A Decision Tree to Guide Human and Mouse Mammary Organoid Model Selection.

Over the past 50 years, researchers from the mammary gland field have launched a collection of distinctive 3D cell culture systems to study multiple aspects of mammary gland physiology and disease. As our knowledge about the mammary gland evolves, more sophisticated 3D cell culture systems are required to answer more and more complex questions. Nowadays, morphologically complex mammary organoids can be generated in distinct 3D settings, along with reproduction of multiple aspects of the gland microenvironment. Yet, each 3D culture protocol comes with its advantages and limitations, where some culture systems are best suited to study stemness potential, whereas others are tailored towards the study of mammary gland morphogenesis. Therefore, prior to starting a 3D mammary culture experiment, it is important to consider and select the ideal culture model to address the biological question of interest. The number and technical requirements of novel 3D cell culture methods vastly increased over the past decades, making it currently challenging and time consuming to identify the best experimental testing. In this chapter, we provide a summary of the most promising murine and human 3D organoid models that are currently used in mammary gland biology research. For each model, we will provide a brief description of the protocol and an overview of the expected morphological outcome, the advantages of the model, and the potential pitfalls, to guide the reader to the best model of choice for specific applications.

Proteomic Assessment of the Murine Mammary Gland Extracellular Matrix.

The extracellular matrix (ECM) is a molecular scaffold mainly comprising fibrous proteins, glycoproteins, proteoglycans, and polysaccharides. Aside from acting as a structural support, the ECM's composition dictates cell-matrix interactions at the biochemical and biophysical level. In the context of cancer, the ECM is a critical component of the tumor microenvironment (TME) and dysregulation of its deposition and remodelling has been shown to promote tumor onset, progression, and metastasis. Here, we describe a robust protocol for the isolation and subsequent proteomic analysis of the ECM of murine mammary glands, for downstream assays studying the role of the ECM in breast cancer. The protocol yields sufficient protein amounts to enable not only the global quantitation of protein expression but furthermore the enrichment and quantitative analysis of post-translationally modified peptides to study aberrant signalling.

Assessment of the use of the Magseed marker in the localization of non-palpable lesions in the mammary gland.

Introduction Currently, more and more cases of breast cancer are detected in the early stages of advancement. Removal of the minimum required tissue volume ensures that the proper shape of the breast is maintained. On the other hand, it is important to get negative tissue margins. Objective To present your own experience with the use of preoperative breast tumor determination using the Magseed marker. Material and methods On the eve of the procedure, a Magtrace magnetic marker was administered to determine the lymph nodes and, under ultrasound control, a Magseed magnetic marker to the tumor, and the site of the lesion was marked with a skin marker as the operated site. Before the skin incision, the lesion was located using intraoperative ultrasound and the Sentimag probe. After the tumor was excision, the presence of the marker was confirmed in the preparation using the magnetic method and the compatibility of the ultrasound image before and after the procedure. The results of the research group were 23 patients. Radicality of the procedure was achieved in 20 patients (87%). To assess the size of the preparation and tumor, a formula from the work of Angarita et al. on the volume of the ellipsoid was used. It was assessed what part of the excised preparation was a tumor marked using the Magseed marker. Cohorts of 11 patients at the beginning and end of the evaluated group were compared, showing a significant increase in this parameter. Together with the learning curve, you can identify the tumor much more precisely and save healthy breast tissues by improving the aesthetic effect in the breast range. Conclusions The method of localization of non-pallpatory lesions in the mammary gland using the Magseed marker is simple to use, and the high detection rate directly translates into a reduction in the percentage of non-radical treatments in the case of sparing treatment.

Comparative toxicity assessment of nano- and bulk-phase titanium dioxide particles on the human mammary gland in vitro.

