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4.
In Vivo ; 36(5): 2255-2259, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099097

RESUMO

BACKGROUND/AIM: Magnetic resonance imaging (MRI) is an important diagnostic tool in the detection of breast cancer. The Breast Center of the municipal Hospital Holweide, Cologne, annually cares for and treats patients with changes in the breast. A special problem is posed by Breast Imaging-Reporting and Data System (BI-RADS) 4 lesions. If a BI-RADS 4 finding is present, is a vacuum biopsy indicated in every case or, if there is already an indication for surgery due to other findings, can the corresponding finding be removed openly without histological clarification? We require real world data regarding the actual in-center likelihood of a BIRADS 4 lesion to be DCIS (Ductal carcinoma in situ) or invasive disease. PATIENTS AND METHODS: This is a retrospective study of 1,641 patients who received MRI examination in the radiological department of the municipal hospital Holweide in 2012 and 2013. Each BI-RADS 4 finding (or higher) classified by MRI was compared with the final histological result. RESULTS: 347 MRIs showed BI-RADS 4 findings or higher and 280 (80.7%) cases showed benign histology. In 67 (19.3%) cases, histology showed DCIS or invasive carcinoma. CONCLUSION: BI-RADS 4 lesions have a low probability of malignancy based on real-world data from this center. If there is already an indication for surgery due to other lesions, the patient can also be offered a simultaneous open biopsy in the context of the already initiated surgical treatment. Each center should know the sensitivity and specificity of the MRI imaging performed and counsel patients based on that.


Assuntos
Neoplasias da Mama , Carcinoma Intraductal não Infiltrante , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Carcinoma Intraductal não Infiltrante/diagnóstico por imagem , Feminino , Humanos , Imageamento por Ressonância Magnética/métodos , Estudos Retrospectivos
5.
In Vivo ; 36(5): 2342-2349, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-36099117

RESUMO

BACKGROUND/AIM: Smaller, earlier-stage breast tumors are being found in breast cancer screening, and neoadjuvant chemotherapy is the gold standard when chemotherapy is indicated. Precise marking and localization of the tumor are thus becoming increasingly important. Wire-free localization techniques are under investigation in order to reduce presurgical radiography, pain, the risk of wire dislocation, and allow scheduling flexibility for patients and surgery departments. PATIENTS AND METHODS: This single-center observational study from June 2020 to October 2021 included 15 patients with mammographically or sonographically detected nonpalpable breast lesions. Radiofrequency identification (RFID) tags were placed preoperatively under ultrasound or radiologic guidance to localize lesions for planned surgery. All patients underwent breast conservation surgery, including one bilateral and one targeted axillary dissection. RESULTS: Histology identified two benign and 13 malignant lesions, including three ductal carcinomas in situ and 11 invasive breast cancers. Placement, control radiography, and handling of the RFID tag were feasible in everyday routine for different radiologists and surgeons and managed cost-effectively. All of the RFID tags were found in the specimen radiographs. CONCLUSION: The feasibility and cost-effectiveness of this non-wire localization method were demonstrated in this rather small cohort of patients. Further studies including larger numbers of patients are needed to confirm the method's accuracy.


Assuntos
Neoplasias da Mama , Mastectomia , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/cirurgia , Análise Custo-Benefício , Estudos de Viabilidade , Feminino , Humanos
6.
Int J Mol Sci ; 23(17)2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-36077256

RESUMO

Atropine (ATR) is extracted from a belladonna plant that belongs to a class of anticholinergic drugs and is therefore involved in the treatment of the overdose of cholinergic drugs or mushroom poisoning. It is a well-known blocker of muscarinic acetylcholine receptors (mAChRs) that are expressed in various tumor cells, including breast tumors from animal and human origin, but it has yet to be recommended as an anticancer drug. Our in silico docking analysis indicates that atropine has a roust virtual binding, with a stable binding energy, to two major signaling molecules involved in EMT regulation: E-cad and ZEB-2. For both, the gene and the protein expression level results show that atropine is an effective molecule in reducing epithelial-mesenchymal transition (EMT) and colony formation induced by TGF-B or carboplatin in both the mesenchymal-like cell line MDA-MB-231 and the epithelial-like cell line T47D. We conclude that atropine as a potential suppressor of EMT could be co-administrated with other chemotherapeutic drugs to reduce stemness in drug-resistant breast tumor cells.


