration of symptoms and mammographic types of gynecomastia according to Appelbaum's classifications were evaluated, besides the sonographic findings in mammographic types of gynecomastia. The distribution of 69 cases were as follows: gynecomastia 47 (68.11%), pseudogynecomastia 6 (8.69%) primary breast carcinoma 7 (10.14%), metastatic carcinoma 1 (1.4%), epidermal inclusion cyst 2 (2.8%), abscess 2 (2.8%), lipoma 2 (2.8%), pyogenic granuloma 1 (1.4%), and granulomatous lobular mastitis 1 (1.4%). Gynecomastia patients who had symptoms less than 1 year had nodular gynecomastia (34.6%) as opposed to dendritic gynecomastia (61.5%) (p<0.01) based on mammography results according to Appelbaum's classifications. In patients having symptoms for 1 to 2 years, diffuse gynecomastia (70%) had a higher rate than the dendritic type (20%). Patients having the symptoms more than 2 years had diffuse gynecomastia (57.1%) while 42.9% had dendritic gynecomastia (p<0.001). With sonographic examination patients who had symptoms less than 1 year had higher rates of dendritic gynecomastia (92.3%) than noduler type (1.9 %). Patients having symptoms for 1 to 2 years had more dentritic gynecomastia (70%) than diffuse type (30%). Patients having symptoms more than 2 years had diffuse gynecomastia (57.1%) comparable to dendritic gynecomastia (42.9 %). Diagnostic imaging modalities are efficient tools for estimation of gynecomastia evolution as well as the diagnosis of other male breast diseases. There seems to be an incongruity between duration of clinical complaints and diagnostic imaging classification of gynecomastia. The use of these high resolution US findings may demonstrate an early phase fibrosis especially in patients visualized by mammography as with nodular phase.

Role of ultrasound in diagnosis and management of inflammatory breast diseases

Introduction Inflammatory breast diseases are frequently encountered clinical complaints, and they range from benign to malignant forms, namely inflammatory breast carcinoma (IBC). It is crucial to differentiate IBC from other types of mastitis because there are major differences in its prognosis and treatment. Ultrasound (US) is one of the main diagnostic tools for discriminating benign and malignant mastitis. US-guided aspiration and core needle biopsy are the mainstay in diagnosis and management of inflammatory breast diseases. Materials and methods The study is a prospective study that included 48 patients referred to the Radiology Department, Women’s Imaging Unit from the ‘Surgical Breast Clinic’, and surgical outpatient’s clinics and wards in the period between January 2016 and July 2016. US examination was performed for all the cases by 8–12 MHz linear array transducer. Full field digital mammography was performed for 33/48 patients. US-guided core biopsies of the breast were performed in indicated cases. Drainage under US guidance and cytological assessment was performed also in certain cases. Results In all, 36/48 (75%) cases were finally diagnosed as benign mastitis, and 12/48 (25%) cases were finally diagnosed as malignant. Within the examined group, 40/48 (83.3%) cases underwent short-term first look follow-up US study after a course of antibiotic therapy: seven/40 (17.5%) patients showed complete resolution of the symptoms and the diagnosis of simple infectious mastitis was confirmed, whereas 33/40 (82.5%) patients showed no response to treatment. Conclusion US plays a specific role in diagnostic approach and management of inflammatory breast diseases. It is essential to discriminate benign from malignant etiologies as there are major differences in their prognosis and treatment options.

Homeopathy for breast cancer treatment towards Hindu women

This study was intended to reveal the facts regarding homeopathy in the breast cancer treatment for Hindu women in Buleleng regency. Through qualitative research methods, phenomenology theory, power and knowledge relation, health-seeking behavior, and the theory of health believe and explanatory model can reveal the reasons underlying the homeopathy occurrence in the breast cancer treatment, i.e., low medical awareness, accumulated awareness of praxis, and chemotherapy, confidence and treatment behaviors. Homeopathic practices in the breast cancer treatment included Balian/shaman (Balinese spiritual) as a traditional Balinese homeopath, breast cancer etiology, disease diagnosis, preliminary therapy, core therapy, and advanced therapy, and cure categories. Homeopathy in the breast cancer treatment has implications for the sustainability of the traditional Balinese treatment culture; implicates the patient in three ways, e.g., the delay and increased stage of cancer, giving psychic comfort to the patient without positive effects for healing, and providing psychic comfort as well as positive effects for healing; has medical implications as the antithesis of medical systems, media of reflection and instruction for the medical, and the desire emergence for some medical circles to combine medical and nonmedical.