There is a major concern that exposure to titanium dioxide (TiO2) nanoparticles (NPs) can have degrading effects on human health as well as mammary gland because of the increased use in numerous sorts of nanotech-based health care and food merchandise. Also, there is a scarcity in NP toxicity studies on the mammary gland; therefore, the aim of the present study was to compare toxicity caused by nano- and bulk-phase TiO2 particles on the human mammary gland in vitro. In comparison to bulk-TiO2 particles, nano-TiO2 cause a significant (p < 0.05) reduction in viability and increased reactive oxygen species generation in the human mammary epithelial cells after a dose- (1, 2, 5, 10, 20, 50, and 100 µg/mL) and time (6, 12, 24, and 48 h)-dependent exposure. Further, an increase in genotoxicity in the mammary epithelial cells was observed as percent tail DNA and comet area was increased significantly (p < 0.05) at 12 h of exposure (10 and 100 µg/mL) with nano-TiO2. The scanning electron microscopic examination showed that a 50 µg/mL dose of both nano-TiO2 and bulk-TiO2 particles cause morphological changes and retarded growth pattern of mammary epithelial cells at 12 h. Moreover, a significant (p < 0.05) increase in apoptosis at 10 µg/mL and necrosis at 50 µg/mL concentrations of nano-TiO2 in comparison to bulk-TiO2 was observed in mammary epithelial cells. Finally, we can conclude that the toxicity caused by nano-TiO2 particles on the human mammary gland cells was comparatively higher than the bulk-TiO2 particles.

In silico identification of MAPK14-related lncRNAs and assessment of their expression in breast cancer samples.

Mitogen-activated protein kinase (MAP kinase) pathways participate in regulation of several cellular processes involved in breast carcinogenesis. A number of non-coding RNAs including both microRNAs (miRNAs) and long non-coding RNAs (lncRNAs) regulate or being regulated by MAPKs. We performed an in-silico method for identification of MAPKs with high number of interactions with miRNAs and lncRNAs. Bioinformatics approaches revealed that MAPK14 ranked first among MAPKs. Subsequently, we identified miRNAs and lncRNAs that were predicted to be associated with MAPK14. Finally, we selected four lncRNAs with higher predicted scores (NORAD, HCG11, ZNRD1ASP and TTN-AS1) and assessed their expression in 80 breast cancer tissues and their adjacent non-cancerous tissues (ANCTs). Expressions of HCG11 and ZNRD1ASP were lower in tumoral tissues compared with ANCTs (P values < 0.0001). However, expression levels of MAPK14 and NORAD were not significantly different between breast cancer tissues and ANCTs. A significant association was detected between expression of HCG11 and estrogen receptor (ER) status in a way that tumors with up-regulation of this lncRNA were mostly ER negative (P value = 0.04). Expressions of ZNRD1ASP and HCG11 were associated with menopause age and breast feeding duration respectively (P values = 0.02 and 0.04 respectively). There was a trend towards association between ZNRD1ASP expression and patients' age of cancer diagnosis. Finally, we detected a trend toward association between expression of NORAD and history of hormone replacement therapy (P value = 0.06). Expression of MAPK14 was significantly higher in grade 1 tumors compared with grade 2 tumors (P value = 0.02). Consequently, the current study provides evidences for association between lncRNA expressions and reproductive factors or tumor features.

Estimation of glandular dose in mammography based on artificial neural networks.

This work proposes using artificial neural networks (ANNs) for the regression of the dosimetric quantities employed in mammography. The data were generated by Monte Carlo (MC) simulations using a modified and validated version of the PENELOPE (v. 2014) + penEasy (v. 2015) code. A breast model of a homogeneous mixture of adipose and glandular tissue was adopted. The ANNs were constructed using the Keras and scikit-learn libraries for mean glandular dose (MGD) and air kerma (Kair ) regressions, respectively. In total, seven parameters were considered, including the incident photon energies (from 8.25 to 48.75 keV), breast geometry, breast glandularity and Kair acquisition geometry. Two ensembles of five ANNs each were formed to calculate MGD and Kair . The normalized glandular dose coefficients (DgN) were calculated using the ratio of the ensemble outputs for MGD and Kair . Polyenergetic DgN values were calculated by weighting monoenergetic values by the spectrum bin probabilities. The results indicate a very good ANN prediction performance when compared to the validation data, with median errors on the order of the average simulation uncertainties (≈ 0.2%). Moreover, the predicted DgN values are in good agreement compared with previously published works, with mean (maximum) differences up to 2.2% (9.4%). Therefore, it is shown that ANNs could be a complementary or alternative technique to tables, parametric equations and polynomial fits to estimate DgN values obtained via MC simulations.

Assessment of breast self- examination practice and associated factors among female workers in Debre Tabor Town public health facilities, North West Ethiopia, 2018: Cross- sectional study.