Assuntos
Neoplasias da Mama , Transição Epitelial-Mesenquimal , Animais , Atropina/farmacologia , Mama/patologia , Neoplasias da Mama/patologia , Linhagem Celular Tumoral , Movimento Celular , Transição Epitelial-Mesenquimal/genética , Feminino , Humanos
7.
Annu Int Conf IEEE Eng Med Biol Soc ; 2022: 1891-1894, 2022 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-36086063

RESUMO

Breast conserving surgery aims at the complete removal of malignant lesions while minimizing healthy tissue loss. To ensure the balance between complete resection of the cancer and conservation of healthy tissue, intra-operative margin assessment is necessary. Deep ultraviolet (DUV) fluorescence scanning microscope provides fast whole-surface-imaging (WSI) of excised tissue with contrast between malignant and normal tissues. Then, an automated breast cancer classification method on DUV images is required for intra-operative margin assessment. Deep learning shows the promising results in breast cancer classification, but limited DUV image dataset poses overfitting challenge to train the robust network. To tackle this challenge, we partition the DUV WSI image into small patches and extract pathological features for each patch from a pre-trained network using a transfer learning approach. We feed pathological features into a decision-tree-based classifier and fuse patch-level classification results based on regional importance to determine malignant or benign WSI. Experimental results on 60 DUV images show that our proposed method outperforms the standard deep learning classification in terms of improving the classification performance and identifying cancerous regions.


Assuntos
Neoplasias da Mama , Aprendizado Profundo , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Feminino , Fluorescência , Humanos , Margens de Excisão , Redes Neurais de Computação
9.
Clin. transl. oncol. (Print) ; 24(9): 1800–1808, septiembre 2022.
Artigo em Inglês | IBECS | ID: ibc-206265

RESUMO

BackgroundBreast cancer (BC) prevalence steadily increases in older patients but their treatment is based on the geriatric evaluations of comorbidities and potential benefits proved in clinical trials with younger patients. The lack of better decision-making tools urges to promote the search for new prognostic markers. The association between inflammation, aging and cancer may be crucial for better treatment selection. We sought to analyze its impact on the survival of older BC patients, evaluating the interaction with age and comorbidities.MethodsWe evaluated the relationship between inflammatory biomarkers at BC diagnosis (circulating blood cell counts and inflammatory indexes) and BC-related and not related mortality rate, evaluating the influence of comorbidities and age through the competitive risks assessment.ResultsWe analyzed 148 consecutive BC patients aged ≥ 70 years old, diagnosed with BC and regional lymph node metastases. After the median follow-up of 51.5 months, 59 patients died (28 due to breast cancer progression and 31 because of other causes). Increased levels of circulating monocytes, neutrophils and neutrophil-to-lymphocytes ratio and decreased level of eosinophils and eosinophil multiple by neutrophils-to-lymphocytes ratio were associated with higher probability of BC-related death but not with death related to other causes.ConclusionOur data suggest a role of inflammatory parameters as a possible prognostic tool in therapeutic decision-making process in older patients with BC, as increased level of inflammation was associated with cancer-specific mortality. Prospective studies may give the possibility of refining the geriatric evaluation for BC treatment in elderly. (AU)


Assuntos
Humanos , Mama/patologia , Neoplasias da Mama/patologia , Inflamação/patologia , Prognóstico , Estudos Retrospectivos
10.
Eur J Cancer ; 174: 212-220, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-36058128

