Sensitivity Of Breast Cancer Diagnosis Research Articles

Diagnostic and Practical Value of Abbreviated Contrast Enhanced Magnetic Resonance Imaging in Breast Cancer Diagnostics.

Although MRI is the most efficient method of detecting breast cancer, its standard protocol is time-consuming and expensive. The objective of this study was to compare the diagnostic accuracy of the modified innovative abbreviated MRI protocol (AMRP) and the standard magnetic resonance protocol (SMRP) when detecting breast cancer. The research involved 477 patients referred for breast MRI due to suspected lesions. They were randomly assigned to the AMRP group (N = 232) or the SMRP group (N = 245). The AMRP comprised one native (contrast-free) and four post-contrast dynamic sequences of T1-weighted volume imaging for breast assessment (VIBRANT) and 3d MIP (maximum intensity projection) lasting for eight minutes. All the patients underwent a core biopsy of their lesions and histopathological analysis. The groups were comparable regarding the pre-screening and post-diagnostic characteristics and were of average (±SD) age at breast cancer diagnosis of 53.6 ± 12.7 years. There was no significant difference between the two protocols in terms of specificity or sensitivity of breast cancer diagnosis. The sensitivity (95% Cis) of the AMRP was 99.05% (96.6-99.9%), and its specificity was 59.09% (36.4-79.3%), whereas the sensitivity of the SMRP was 98.12% (95.3-99.5%) and its specificity was 68.75% (50.0-83.9%). Most of the tumors comprised one solid lesion in one of the breasts (77.3%), followed by multicentric tumors (16%), bilateral tumors (4.3%), and multifocal tumors (1.7%). The average size of tumors was approximately 14 mm (ranging from 3 mm to 72 mm). Our innovative AMR protocol showed comparable specificity and sensitivity for the diagnosis of breast cancer when compared to SMRP, which is the "gold standard" for histopathological diagnosis. This can lead to great savings in terms of the time and cost of imaging and interpretation.

Comparison of diagnostic potential of shear wave elastography between breast mass lesions and non–mass–like lesions

BackgroundShear wave elastography (SWE) can improve the specificity of B-mode ultrasound (US) without reducing the sensitivity for breast cancer diagnosis. Existing research on SWE includes both mass lesions and non‑mass‑like (NML) lesions or only NML lesions; however, there are no studies comparing the diagnostic potential of SWE in the detection of mass and NML lesions in the same trial. ObjectiveThis study aimed to compare the diagnostic performance of SWE in detecting mass lesions and NML lesions and determine the different individualised thresholds of the SWE parameters according to the lesion type. MethodsThis Study included 623 breast lesions of 562 consecutive women, who were scheduled for conventional US and SWE between January 2021 and December 2021. The diagnostic performances of conventional US and each quantitative SWE parameter (maximum elastic modulus [Emax], mean elastic modulus [Emean], and elastic modulus standard deviation [Esd]) were assessed. Histological diagnosis for all Breast Imaging Reporting and Database System (BI-RADS) category 4/5 patients and some BI-RADS category 3 patients and the follow-up results of other BI-RADS category 3 patients were used as the reference standard. ResultsIn this study, 281 benign lesions and 342 malignant lesions were identified. The diagnostic performance of conventional US and SWE was better in the mass lesion group than in the NML lesion group. Every SWE parameter had a different threshold in each group, and the thresholds of the SWE parameters were higher in the mass lesion group than in the NML lesion group. In the mass lesion group, Esd had the highest Az value, whereas in the NML lesion group, Emax had the highest Az value. In both the mass and NML lesion groups, the diagnostic specificity of the combination of conventional US and SWE was significantly higher than that of conventional US alone (P < 0.05), without a significantly decrease in the diagnosticsensitivity. ConclusionsSWE could increase the confidence of breast ultrasound diagnosis, especially for NML lesions. NML lesions had lower thresholds of SWE parameters than did the mass lesions.

Value of Artificial Neural Network Ultrasound in Improving Breast Cancer Diagnosis.