BACKGROUND: Although breast Self-Examination is no longer tenable as a standard method to detect early breast cancer, world health organization recommends breast self -examination for raising awareness of women about breast cancer. Secondary prevention through monthly breast self-examination is the best option to tackle the rising incidence of breast cancer. Therefore, the aim of this study was to assess breast self -examination practice and associated factors. METHODS: This cross-sectional study was conducted from April 23 to May 23, 2018. A total of 421 female workers in Debre Tabor Town public health facilities were included. The study participants were selected using simple random sampling technique from the study population. The collected data were checked for completeness. The data were entered and cleaned using EpiData version 3.1 then exported to SPSS version 20 for analysis. Crude odd ratio and probability value were identified for each independent variable and all independent variables with probability value of less than 0.2 were entered into multivariables logistic regression. Statistically significant associated factors were identified based on probability value (p-value) less than 0.05 and adjusted odd ratio with 95% confidence interval. RESULT: The mean age of participants was 25.2 (S.D = 4.12) and 137 (32.5%) of the participants had practiced breast self -examination and 64 (15.2%) of them performed it monthly. Family history of breast cancer (adjusted OR = 6.5, CI = 1.54-21.4), Knowledge about breast -self examination (adjusted OR = 5.74, CI = 2.3-14.4) and self- efficacy in practicing breast self -examination (adjusted OR = 4.7, CI = 1.84-12.11) were significantly associated with breast self -examination practice. CONCLUSIONS: The study showed that the prevalence of breast self-examination was low. Family history of breast cancer, knowledge about breast self -examination and self- efficacy in practicing breast self- examination did have statistically significant association with breast self-examination practice.

Role of Liver X Receptor in Mastitis Therapy and Regulation of Milk Fat Synthesis.

Mastitis is important disease that causes huge economic losses in the dairy industry. In recent years, antibiotic therapy has become the primary treatment for mastitis, however, due to drug residue in milk and food safety factors, we lack safe and effective drugs for treating mastitis. Therefore, new targets and drugs are urgently needed to control mastitis. LXRα, one of the main members of the nuclear receptor superfamily, is reported to play important roles in metabolism, infection and immunity. Activation of LXRα could inhibit LPS-induced mastitis. Furthermore, LXRα is reported to enhance milk fat production, thus, LXRα may serve as a new target for mastitis therapy and regulation of milk fat synthesis. This review summarizes the effects of LXRα in regulating milk fat synthesis and treatment of mastitis and highlights the potential agonists involved in both issues.

Cáncer de mama en hombre: Presentación de caso / Male Breast Cancer: Case Report

El cáncer de mama en hombres es poco frecuente, representa menos del 1 % de todos los cánceres masculinos, se presenta entre los 60-70 años con un pico de edad de 67 años; el carcinoma ductal invasivo es el que prevalece en varones, clínicamente se detecta como un nódulo unilateral indoloro retroareolar, o paraareolar. A diferencia de la mujer donde se realizan estudios de tamizaje, en los hombres suele diagnosticarse más tarde, porque buscan atención médica tardíamente por la poca incidencia de cáncer en pacientes masculinos, por la ausencia de signos y síntomas tempranos. Actualmente se puede utilizar para el diagnóstico la mamografía que ayuda a diferenciar entre enfermedades mamarias benignas y malignas. En este artículo se presenta el caso clínico de un paciente que acude al Instituto Hondureño de Seguridad Social, a quien se le diagnosticó carcinoma ductal.

Breast cancer in men is rare, it represents less then 1% of all male cancers, it's present between the ages of 60 through 70 years with an age peak at 67 years; the invasive ductal carcinoma is the most prevalent in men. Clinically, it is detected as an odorless, unilateral retro- or paraareolar nodule. Unlike with women, where screening studies are performed, in men it's usually diagnosed later on, because the low incidence of this cancer in male patients and the absence of early signs and symptoms leads to a delayed search for medical attention delayed. For diagnosis, a mammography can be used that helps differentiate between benign and malign mammary diseases. In this article we presented the clinical case of a patient that visits the Honduran Social Security Institute, diagnosed with ductal carcinoma.

Assessment of the mean glandular dose using LiF:Mg,Ti, LiF:Mg,Cu,P, Li2B4O7:Mn and Li2B4O7:Cu TL detectors in mammography radiation fields.