RESUMO

INTRODUCTION: In older patients with breast cancer, the risk of dying from other causes than breast cancer strongly increases after the age of 70. The aim of this study was to assess contributions of breast cancer mortality versus other-cause mortality after locoregional or distant recurrence in a population-based cohort of older patients analysed by multi-state models. METHODS: Surgically treated patients ≥70 years diagnosed with stage I-III breast cancer in 2003-2009 were selected from the Netherlands Cancer Registry. A novel multi-state model with locoregional and distant recurrence that incorporates relative survival was fitted. Other-cause and breast cancer mortality were indicated as population and excess mortality. RESULTS: Overall, 18,419 patients were included. Ten-year cumulative incidences of locoregional and distant recurrence were 2.8% (95%CI 2.6-3.1%) and 12.5% (95%CI 11.9-13.1%). Other-cause mortality increased from 23.9% (95%CI 23.7-24.2%) in patients 70-74 years to 73.8% (95%CI 72.2-75.4%) in those ≥80 years. Ten-year probabilities of locoregional or distant recurrence with subsequent breast cancer death were 0.4-1.3% and 10.2-14.6%, respectively. For patients with a distant recurrence in the first two years after diagnosis, breast cancer death probabilities were 95.3% (95%CI 94.2-96.4%), 93.1% (95%CI 91.6-94.6%), and 88.6% (95%CI 86.5-90.8%) in patients 70-74, 75-79, and ≥80 years. CONCLUSION: In older patients without recurrence, prognosis is driven by other-cause mortality. Although locoregional recurrence is a predictor for worse outcome, given its low incidence it contributes little to breast cancer mortality after diagnosis. For patients who develop a distant recurrence, breast cancer remains the dominant cause of death, even at old age.


Assuntos
Neoplasias da Mama , Idoso , Mama/patologia , Neoplasias da Mama/patologia , Feminino , Humanos , Incidência , Recidiva Local de Neoplasia/patologia , Estadiamento de Neoplasias , Prognóstico
11.
BMJ ; 378: e070346, 2022 Sep 21.
Artigo em Inglês | MEDLINE | ID: mdl-36130770

RESUMO

OBJECTIVE: To determine if margin involvement is associated with distant recurrence and to determine the required margin to minimise both local recurrence and distant recurrence in early stage invasive breast cancer. DESIGN: Prospectively registered systematic review and meta-analysis of literature. DATA SOURCES: Medline (PubMed), Embase, and Proquest online databases. Unpublished data were sought from study authors. ELIGIBILITY CRITERIA: Eligible studies reported on patients undergoing breast conserving surgery (for stages I-III breast cancer), allowed an estimation of outcomes in relation to margin status, and followed up patients for a minimum of 60 months. Patients with ductal carcinoma in situ only or treated with neoadjuvant chemotherapy or by mastectomy were excluded. Where applicable, margins were categorised as tumour on ink (involved), close margins (no tumour on ink but <2 mm), and negative margins (≥2 mm). RESULTS: 68 studies from 1 January 1980 to 31 December 2021, comprising 112 140 patients with breast cancer, were included. Across all studies, 9.4% (95% confidence interval 6.8% to 12.8%) of patients had involved (tumour on ink) margins and 17.8% (13.0% to 23.9%) had tumour on ink or a close margin. The rate of distant recurrence was 25.4% (14.5% to 40.6%) in patients with tumour on ink, 8.4% (4.4% to 15.5%) in patients with tumour on ink or close, and 7.4% (3.9% to 13.6%) in patients with negative margins. Compared with negative margins, tumour on ink margins were associated with increased distant recurrence (hazard ratio 2.10, 95% confidence interval 1.65 to 2.69, P<0.001) and local recurrence (1.98, 1.66 to 2.36, P<0.001). Close margins were associated with increased distant recurrence (1.38, 1.13 to 1.69, P<0.001) and local recurrence (2.09, 1.39 to 3.13, P<0.001) compared with negative margins, after adjusting for receipt of adjuvant chemotherapy and radiotherapy. In five studies published since 2010, tumour on ink margins were associated with increased distant recurrence (2.41, 1.81 to 3.21, P<0.001) as were tumour on ink and close margins (1.44, 1.22 to 1.71, P<0.001) compared with negative margins. CONCLUSIONS: Involved or close pathological margins after breast conserving surgery for early stage, invasive breast cancer are associated with increased distant recurrence and local recurrence. Surgeons should aim to achieve a minimum clear margin of at least 1 mm. On the basis of current evidence, international guidelines should be revised. SYSTEMATIC REVIEW REGISTRATION: CRD42021232115.


