Diagnostic value of halo sign in young women (aged 45 to 49 years) in a breast screening programme with synthesized 2D mammography

González-Carrato, Pilar Sánchez-Camacho; Castellano, Cristina Romero; Angulo, Paul Martín Aguilar; Hernández, Lina Marcela Cruz; Casado, Marcelino Sánchez; Martín, Juan Ruiz; Alonso, Iñaki Fraile; Varela, J.M.; Martínez‐Vizcaíno, Vicente

doi:10.1259/bjr.20180444

Cited by 2 publications

(4 citation statements)

References 16 publications

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“…A study by Sánchez-Camacho González-Carrato et al [14] showed that a tomosynthesis halo sign was a good diagnostic predictive marker of benign lesions in women <50 years old, but not for women >50 years old. As many of the patients with breast cancer are 50 years or older, the halo sign as a benign marker only accounts for a small percent of patients.…”

Section: Discussionmentioning

confidence: 99%

“…Traditionally, the halo sign is defined as a radiolucent ring a few millimeters wide that at least partially surrounds a focal lesion. Traditionally, it has been described to appear around lesions with a smooth contour such as cysts or fibroadenomas, and has been considered an indicator of benignity [14]. However, over the last decade, the halo sign has increasingly been acknowledged as also occurring around malignant tumors [13,15].…”

Section: Discussionmentioning

confidence: 99%

“…To improve the differentiation between benign and malignant lesions, some recent studies focused their attention on the peritumoral tissue/halo sign in DBT [14]. This sign describes a thin linear area of hyperlucency surrounding a circumscribed mass in mammography [15].…”

Section: Introductionmentioning

confidence: 99%

“…This results in a low intensity shadow around high-density structures along the direction of the X-ray tube motion and/or sweep direction [16,17]. Although the exact cause of the halo is still not fully clarified, its appearance is considered a macroscopic marker for benign lesions in patients under 50 years of age [14], yet its diagnostic value for older patients is still argued [13].…”

Section: Introductionmentioning

confidence: 99%

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The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors

Deeg,

Swoboda,

Egle

et al. 2023

Tomography

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Background: Compared to conventional 2D mammography, digital breast tomosynthesis (DBT) offers greater breast lesion detection rates. Ring-like hypodense artifacts surrounding dense lesions are a common byproduct of DBT. This study’s purpose was to assess whether minuscule changes spanning this halo—termed the “broken halo sign”—could improve lesion classification. Methods: This retrospective study was approved by the local ethics review board. After screening 288 consecutive patients, DBT studies of 191 female participants referred for routine mammography with a subsequent histologically verified finding of the breast were assessed. Examined variables included patient age, histological diagnosis, architectural distortion, maximum size, maximum halo depth, conspicuous margins, irregular shape and broken halo sign. Results: While a higher halo strength was indicative of malignancy in general (p = 0.031), the broken halo sign was strongly associated with malignancy (p < 0.0001, odds ratio (OR) 6.33), alongside architectural distortion (p = 0.012, OR 3.49) and a diffuse margin (p = 0.006, OR 5.49). This was especially true for denser breasts (ACR C/D), where the broken halo sign was the only factor predicting malignancy (p = 0.03, 5.22 OR). Conclusion: DBT-associated halo artifacts warrant thorough investigation in newly found breast lesions as they are associated with malignant tumors. The “broken halo sign”—the presence of small lines of variable diameter spanning the peritumoral areas of hypodensity—is a strong indicator of malignancy, especially in dense breasts, where architectural distortion may be obfuscated due to the surrounding tissue.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors

Deeg,

Swoboda,

Egle

et al. 2023

Tomography

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Focus on the Predictive Value of Subclassification of Extratumoral Structural Abnormalities for Malignant Nonspiculate and Noncalcified Masses on Digital Mammography

Sun

Guo

et al. 2022

Front. Genet.

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Purpose: To determine the independent risk factors associated with malignant nonspiculate and noncalcified masses (NSNCMs) and evaluate the predictive values of extratumoral structural abnormalities on digital mammography.Methods: A total of 435 patients were included between January and May 2018. Tumor signs included shape, density, and margin, which were evaluated. Extratumoral signs were classified into extratumoral structural abnormalities (parenchymal and trabecular) and halo; subclassification included contraction, distortion, pushing and atrophy sign of parenchyma, parallel, vertical, and reticular trabecula sign, and narrow and wide halo. Univariate and multivariate analysis was performed. The positive predictive value (PPV) of the independent predictor was calculated, and diagnostic performance was evaluated using the receiver operating characteristic curve.Results: Of all cases, 243 (55.8%) were benign and 192 (44.2%) were malignant. Extratumoral contraction sign of parenchyma was the strongest independent predictor of malignancy (odds ratio [OR] 36.2, p < 0.001; PPV = 96.6%), followed by parenchymal distortion sign (OR 10.2, p < 0.001; PPV = 92%), parallel trabecula sign (OR 7.2, p < 0.001; PPV = 85.6%), and indistinct margin of tumor (OR 4.3, p < 0.001; PPV =70.9%), and also parenchymal atrophy sign, wide halo, vertical trabecula, age ≥ 47.5 years, irregular shape, and size ≥ 22.5 mm of tumor (OR range, 1.3-4.0; PPV range, 56.6-83.6%). The diagnostic performance of most of the extratumoral signs was between that of indistinct margin and irregular shape of tumor.Conclusion: The subclassification of extratumoral structural abnormalities has important predictive value for mammographic malignant NSNCM, which should be given more attention.

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Diagnostic value of halo sign in young women (aged 45 to 49 years) in a breast screening programme with synthesized 2D mammography

Abstract: The trend of a positive halo sign to act as a marker of benign lesion could be improve the recall rate and positive predictive values in the breast screening programme with tomosynthesis and synthesized 2D mammography, especially in young females.

Cited by 2 publications

References 16 publications

The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors

The Tomosynthesis Broken Halo Sign: Diagnostic Utility for the Classification of Newly Diagnosed Breast Tumors

Focus on the Predictive Value of Subclassification of Extratumoral Structural Abnormalities for Malignant Nonspiculate and Noncalcified Masses on Digital Mammography

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