Ultrasound-guided needle biopsy based on artificial neural network, as a safe, effective, and simple preoperative pathological diagnosis technique, has been widely used in clinical practice. Ultrasound-guided needle biopsy based on artificial neural networks for suspicious breast lesions found in conventional ultrasound examinations is an effective method for preoperative diagnosis. The purpose of this article is to study the value of artificial neural network ultrasound in improving breast cancer diagnosis. This article summarizes the neuron model of PCNN by observing and studying its impulse synchronization phenomenon. Aiming at gray-scale images disturbed by mixed noise (impulse noise and the Gaussian noise), a comprehensive filtering algorithm based on the simplified PCNN model is proposed. In this paper, the benign and malignant breast masses were evaluated based on the two-dimensional and three-dimensional ultrasound imaging signs of the mass, and compared with the postoperative pathological results, a logistic regression model was established to analyze the shape, boundary, microcalcification, and posterior echo attenuation of the mass, values for keratinization or burrs, convergent signs, and blood flow classification in the differential diagnosis of benign and malignant. In this paper, a color ultrasound diagnostic device is used, Sonobi is used as a contrast medium, and the injection volume is 2.4 ml/dose. During the imaging process, the sound image performance of the lesion is dynamically observed, the original dynamic data are stored throughout the whole process, and the playback analysis is performed after the imaging is completed. Studies have shown that CDUS elastography (UE) combined with MRI can increase the sensitivity of breast cancer diagnosis, with a diagnostic accuracy rate of 92.4%.

Exosomal miR-1910-3p promotes proliferation, metastasis, and autophagy of breast cancer cells by targeting MTMR3 and activating the NF-κB signaling pathway.

Exosomes are key mediators of intercellular communication and play a role in the pathogenesis and progression of cancer. Exosomes in circulating body fluids serve as molecular markers for cancer diagnosis. This study aimed to investigate the role of exosomal microRNA (miR)-1910-3p in breast cancer and determine its clinical diagnostic value. MiR-1910-3p promoted proliferation and migration of breast cancer cells in vitro and in vivo. In vitro, exosomes enriched in miR-1910-3p transferred miR-1910-3p to mammary epithelial cells and breast cancer cells, promoting proliferation and migration, inhibiting apoptosis, and inducing autophagy. In vivo, exosomes enriched in miR-1910-3p promoted the proliferation and migration of breast cancer cells. MiR-1910-3p downregulated myotubularin-related protein 3, activated the NF-κB and wnt/β-catenin signaling pathway, and promoted breast cancer progression. Serum miR-1910-3p in exosomes was an effective diagnostic marker that improved the sensitivity of breast cancer diagnosis when used in combination with the traditional tumor marker CA153. In conclusion, breast cancer cell-derived exosomes promoted the growth, metastasis, and autophagy of breast cancer cells by transferring miR-1910-3p. MiR-1910-3p in serum exosomes may serve as a novel molecular marker for breast cancer diagnosis.

20P - Diagnostic value of serum HER-2 level in compression with tissue HER-2 in breast cancer: A systematic review and meta-analysis

BackgroundMeasurement of serum human epidermal growth factor receptor-2 (HER-2/neu) levels for breast cancer is still controversial and not recommended in any clinical procedures. However, it seems that HER-2 measuring can plays an important role as a diagnostic marker for early selection of therapeutic approach as well as predict of prognosis in breast cancer patients. We aimed to undertake a systematic review and meta-analysis focuses on the diagnostic value of serum HER-2 level measures by ELISA in compare to other methods due to its ease of implementation and cost-effectiveness for HER-2 positive two plus in IHC. MethodsWe performed a systematic search via PubMed, Scopus, Cochrane Library and Web of Science databases for human diagnostic studies reported the levels of serum HER2 in breast cancer patients, which was confirmed using histopathological examination such as immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH). Meta-analyses were carried out for sensitivity, specificity, accuracy, positive predictive value (PPV), negative predictive value (NPV), positive likelihood ratio (PLR) and negative likelihood ratio (NLR). ResultsFourteen studies entered into the study. The meta-analysis indicated that serum HER2 levels had sensitivity 53.05 (95%CI 40.82-65.28), specificity 79.27 (95%CI 73.02-85.51), accuracy 72.06 (95%CI 67.04-77.08), PPV 56.18 (95%CI 44.16-68.20), NPV 76.93 (95%CI 69.56-84.31), PLR 2.10 (95%CI 1.69-2.50) and NLR 0.58 (95%CI 0.44-0.71). ConclusionsOur findings revealed that, although serum HER2 levels showed a low sensitivity for breast cancer diagnosis, its specificity is significantly high in this regard. Hence, it seems that measurement of serum HER2 levels can play a significant role as a verification test for initial negative screening test results, especially in low-income regions due to its cost-effectiveness and ease of implementation in comparison with monitoring of tissue HER-2. Legal entity responsible for the studyAmir Shamshirian and Reza Alizadeh-Navaei. FundingHas not received any funding. DisclosureAll authors have declared no conflicts of interest.