Assuntos
Neoplasias da Mama , Mama/patologia , Feminino , Humanos , Margens de Excisão , Mastectomia , Mastectomia Segmentar , Recidiva Local de Neoplasia
12.
J Med Case Rep ; 16(1): 341, 2022 Sep 08.
Artigo em Inglês | MEDLINE | ID: mdl-36071506

RESUMO

BACKGROUND: Accessory breast(s) is defined as the presence of more than two breasts with or without a nipple and areola in human beings. It may occur anywhere along the primitive embryonic milk lines, which extend from the axilla to the groin. Accessory breast tissue can potentially undergo the same physiological and pathological processes as the normally located breast, including lactational change, fibroadenoma, and carcinoma. Although common in the normally located breast tissue, the incidence of fibroadenoma in accessory breast tissue is rare. Furthermore, if the swelling occurs in the axilla or groin, it may present a diagnostic challenge by clinically mimicking a lymphoma or other causes of lymphadenopathy. Owing to its rarity and its tendency to pose a clinical diagnostic challenge, we decided to report a case of fibroadenoma in axillary accessory breast. CASE PRESENTATION: A 28-year-old Ethiopian female patient came to University of Gondar comprehensive specialized hospital with a complaint of left axillary swelling of 3 years duration. There was no history of cough, fever, weight loss, or night sweating. On physical examination, there was an approximately 5 × 4 cm, firm, well-defined, mobile, nontender solitary mass in the left axilla that was completely separated from the left breast. Fine-needle aspiration cytology suggested a diagnosis of fibroadenoma in axillary accessory breast tissue. The mass was completely excised, and histopathologic examination confirmed the diagnosis. Her recovery was uneventful. She was informed about the diagnosis, reassured, and discharged from care. CONCLUSION: In the clinical evaluation of a patient with axillary swelling, accessory breast tissue disorders such as fibroadenoma must be considered as a differential diagnosis for early diagnostic workup and management. Moreover, this case underscores the fact that, similar to normal breast tissue, accessory breast tissue is also susceptible to the same pathologic disease processes including neoplasms such as fibroadenoma.


Assuntos
Doenças Mamárias , Neoplasias da Mama , Coristoma , Fibroadenoma , Fibroma , Adulto , Axila/patologia , Mama/patologia , Doenças Mamárias/diagnóstico , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/patologia , Neoplasias da Mama/cirurgia , Coristoma/diagnóstico , Coristoma/patologia , Coristoma/cirurgia , Feminino , Fibroadenoma/diagnóstico , Fibroadenoma/patologia , Fibroadenoma/cirurgia , Humanos
13.
Curr Oncol ; 29(8): 5508-5516, 2022 08 04.
Artigo em Inglês | MEDLINE | ID: mdl-36005173

RESUMO

AIM: To compare digital breast tomosynthesis (DBT) and ultrasound in women recalled for assessment after a positive screening mammogram and assess the potential for each of these tools to reduce unnecessary biopsies. METHODS: This data linkage study included 538 women recalled for assessment from January 2017 to December 2019. The association between the recalled mammographic abnormalities and breast density was analysed using the chi-square independence test. Relative risks and the number of recalled cases requiring DBT and ultrasound assessment to prevent one unnecessary biopsy were compared using the McNemar test. RESULTS: Breast density significantly influenced recall decisions (p < 0.001). Ultrasound showed greater potential to decrease unnecessary biopsies than DBT: in entirely fatty (21% vs. 5%; p = 0.04); scattered fibroglandular (23% vs. 10%; p = 0.003); heterogeneously dense (34% vs. 7%; p < 0.001) and extremely dense (39% vs. 9%; p < 0.001) breasts. The number of benign cases needing assessment to prevent one unnecessary biopsy was significantly lower with ultrasound than DBT in heterogeneously dense (1.8 vs. 7; p < 0.001) and extremely dense (1.9 vs. 5.1; p = 0.03) breasts. CONCLUSION: Women with dense breasts are more likely to be recalled for assessment and have a false-positive biopsy. Women with dense breasts benefit more from ultrasound assessment than from DBT.