The aim of this paper is the characterization of four thermoluminescence detectors (TLD), namely, LiF:Mg,Ti, LiF:Mg,Cu,P, Li2B4O7:Mn and Li2B4O7:Cu for the measurement of the entrance surface air kerma (ESAK) and estimation of the mean glandular dose (MGD) in digital mammography examinations at hospitals and clinics. Low-energy x-ray beams in the typical energy ranges of mammography, produced with a tungsten target and additional 60 µm molybdenum filtration were implemented and characterized at the Laboratory of Metrology of Ionizing Radiation at Instituto Superior Técnico. These beams were used for the characterization of the TLDs in terms of sensitivity, linearity, reproducibility, energy dependence and fading at 40 °C. The energy dependence test was further extended using clinical beams produced by mammography units at hospitals and clinics. The method proposed by the International Atomic Energy Agency was used for the measurement of ESAK and assessment of MGD. The combined standard uncertainty for the measurement of ESAK (and MGD) was determined in accordance to the Guide to the expression of uncertainty in measurement. The x-ray beams generated in the 23-40 kVp range presented HVL values from 0.36 to 0.46 mm Al. The beam produced at 28 kVp (HVL 0.39 mm Al) was considered as reference. The radiation field defined a circle with 84 mm diameter with a maximum variation of the beam intensity of less than 1% at the top flat (plateau) within 4 cm of the central axis. The estimated total uncertainty for the measurement of air kerma was 0.42%. All the TL detectors tested showed good performance except the commercial Li2B4O7:Mn (or TLD-800) which was excluded due to its poor sensitivity in our experimental set up. Both lithium fluorides showed better linearity and reproducibility as well as lower energy dependence and fading when compared to lithium borates. The stable behaviour of LiF:Mg,Ti and LiF:Mg,Cu,P detectors is reflected in the low combined standard uncertainty of ±5.6% and ±4.3% respectively (or ±5.1% and ±3.6% if fading is neglected). In general a total combined uncertainty lower than ±10% for the measurement of ESAK was obtained for the four TL materials studied.

Missed opportunities for breast awareness information among women attending the maternal and child health services of an urban tertiary hospital in Northern Nigeria.

BACKGROUND: Breast cancer is the most common cancer that affects women worldwide. Many women, however, are not exposed to information that will promote awareness and early detection of this disease. We undertook this study to determine the missed opportunities to breast awareness information at the maternal and child health (MCH) services of our hospital. MATERIALS AND METHODS: Between July and September 2011, we conducted a cross-sectional survey of women attending the postnatal and immunization clinics (ICs) of our hospital. Data were collected using a structured interviewer-administered questionnaire. A total of 492 respondents were randomly selected. Data were analyzed using SPSS version 15.0 for Windows (SPSS Inc., Chicago, IL, USA). RESULTS: The mean age of the respondents was 27.67 years (standard deviation 5.92 years). Only 56.1% (276/492) had a postsecondary education, and 58.7% (289/492) were multiparous. Among the respondents, 81.7% had been exposed to breast awareness information at the antenatal clinic, 6.55% at the postnatal clinic, and 5.24% at the IC. There was a statistically significant association (P < 0.05) between missed opportunity for breast awareness information and family income (P = 0.019) and also with the level of education (P = 0.007). CONCLUSION: Most of the opportunities to educate women on breast awareness were missed at the postnatal and ICs of our hospital. Integrating breast health education into MCH care programs in developing countries will assist in the early detection of breast pathologies.

Assessment of Interradiologist Agreement Regarding Mammographic Breast Density Classification Using the Fifth Edition of the BI-RADS Atlas.