Biomarker triplet NAMPT/VEGF/HER2 as a de novo detection panel for the diagnosis and prognosis of human breast cancer.

The early detection of breast cancer, the most common malignant tumor disease in women worldwide, relies on mammography and self breast examination. Here we evaluated the concentration of nicotinamide phosphoribosyltransferase (NAMPT), vascular endothelial growth factor (VEGF) and human epidermal growth factor receptor-2 (HER2) in serum and their expression in breast tissues associated with the clinicopathological features of patients with benign and malignant breast tumors. The immunohistochemical analysis showed that NAMPT, VEGF and HER2 proteins were overexpressed in breast tumors. The highest expression was observed in malignant tumors, low in benign tumors and negative in the adjacent normal tissue, indicating that the triplets may be progression markers and correlated with each other. The detection rate of NAMPT, VEGF and HER2 alone in tissue was 54.17, 64.58 and 60.42%, respectively, and was increased to about 79% in double combination and to 90% in triple combination. The basal levels of serum NAMPT, VEGF and HER2 in healthy controls were 94.90±4.24 pg/ml, 87.02±2.41 pg/ml and 1.12±0.04 ng/ml, respectively, measured by ELISA and found to be increased by 6.64-, 1.76- and 2.52-fold, respectively, in patients with malignant breast tumor. These elevated serum levels of NAMPT, VEGF and HER2 in patients were decreased after tumor removal, suggesting that these molecules are the indicators of treatment efficacy. The combined measurement of these triplets together may improve the sensitivity of breast cancer diagnosis and may potentially be used as a testing panel for the detection of malignant tumors, the assessment of treatment effectiveness and the monitoring of the disease progression in patients with breast cancer. Thus, we propose that the biomarker triplet NAMPT/VEGF/HER2 can be used as a de novo detection panel for the diagnosis and prognosis of human breast cancer.

Clinical significance of serum miR-21 in breast cancer compared with CA153 and CEA.

MicroRNA-21 (miR-21) has been shown to be a key regulator of carcinogenesis. There were few reports about the comparison of serum miR-21 with conventional tumor markers. This study aimed to explore the diagnostic value of circulating miR-21 as a tumor marker in breast cancer (BC) and compare it with CA153 and carcinoembryonic antigen (CEA). Circulating miR-16 and miR-21 were amplified and quantitatively detected by real-time PCR in 89 BC patients and 55 healthy controls. The levels of CA153 and CEA were measured through electrochemiluminescence assays. Then the sensitivity in diagnosis of BC was compared among miR-21, CA153 and CEA. The level of serum miR-21 was significantly higher in BC patients than controls (P<0.001). The sensitivity and specificity of miR-21 were 87.6% and 87.3%, respectively, whereas the sensitivities of CEA and CA153 were only 22.47% and 15.73%. Compared with CEA and CA153, serum miR-21 has a higher sensitivity in diagnosis of BC. Although not correlated with the status of ER, PR and clinical stages, serum miR-21 may be a potential diagnostic indicator for BC, especially for the early stage.