Assuntos
Neoplasias da Mama , Mamografia , Biópsia , Mama/diagnóstico por imagem , Mama/patologia , Densidade da Mama , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Detecção Precoce de Câncer , Feminino , Humanos
14.
Curr Oncol ; 29(8): 5664-5681, 2022 08 11.
Artigo em Inglês | MEDLINE | ID: mdl-36005185

RESUMO

Columnar cell lesions (CCLs) of the breast comprise a spectrum of morphologic alterations of the terminal duct lobular unit involving variably dilated and enlarged acini lined by columnar epithelial cells. The World Health Organization currently classifies CCLs without atypia as columnar cell change (CCC) and columnar cell hyperplasia (CCH), whereas flat epithelial atypia (FEA) is a unifying term encompassing both CCC and CCH with cytologic atypia. CCLs have been increasingly recognized in stereotactic core needle biopsies (CNBs) performed for the assessment of calcifications. CCLs are believed to represent the earliest non-obligate precursor of low-grade invasive breast carcinomas as they share molecular alterations and often coexist with entities in the low-grade breast neoplasia pathway. Despite this association, however, the risk of progression of CCLs to invasive breast carcinoma appears low and may not exceed that of concurrent proliferative lesions. As the reported upgrade rates of pure CCL/FEA when identified as the most advanced high-risk lesion on CNB vary widely, the management of FEA diagnosed on CNB remains controversial. This review will include a historical overview of CCLs and will examine histologic diagnostic criteria, molecular alterations, prognosis and issues related to upgrade rates and clinical management.


Assuntos
Neoplasias da Mama , Mama/patologia , Neoplasias da Mama/patologia , Células Epiteliais/patologia , Feminino , Humanos , Hiperplasia/patologia
15.
Medicine (Baltimore) ; 101(31): e29953, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35945803

RESUMO

We evaluated the features of breast cancers initially assessed as probably benign at ultrasound (US). Of the 7098 patients who underwent breast cancer surgery at our institution between 2014 and 2016, 179 lesions in 178 patients who had both a prior US with Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment and a recent US with a diagnosis of breast cancer were enrolled. Prior and recent US findings and category were retrospectively reassessed in line with the BI-RADS Atlas and analyzed. Of the 179 BI-RADS 3 lesions, 105 (59%) were retrospectively reassessed to category 4 and 74 (41%) retained category 3. Noncircumscribed margin, irregular shape, posterior enhancement, and nonparallel orientation were more frequently observed in the reassessment category 4 group than in the reassessment category 3 group (94% vs 43%, 81% vs 19%, 16% vs 4%, 14% vs 0%, respectively). The recent US revealed that 150 of the 179 lesions (84%) had > 20% size increase, and 121 (68%) showed morphologic changes. Margin was the most frequently observed morphologic feature to change (41%, 73/179). Care should be taken to look for subtle but suspicious US features and changes in mass, especially of margin, for early diagnosis of breast cancer.


Assuntos
Neoplasias da Mama , Ultrassonografia Mamária , Mama/diagnóstico por imagem , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Margens de Excisão , Estudos Retrospectivos , Ultrassonografia , Ultrassonografia Mamária/métodos
16.
Sci Rep ; 12(1): 14720, 2022 Aug 30.
Artigo em Inglês | MEDLINE | ID: mdl-36042216