OBJECTIVE: The objective of the present study was to assess interradiologist agreement regarding mammographic breast density assessment performed using the rating scale outlined in the fifth edition of the BI-RADS atlas of the American College of Radiology. MATERIALS AND METHODS: Breast density assessments of 1000 cases were conducted by five radiologists from the same institution who together had recently undergone retraining in mammographic breast density classification based on the fifth edition of BI-RADS. The readers assigned breast density grades (A-D) on the basis of the BI-RADS classification scheme. Repeat assessment of 100 cases was performed by all readers 1 month after the initial assessment. A weighted kappa was used to calculate intrareader and interreader agreement. RESULTS: Intrareader agreement ranged from a kappa value of 0.86 (95% CI, 0.77-0.93) to 0.89 (95% CI, 0.81-0.95) on a four-category scale (categories A-D) and from 0.89 (95% CI, 0.86-0.92) to 0.94 (95% CI, 0.89-0.97) on a two-category scale (category A-B vs category C-D). Interreader agreement ranged from substantial (κ = 0.76; 95% CI, 0.73-0.78) to almost perfect (κ = 0.87; 95% CI, 0.86-0.89) on a four-category scale, and the overall weighted kappa value was substantial (0.79; 95% CI, 0.78-0.83). Interreader agreement on a two-category scale ranged from a kappa value of 0.85 (95% CI, 0.83-0.86) to 0.91 (95% CI, 0.90-0.92), and the overall weighted kappa was 0.88 (95% CI, 0.87-0.89). CONCLUSION: Overall, with regard to mammographic breast density classification, radiologists had substantial interreader agreement when a four-category scale was used and almost perfect interreader agreement when a dichotomous scale was used.

Salinomycin efficiency assessment in non-tumor (HB4a) and tumor (MCF-7) human breast cells.

The search for anticancer drugs has led researchers to study salinomycin, an ionophore antibiotic that selectively destroys cancer stem cells. In this study, salinomycin was assessed in two human cell lines, a breast adenocarcinoma (MCF-7) and a non-tumor breast cell line (HB4a), to verify its selective action against tumor cells. Real-time assessment of cell proliferation showed that HB4a cells are more resistant to salinomycin than MCF-7 tumor cell line, and these data were confirmed in a cytotoxicity assay. The half maximal inhibitory concentration (IC50) values show the increased sensitivity of MCF-7 cells to salinomycin. In the comet assay, only MCF-7 cells showed the induction of DNA damage. Flow cytometric analysis showed that cell death by apoptosis/necrosis was only induced in the MCF-7 cells. The increased expression of GADD45A and CDKN1A genes was observed in all cell lines. Decreased expression of CCNA2 and CCNB1 genes occurred only in tumor cells, suggesting G2/M cell cycle arrest. Consequently, cell death was activated in tumor cells through strong inhibition of the antiapoptotic genes BCL-2, BCL-XL, and BIRC5 genes in MCF-7 cells. These data demonstrate the selectivity of salinomycin in killing human mammary tumor cells. The cell death observed only in MCF-7 tumor cells was confirmed by gene expression analysis, where there was downregulation of antiapoptotic genes. These data contribute to clarifying the mechanism of action of salinomycin as a promising antitumor drug and, for the first time, we observed the higher resistance of HB4a non-tumor breast cells to salinomycin.

Mammographic density: Comparison of visual assessment with fully automatic calculation on a multivendor dataset.

OBJECTIVES: To compare breast density (BD) assessment provided by an automated BD evaluator (ABDE) with that provided by a panel of experienced breast radiologists, on a multivendor dataset. METHODS: Twenty-one radiologists assessed 613 screening/diagnostic digital mammograms from nine centers and six different vendors, using the BI-RADS a, b, c, and d density classification. The same mammograms were also evaluated by an ABDE providing the ratio between fibroglandular and total breast area on a continuous scale and, automatically, the BI-RADS score. A panel majority report (PMR) was used as reference standard. Agreement (κ) and accuracy (proportion of cases correctly classified) were calculated for binary (BI-RADS a-b versus c-d) and 4-class classification. RESULTS: While the agreement of individual radiologists with the PMR ranged from κ = 0.483 to κ = 0.885, the ABDE correctly classified 563/613 mammograms (92 %). A substantial agreement for binary classification was found for individual reader pairs (κ = 0.620, standard deviation [SD] = 0.140), individual versus PMR (κ = 0.736, SD = 0.117), and individual versus ABDE (κ = 0.674, SD = 0.095). Agreement between ABDE and PMR was almost perfect (κ = 0.831). CONCLUSIONS: The ABDE showed an almost perfect agreement with a 21-radiologist panel in binary BD classification on a multivendor dataset, earning a chance as a reproducible alternative to visual evaluation. KEY POINTS: Individual BD assessment differs from PMR with κ as low as 0.483. An ABDE correctly classified 92 % of mammograms with almost perfect agreement (κ = 0.831). An ABDE can be a valid alternative to subjective BD assessment.

Quantification of Estrogen Receptor-Alpha Expression in Human Breast Carcinomas With a Miniaturized, Low-Cost Digital Microscope: A Comparison with a High-End Whole Slide-Scanner.