Accuracy of the “Triple Test” in the Diagnosis of Palpable Breast Masses in Saudi Females

For patients who present to clinicians with palpable breast lesions, the triple test: (physical examination, mammography and fine-needle aspiration cytology) can be employed to provide accurate diagnosis. In this study, the sensitivity, specificity and predictive values of triple test components were studied separately and in combination. During the study period (from January 1998 to December 1999), 140 patients with palpable breast masses were subjected to all components of the triple test followed by confirmatory open biopsy. Physical examination showed 82.6% sensitivity, 97.3% specificity and 86.4% positive predictive value. Mammography showed 87.5% sensitivity, 97.3% specificity and 87.5% positive predictive value and fine-needle aspiration cytology (FNAC) showed 91.7% sensitivity, 100% specificity and 100% positive predictive value in concordant cases (elements had either all malignant or all benign results). The triple test was 100% accurate in the diagnosis of palpable breast lesions when all three elements were concordant. Based on these results, we recommend elimination of the confirmatory open biopsy, which will result in reduced expenses and morbidity compared with open biopsy.

A computer‐aided diagnostic scheme for classification of clustered microcalcifications in mammograms

The hypothesis of this dissertation is that computer‐aided diagnosis (CAD) can improve radiologists' diagnostic performance in breast cancer diagnosis. An automated computerized classification scheme was developed to differentiate malignant from benign clustered microcalcifications. This computer scheme used an artificial neural network (ANN) to analyze eight computer‐extracted image features based on number, size, uniformity, and shape of individual microcalcifications, and on size and shape of a cluster. The features correlated qualitatively with radiologists' perceptual experience. The performance of this computer scheme was evaluated on two independent databases of standard‐view mammograms digitized at 0.1‐mm pixel size: database A contained mammograms from 53 patients with biopsies and database B contained mammograms from 104 patients in a consecutive biopsy series. The computer scheme performed better than radiologists on both databases (p=0.03 and p&lt;0.0001, respectively). An observer performance study was conducted using database B. Ten radiologists read the original standard‐ and magnification‐view mammograms with and without the aid of our computer scheme. The performance of the radiologists improved significantly (p&lt;0.0001) when the computer aid was used: on average, each radiologist recommended 6.4 more biopsies for malignant tumors (p=0.0006) and 6.0 fewer biopsies for benign lesions (p=0.003). We concluded that our computer scheme classifies malignant and benign clustered microcalcifications more accurately than radiologists, and that it can be used to reduce the number of biopsies for benign lesions while maintaining or improving sensitivity for breast cancer diagnosis.

Improvement of sensitivity of breast cancer diagnosis with adaptive neighborhood contrast enhancement of mammograms.

Mammograms are difficult to interpret, especially of cancers at their early stages. In this paper, we analyze the effectiveness of our adaptive neighborhood contrast enhancement (ANCE) technique in increasing the sensitivity of breast cancer diagnosis. Seventy-eight screen-film mammograms of 21 difficult cases (14 benign and seven malignant), 222 screen-film mammograms of 28 interval cancer patients and six benign control cases were digitized with a high-resolution of about 4096 x 2048 x 10-bit pixels and then processed with the ANCE method. Unprocessed and processed digitized mammograms as well as the original films were presented to six experienced radiologists for a receiver operating characteristic (ROC) evaluation for the difficult case set and to three reference radiologists for the interval cancer set. The results show that the radiologists' performance with the ANCE-processed images is the best among the three sets of images (original, digitized, and enhanced) in terms of area under the ROC curve and that diagnostic sensitivity is improved by the ANCE algorithm. All of the 19 interval cancer cases not detected with the original films of earlier mammographic examinations were diagnosed as malignant with the corresponding ANCE-processed versions, while only one of the six benign cases initially labeled correctly with the original mammograms was interpreted as malignant after enhancement. McNemar's tests of symmetry indicated that the diagnostic confidence for the interval cancer cases was improved by the ANCE procedure with a high level of statistical significance (p-values of 0.0001-0.005) and with no significant effect on the diagnosis of the benign control cases (p-values of 0.08-0.1). This study demonstrates the potential for improvement of diagnostic performance in early detection of breast cancer with digital image enhancement.