RESUMO

The survival rate of breast cancer patients is closely related to the pathological stage of cancer. The earlier the pathological stage, the higher the survival rate. Breast ultrasound is a commonly used breast cancer screening or diagnosis method, with simple operation, no ionizing radiation, and real-time imaging. However, ultrasound also has the disadvantages of high noise, strong artifacts, low contrast between tissue structures, which affect the effective screening of breast cancer. Therefore, we propose a deep learning based breast ultrasound detection system to assist doctors in the diagnosis of breast cancer. The system implements the automatic localization of breast cancer lesions and the diagnosis of benign and malignant lesions. The method consists of two steps: 1. Contrast enhancement of breast ultrasound images using segmentation-based enhancement methods. 2. An anchor-free network was used to detect and classify breast lesions. Our proposed method achieves a mean average precision (mAP) of 0.902 on the datasets used in our experiment. In detecting benign and malignant tumors, precision is 0.917 and 0.888, and recall is 0.980 and 0.963, respectively. Our proposed method outperforms other image enhancement methods and an anchor-based detection method. We propose a breast ultrasound image detection system for breast cancer detection. The system can locate and diagnose benign and malignant breast lesions. The test results on single dataset and mixed dataset show that the proposed method has good performance.


Assuntos
Neoplasias da Mama , Ultrassonografia Mamária , Artefatos , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Ultrassonografia , Ultrassonografia Mamária/métodos
17.
Sci Rep ; 12(1): 14004, 2022 Aug 17.
Artigo em Inglês | MEDLINE | ID: mdl-35978031

RESUMO

Breast cancer is the most commonly diagnosed female malignancy globally, with better survival rates if diagnosed early. Mammography is the gold standard in screening programmes for breast cancer, but despite technological advances, high error rates are still reported. Machine learning techniques, and in particular deep learning (DL), have been successfully used for breast cancer detection and classification. However, the added complexity that makes DL models so successful reduces their ability to explain which features are relevant to the model, or whether the model is biased. The main aim of this study is to propose a novel visualisation to help characterise breast cancer patients using Fisher Information Networks on features extracted from mammograms using a DL model. In the proposed visualisation, patients are mapped out according to their similarities and can be used to study new patients as a 'patient-like-me' approach. When applied to the CBIS-DDSM dataset, it was shown that it is a competitive methodology that can (i) facilitate the analysis and decision-making process in breast cancer diagnosis with the assistance of the FIN visualisations and 'patient-like-me' analysis, and (ii) help improve diagnostic accuracy and reduce overdiagnosis by identifying the most likely diagnosis based on clinical similarities with neighbouring patients.


Assuntos
Neoplasias da Mama , Aprendizado Profundo , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Feminino , Humanos , Serviços de Informação , Mamografia/métodos
18.
Ann Surg Oncol ; 29(10): 6484-6494, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35951136

RESUMO

BACKGROUND: Multiple studies have demonstrated a link between obesity and breast cancer; however, the potential association between obesity and atypical high-risk breast lesions has not been well characterized. We sought to evaluate the characteristics and clinical outcomes of patients with breast atypia based on a woman's body mass index (BMI). METHODS: We retrospectively identified adult women diagnosed with atypical ductal hyperplasia (ADH), atypical lobular hyperplasia (ALH), and/or lobular carcinoma in situ (LCIS) at a single institution from 2008 to 2017. BMI groups were defined as a BMI 18.5 to < 30 or BMI ≥ 30 (obese). Adjusted logistic regression was used to estimate the association of BMI group with the odds of (1) upstage to cancer after atypia on needle biopsy, and (2) subsequent diagnosis of breast cancer. RESULTS: Breast atypia was identified in 503 patients (most advanced atypia: 74.8% ADH, 4.6% ALH, 20.7% LCIS), and 41% of these patients were classified as obese. After adjustment, BMI group was not associated with upstage to breast cancer at surgical excision following needle biopsy (p = 0.16) or development of a subsequent breast cancer (p = 0.08). For those upstaged to breast cancer at the time of surgical excision, or those who developed a subsequent malignancy, tumor subtype, grade and stage were not associated with BMI group (p > 0.05). CONCLUSION: In a large cohort of patients diagnosed with atypical breast histology, the risk of upstaging and/or subsequent progression to a breast malignancy was not associated with BMI. Factors other than obesity may influence breast cancer risk.


