Age-Related Structural and Functional Changes in the Breast: Multimodality Correlation With Digital Mammography, Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography

Abramson, Richard G.; Mavi, Ayşe; Çermik, Tevfik Fikret; Basu, Sandip; Wehrli, Natasha E.; Houseni, Mohamed; Mishra, Saurabh; Udupa, Jay; Lakhani, Paras; Maidment, Andrew D. A.; Torigian, Drew A.; Alavi, Abass

doi:10.1053/j.semnuclmed.2007.01.003

Cited by 18 publications

(11 citation statements)

References 40 publications

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“…However, postmenopausal breast density is known to decline with age [31], and two studies with longitudinal measurements found women with the highest breast density remained at high risk of breast cancer even if their breast density declined over time [32,33]. The histological features and age-related changes in breast tissue are complex and it is possible that the decline in density associated with age does not involve those tissue components most relevant to breast cancer development [34].…”

Section: Discussionmentioning

confidence: 98%

Breast cancer risk assessment in women aged 70 and older

Vacek

Skelly

Geller

2011

Breast Cancer Res Treat

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Although the benefit of screening mammography for women over 69 has not been established, it is generally agreed that screening recommendations for older women should be individualized based on health status and breast cancer risk. However, statistical models to assess breast cancer risk have not been previously evaluated in this age group. In this study, the original Gail model and three more recent models that include mammographic breast density as a risk factor were applied to a cohort of 19,779 Vermont women aged 70 and older. Women were followed for an average of 7.1 years and 821 developed breast cancer. The predictive accuracy of each risk model was measured by its c-statistic and associations between individual risk factors and breast cancer risk were assessed by Cox regression. C-statistics were 0.54 (95% CI = 0.52-0.56) for the Gail model, 0.54 (95% CI = 0.51-0.56) for the Tice modification of the Gail model, 0.55 (95% CI = 0.53-0.58) for a model developed by Barlow and 0.55 (95% CI = 0.53-0.58) for a Vermont model. These results indicate that the models are not useful for assessing risk in women aged 70 and older. Several risk factors in the models were not significantly associated with outcome in the cohort, while others were significantly related to outcome but had smaller relative risks than estimated by the models. Age-related attenuation of the effects of some risk factors makes the prediction of breast cancer in older women particularly difficult.

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Section: Discussionmentioning

confidence: 98%

Breast cancer risk assessment in women aged 70 and older

Vacek

Skelly

Geller

2011

Breast Cancer Res Treat

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“…Stromal tissue, which makes up a larger percentage of breast tissue in younger patients, is primarily composed of connective tissue and favorably, is generally less scattering compared to tumor tissue (50). Studies have shown that the optical refractive index does not differ greatly between stromal and tumor tissue (46).…”

Section: Discussionmentioning

confidence: 99%

Intraoperative Evaluation of Breast Tumor Margins with Optical Coherence Tomography

et al. 2009

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As breast cancer screening rates increase, smaller and more numerous lesions are being identified earlier, leading to more breast-conserving surgical procedures. Achieving a clean surgical margin represents a technical challenge with important clinical implications. Optical coherence tomography (OCT) is introduced as an intraoperative high-resolution imaging technique that assesses surgical breast tumor margins by providing real-time microscopic images up to 2 mm beneath the tissue surface. In a study of 37 patients split between training and study groups, OCT images covering 1 cm 2 regions were acquired from surgical margins of lumpectomy specimens, registered with ink, and correlated with corresponding histologic sections. A 17-patient training set used to establish standard imaging protocols and OCT evaluation criteria showed that areas of higher scattering tissue with a heterogeneous pattern were indicative of tumor cells and tumor tissue in contrast to lower scattering adipocytes found in normal breast tissue. The remaining 20 patients were enrolled into the feasibility study. Of these lumpectomy specimens, 11 were identified with a positive or close surgical margin and 9 were identified with a negative margin under OCT. Based on histologic findings, 9 true positives, 9 true negatives, 2 false positives, and 0 false negatives were found, yielding a sensitivity of 100% and specificity of 82%. These results show the potential of OCT as a real-time method for intraoperative margin assessment in breast-conserving surgeries. [Cancer Res 2009;69(22):8790-6]

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“…One limitation of this study is that the registration algorithm may not correct the change in the whole breast volume over time, e.g., due to hormonal fluctuations over the menstrual cycle [31]. In the current technique, the constrained term is applied to the tumor ROI to preserve the tumor volumes, and NMI is used to perform the alignment.…”

Section: Discussionmentioning

confidence: 99%

An algorithm for longitudinal registration of PET/CT images acquired during neoadjuvant chemotherapy in breast cancer: preliminary results

Abramson

Arlinghaus

et al. 2012

EJNMMI Res

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BackgroundBy providing estimates of tumor glucose metabolism, 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) can potentially characterize the response of breast tumors to treatment. To assess therapy response, serial measurements of FDG-PET parameters (derived from static and/or dynamic images) can be obtained at different time points during the course of treatment. However, most studies track the changes in average parameter values obtained from the whole tumor, thereby discarding all spatial information manifested in tumor heterogeneity. Here, we propose a method whereby serially acquired FDG-PET breast data sets can be spatially co-registered to enable the spatial comparison of parameter maps at the voxel level.MethodsThe goal is to optimally register normal tissues while simultaneously preventing tumor distortion. In order to accomplish this, we constructed a PET support device to enable PET/CT imaging of the breasts of ten patients in the prone position and applied a mutual information-based rigid body registration followed by a non-rigid registration. The non-rigid registration algorithm extended the adaptive bases algorithm (ABA) by incorporating a tumor volume-preserving constraint, which computed the Jacobian determinant over the tumor regions as outlined on the PET/CT images, into the cost function. We tested this approach on ten breast cancer patients undergoing neoadjuvant chemotherapy.ResultsBy both qualitative and quantitative evaluation, our constrained algorithm yielded significantly less tumor distortion than the unconstrained algorithm: considering the tumor volume determined from standard uptake value maps, the post-registration median tumor volume changes, and the 25th and 75th quantiles were 3.42% (0%, 13.39%) and 16.93% (9.21%, 49.93%) for the constrained and unconstrained algorithms, respectively (p = 0.002), while the bending energy (a measure of the smoothness of the deformation) was 0.0015 (0.0005, 0.012) and 0.017 (0.005, 0.044), respectively (p = 0.005).ConclusionThe results indicate that the constrained ABA algorithm can accurately align prone breast FDG-PET images acquired at different time points while keeping the tumor from being substantially compressed or distorted.Trial registrationNCT00474604

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Age-Related Structural and Functional Changes in the Breast: Multimodality Correlation With Digital Mammography, Computed Tomography, Magnetic Resonance Imaging, and Positron Emission Tomography

Cited by 18 publications

References 40 publications

Breast cancer risk assessment in women aged 70 and older

Breast cancer risk assessment in women aged 70 and older

Intraoperative Evaluation of Breast Tumor Margins with Optical Coherence Tomography

An algorithm for longitudinal registration of PET/CT images acquired during neoadjuvant chemotherapy in breast cancer: preliminary results

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