INTRODUCTION: A significant barrier to medical diagnostics in low-resource environments is the lack of medical care and equipment. Here we present a low-cost, cloud-connected digital microscope for applications at the point-of-care. We evaluate the performance of the device in the digital assessment of estrogen receptor-alpha (ER) expression in breast cancer samples. Studies suggest computer-assisted analysis of tumor samples digitized with whole slide-scanners may be comparable to manual scoring, here we study whether similar results can be obtained with the device presented. MATERIALS AND METHODS: A total of 170 samples of human breast carcinoma, immunostained for ER expression, were digitized with a high-end slide-scanner and the point-of-care microscope. Corresponding regions from the samples were extracted, and ER status was determined visually and digitally. Samples were classified as ER negative (<1% ER positivity) or positive, and further into weakly (1-10% positivity) and strongly positive. Interobserver agreement (Cohen's kappa) was measured and correlation coefficients (Pearson's product-momentum) were calculated for comparison of the methods. RESULTS: Correlation and interobserver agreement (r = 0.98, p < 0.001, kappa = 0.84, CI95% = 0.75-0.94) were strong in the results from both devices. Concordance of the point-of-care microscope and the manual scoring was good (r = 0.94, p < 0.001, kappa = 0.71, CI95% = 0.61-0.80), and comparable to the concordance between the slide scanner and manual scoring (r = 0.93, p < 0.001, kappa = 0.69, CI95% = 0.60-0.78). Fourteen (8%) discrepant cases between manual and device-based scoring were present with the slide scanner, and 16 (9%) with the point-of-care microscope, all representing samples of low ER expression. CONCLUSIONS: Tumor ER status can be accurately quantified with a low-cost imaging device and digital image-analysis, with results comparable to conventional computer-assisted or manual scoring. This technology could potentially be expanded for other histopathological applications at the point-of-care.

Acceptability of physical examination by male doctors in medical care: Taking breast palpation as an example.

In this study, we conducted an investigation among medical workers, patients and college students concerning their acceptability of breast palpation performed by male doctors (hereinafter referred to as "acceptability", or "the examination", respectively, if not otherwise indicated), to get the information about their acceptability and reasons for accepting or declining the examination among the three population. A questionnaire investigation was conducted in 500 patients with breast diseases, 700 students of medical colleges, and 280 medical workers working in hospitals. The subjects were asked to choose between two options: accept or do not accept (the examination). The subjects were asked to fill out the questionnaire forms on free and anonymous basis and the questionnaire forms were collected on spot, immediately after completion. The questionnaires collected were coded, sorted out and checked. Data of the eligible questionnaires were input into Epidata software and analyzed by SPSS. Upon the establishment of the database, the intra-group data were tested by utilizing χ(2) test. Among 1480 questionnaires, 1293 (90.41%) questionnaires were retrieved. Our results showed that 56.78% of patients reported that they could accept breast palpation by male doctors. About 59.66% of medical staff expressed their acceptance of the examination, but only 35.03% of students said the examination. On the basis of this study, we were led to conclude that the examination is not well accepted by different populations, and therefore, (1) medical professionals and administrators should pay attention to the gender-related ethics in their practice and the feeling of patients should be respected when medical examinations involve private or sensitive body parts; (2) to this end, related departments should be properly staffed with doctors of both sexes, and this is especially true of the departments involving the examination or treatment of private or sensitive body parts; (3) health education should, among other things, include helping female patients to overcome the fear and anxiety in such examinations. This is of great importance since some women may miss the opportunity to get timely diagnosis.

Preliminary evaluation of the publicly available Laboratory for Breast Radiodensity Assessment (LIBRA) software tool: comparison of fully automated area and volumetric density measures in a case-control study with digital mammography.