Assuntos
Carcinoma de Mama in situ , Neoplasias da Mama , Carcinoma in Situ , Carcinoma Intraductal não Infiltrante , Carcinoma Lobular , Lesões Pré-Cancerosas , Adulto , Índice de Massa Corporal , Mama/patologia , Mama/cirurgia , Carcinoma de Mama in situ/patologia , Neoplasias da Mama/cirurgia , Carcinoma in Situ/patologia , Carcinoma Intraductal não Infiltrante/patologia , Carcinoma Lobular/patologia , Carcinoma Lobular/cirurgia , Feminino , Humanos , Hiperplasia/patologia , Obesidade/complicações , Obesidade/patologia , Lesões Pré-Cancerosas/patologia , Estudos Retrospectivos
19.
Comput Biol Med ; 149: 105920, 2022 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-35986969

RESUMO

PURPOSE: The ultrasound (US) diagnosis of breast cancer is usually based on a single-region of a whole breast tumor from a single ultrasonic modality, which limits the diagnostic performance. Multiple regions on multimodal US images of breast tumors may all have useful information for diagnosis. This study aimed to propose a multi-region radiomics approach with multimodal US for artificially intelligent diagnosis of malignant and benign breast tumors. MATERIALS AND METHODS: Firstly, radiomics features were extracted from five regions of interest (ROIs) on B-mode US and contrast-enhanced ultrasound (CEUS) images, including intensity statistics, gray-level co-occurrence matrix texture features and binary texture features. The multiple ROIs included the whole tumor region, strongest perfusion region, marginal region and surrounding region. Secondly, a deep neural network, composed of the point-wise gated Boltzmann machine and the restricted Boltzmann machine, was adopted to comprehensively learn and select features. Thirdly, the support vector machine was used for classification between benign and malignant breast tumors. Finally, five single-region classification models were generated from five ROIs, and they were fused to form an integrated classification model. RESULTS: Experimental evaluation was conducted on multimodal US images of breast from 187 patients with breast tumors (68 malignant and 119 benign). Under five-fold cross-validation, the classification accuracy, sensitivity, specificity, Youden's index and area under the receiver operating characteristic curve (AUC) with our model were 87.1% ± 3.3%, 77.4% ± 11.8%, 92.4% ± 7.2%, 69.8% ± 8.6% and 0.849 ± 0.043, respectively. Our model was significantly better than single-region single-modal methods in terms of the AUC and accuracy (p < 0.05). CONCLUSION: In addition to the whole tumor region, the other regions including the strongest perfusion region, marginal region and surrounding region on US images can assist breast cancer diagnosis. The multi-region multimodal radiomics model achieved the best classification results. Our artificially intelligent model would be potentially useful for clinical diagnosis of breast cancer.


Assuntos
Neoplasias da Mama , Técnicas de Imagem por Elasticidade , Mama/patologia , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/patologia , Técnicas de Imagem por Elasticidade/métodos , Feminino , Humanos , Estudos Retrospectivos , Máquina de Vetores de Suporte , Ultrassonografia/métodos
20.
Pan Afr Med J ; 42: 70, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35949476

RESUMO

Collision tumor is a rare entity composed of two different tumors that occur in close to one another and maintain distinct borders. Only few cases have been reported in the breast. We report the first case of concomitant and adjacent primary angiosarcoma (PBAS) and invasive carcinoma of the breast (IBC), in a 45-year-old patient which presented with a lump in her right breast. Biopsy revealed PBAS. She underwent mastectomy. Gross examination showed a hemorrhagic and spongy tumor in contact with a second small grayish-white mass. Histologically, the hemorrhagic tumor was consistent with a high grade (HG) PBAS; the second mass was consistent with an IBC with no images of histological admixture. The diagnosis of a collision tumor composed of HG PBAS and IBC was established. During follow-up, the patient developed ovarian angiosarcomatous metastasis. The diagnosis of breast collision tumor is very uncommon and hence is challenging for pathologist. Careful gross and microscopic examinations help in establishing the appropriate diagnosis.


Assuntos
Neoplasias da Mama , Carcinoma , Hemangiossarcoma , Mama/patologia , Neoplasias da Mama/patologia , Feminino , Hemangiossarcoma/diagnóstico , Hemangiossarcoma/patologia , Hemangiossarcoma/cirurgia , Humanos , Mastectomia , Pessoa de Meia-Idade
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