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

Demonstration of an algorithm to overcome health system-related barriers to timely diagnosis of breast diseases in rural Zambia

Bovine leukemia virus linked to breast cancer but not coinfection with human papillomavirus: Case-control study of women in Texas.

Bovine leukemia virus (BLV) and human papillomavirus (HPV) were previously identified in human breast tissue and have been associated with breast cancer in independent studies. The objective of the current study was to test for the presence of BLV and HPV in the same breast tissue specimens to determine whether the viruses were associated with breast cancer either singly or together. Archival formalin-fixed paraffin-embedded breast tissue sections from 216 women were received from The University of Texas MD Anderson Cancer Center along with patient diagnosis. In situ polymerase chain reaction and/or DNA hybridization methods were used to detect targeted DNA segments of BLV and HPV. Standard statistical methods were used to calculate age-adjusted odds ratios, attributable risk, and P values for the trend related to the association between presence of a virus and a diagnosis of breast disease. Women diagnosed with breast cancer were significantly more likely to have BLV DNA in their breast tissue compared with women with benign diagnoses and no history of breast cancer. Women with breast pathology classified as premalignant and no history of breast cancer also were found to have an elevated risk of harboring BLV DNA in their breast tissue. HPV status was not associated with malignancy, premalignant breast disease, or the presence of BLV in the breast tissues. The data from the current study supported previous findings of a significant association between BLV DNA in breast tissue and a diagnosis of breast cancer, but did not demonstrate oncogenic strains of HPV associated with breast cancer or the presence of BLV DNA in breast tissue. The authors believe the findings of the current study contribute to overall knowledge regarding a possible causal role for viruses in human breast cancer. Cancer 2018;124:1342-9. © 2017 American Cancer Society.

A step-by-step review on patient-specific biomechanical finite element models for breast MRI to x-ray mammography registration.

Breast magnetic resonance imaging (MRI) and x-ray mammography are two image modalities widely used for the early detection and diagnosis of breast diseases in women. The combination of these modalities leads to a more accurate diagnosis and treatment of breast diseases. The aim of this paper is to review the registration between breast MRI and x-ray mammographic images using patient-specific finite element-based biomechanical models. Specifically, a biomechanical model is obtained from the patient's MRI volume and is subsequently used to mimic the mammographic acquisition. Due to the different patient positioning and movement restrictions applied in each image modality, the finite element analysis provides a realistic physics-based approach to perform the breast deformation. In contrast with other reviews, we do not only expose the overall process of compression and registration but we also include main ideas, describe challenges, and provide an overview of the used software in each step of the process. Extracting an accurate description from the MR images and preserving the stability during the finite element analysis require an accurate knowledge about the algorithms used, as well as the software and underlying physics. The wide perspective offered makes the paper suitable not only for expert researchers but also for graduate students and clinicians. We also include several medical applications in the paper, with the aim to fill the gap between the engineering and clinical performance.

Application of the bi-rads classification for ultrasound diagnosis of breast diseases

Application of the bi-rads classification for ultrasound diagnosis of breast diseases

Supplementary Values of Axillary Lymph Node Ultrasound Imaging in the Diagnosis of Breast Diseases

Supplementary Values of Axillary Lymph Node Ultrasound Imaging in the Diagnosis of Breast Diseases

Role of Digital Breast Tomosynthesis in Screening and Diagnostic Breast Imaging

Digital breast tomosynthesis is quickly becoming the standard of care in breast cancer screening and diagnosis. Since its introduction to the clinical landscape in 2011, radiologists specializing in breast disease diagnosis around the country have made the decision to adopt the technology for both screening and diagnostic applications; with adoption growing substantially in present day. Users of the technology have attested to the benefits the technology affords, both in screening and the diagnostic evaluation of patients, through peer-reviewed publications and scientific presentations in recent years. This review article will describe the history of digital breast tomosynthesis and its implementation; from the early days of research, through Food and Drug Administration approval, to integration into the clinical workflow, in the setting of screening and diagnostic evaluation.

Revisión del estado actual de la resonancia magnética en el cáncer de mama

Breast magnetic resonance imaging is an imaging technique that has been consolidated over time and has shown greater sensitivity in the diagnosis of breast cancer. It is, however, a complex technique because various clinical scenarios must be thoroughly studied for a better application.This article reviews the main clinical indications and the technical points of magnetic resonance imaging.It should be noted that magnetic resonance imaging is still improving technologically, with tools and software gradually emerging that will undoubtedly contribute to the accurate diagnosis of both benign and malignant breast disease.

Will delaying mammography screening to age 50 worsen breast cancer disparities among African American women?

Objective: To determine the impact of mammography exposure in African-American women age 40–49 years by documenting both benign breast disease and breast cancer diagnosis.