INTRODUCTION: Breast density, commonly quantified as the percentage of mammographically dense tissue area, is a strong breast cancer risk factor. We investigated associations between breast cancer and fully automated measures of breast density made by a new publicly available software tool, the Laboratory for Individualized Breast Radiodensity Assessment (LIBRA). METHODS: Digital mammograms from 106 invasive breast cancer cases and 318 age-matched controls were retrospectively analyzed. Density estimates acquired by LIBRA were compared with commercially available software and standard Breast Imaging-Reporting and Data System (BI-RADS) density estimates. Associations between the different density measures and breast cancer were evaluated by using logistic regression after adjustment for Gail risk factors and body mass index (BMI). Area under the curve (AUC) of the receiver operating characteristic (ROC) was used to assess discriminatory capacity, and odds ratios (ORs) for each density measure are provided. RESULTS: All automated density measures had a significant association with breast cancer (OR = 1.47-2.23, AUC = 0.59-0.71, P < 0.01) which was strengthened after adjustment for Gail risk factors and BMI (OR = 1.96-2.64, AUC = 0.82-0.85, P < 0.001). In multivariable analysis, absolute dense area (OR = 1.84, P < 0.001) and absolute dense volume (OR = 1.67, P = 0.003) were jointly associated with breast cancer (AUC = 0.77, P < 0.01), having a larger discriminatory capacity than models considering the Gail risk factors alone (AUC = 0.64, P < 0.001) or the Gail risk factors plus standard area percent density (AUC = 0.68, P = 0.01). After BMI was further adjusted for, absolute dense area retained significance (OR = 2.18, P < 0.001) and volume percent density approached significance (OR = 1.47, P = 0.06). This combined area-volume density model also had a significantly (P < 0.001) improved discriminatory capacity (AUC = 0.86) relative to a model considering the Gail risk factors plus BMI (AUC = 0.80). CONCLUSIONS: Our study suggests that new automated density measures may ultimately augment the current standard breast cancer risk factors. In addition, the ability to fully automate density estimation with digital mammography, particularly through the use of publically available breast density estimation software, could accelerate the translation of density reporting in routine breast cancer screening and surveillance protocols and facilitate broader research into the use of breast density as a risk factor for breast cancer.

Breast tissue composition and its dependence on demographic risk factors for breast cancer: non-invasive assessment by time domain diffuse optical spectroscopy.

BACKGROUND: Breast tissue composition is recognized as a strong and independent risk factor for breast cancer. It is a heritable feature, but is also significantly affected by several other elements (e.g., age, menopause). Nowadays it is quantified by mammographic density, thus requiring the use of ionizing radiation. Optical techniques are absolutely non-invasive and have already proved effective in the investigation of biological tissues, as they are sensitive to tissue composition and structure. METHODS: Time domain diffuse optical spectroscopy was performed at 7 wavelengths (635-1060 nm) on 200 subjects to derive their breast tissue composition (in terms of water, lipid and collagen content), blood parameters (total hemoglobin content and oxygen saturation level), and information on the microscopic structure (scattering amplitude and power). The dependence of all optically-derived parameters on age, menopausal status, body mass index, and use of oral contraceptives, and the correlation with mammographic density were investigated. RESULTS: Younger age, premenopausal status, lower body mass index values, and use of oral contraceptives all correspond to significantly higher water, collagen and total hemoglobin content, and lower lipid content (always p < 0.05 and often p < 10-4), while oxygen saturation level and scattering parameters show significant dependence only on some conditions. Even when age-adjusted groups of subjects are compared, several optically derived parameters (and in particular always collagen and total hemoglobin content) remain significantly different. CONCLUSIONS: Time domain diffuse optical spectroscopy can probe non-invasively breast tissue composition and physiologic blood parameters, and provide information on tissue structure. The measurement is suitable for in vivo studies and monitoring of changes in breast tissue (e.g., with age, lifestyle, chemotherapy, etc.) and to gain insight into related processes, like the origin of cancer risk associated with breast density.

Significance of rat mammary tumors for human risk assessment.

We have previously indicated that the ideal animal tumor model should mimic the human disease. This means that the investigator should be able to ascertain the influence of host factors on the initiation of tumorigenesis, mimic the susceptibility of tumor response based on age and reproductive history, and determine the response of the tumors induced to chemotherapy. The utilization of experimental models of mammary carcinogenesis in risk assessment requires that the influence of ovarian, pituitary, and placental hormones, among others, as well as overall reproductive events are taken into consideration, since they are important modifiers of the susceptibility of the organ to neoplastic development. Several species, such as rodents, dogs, cats, and monkeys, have been evaluated for these purposes; however, none of them fulfills all the criteria specified previously. Rodents, however, are the most widely used models; therefore, this work will concentrate on discussing the rat rodent model of mammary carcinogenesis.