Diagnosis of breast cancer by tissue analysis

In this paper, we propose a technique to locate abnormal growth of cells in breast tissue and suggest further pathological test, when require. We compare normal breast tissue with malignant invasive breast tissue by a series of image processing steps. Normal ductal epithelial cells and ductal/lobular invasive carcinogenic cells also consider for comparison here in this paper. In fact, features of cancerous breast tissue (invasive) are extracted and analyses with normal breast tissue. We also suggest the breast cancer recognition technique through image processing and prevention by controlling p53 gene mutation to some extent.     

Breast microcalcifications: The lesions in anatomical pathology

Microcalcifications are actually indirect signs of pathological processes, and only a few of these processes may be correctly correlated to the morphologic pattern of calcifications. This is true of the microcalcifications typically classified as benign by the 4th edition of the BI-RADS Atlas, except for round and punctuate microcalcifications. This is also the case of polymorphous fine and linear fine microcalcifications most often, but not exclusively, associated with DCIS with necrosis. For other types of microcalcifications, other parameters are analyzed in a more global approach: the associated clinical or mammographical signs; the context, especially genetic; the spatial distribution; the number; the evolution over time. The radiologist should compare the images with the anatomy of the terminal ductal-lobular unit, from where most cancers arise, and estimates the risk by taking into account the clinical context and the antecedents.     

Factors influencing the mammography utilization among Taiwanese women with intellectual disabilities,a nationwide population-based study

Women with intellectual disabilities (ID) have cognitive impairment and communication difficulties; for both caregivers and clinical personnel, discovering the early symptoms of breast cancer among women with ID is challenging. The mammography utilization rate of women with ID was significantly lower than that of women in the general population. This study employed a 2008 database of people with disabilities in Taiwan as a research target and analyzed the mammography utilization rate of women with ID aged 50–69 years. In addition, relevant factors influencing mammography utilization among women with ID were also investigated. A total of 4370 participants were recruited and the majority were illiterate or had elementary-level educations (82.27%). The majority of the participants had ID that was more severe than mild (83.80%). The mammography utilization rate of women with ID was 4.32%, which was significantly lower than that of women in the general population (12%). The mammography utilization rate among women with ID who were married, had higher education levels, and had been diagnosed with cancer, diabetes, or mild ID was significantly higher. However, the mammography utilization rate among women with ID, who had elementary-level educations or were illiterate, was only 4.03%. The utilization rate among women with profound ID was only 2.65%. Women with ID who had undergone pap smears or had utilized adult preventive health services demonstrated a significantly higher mammography utilization rate. This study identified that education level, a diagnosis of diabetes, and the application of pap smears or adult preventive health services were primary factors that influenced the mammography utilization rate among women with ID. This study also observed that in Taiwan, the mammography utilization rate of women with ID was lower than that of pap smears and adult preventive health services, and was only half of that of people with disabilities. An unequal situation existed in regard to the acceptance of breast cancer screening among women with ID, and a different form of strategic planning must be adopted in public health policy. Because ID differs from other disabilities and most women with ID are illiterate, tailored courses are required to train primary caregivers and clinical personnel in providing knowledge and services. The objectives are to diagnose breast cancer at an early stage to decrease the risk of mortality and ensure their rights to health.     

Screening mammography rate and predictors following treatment for colorectal cancer

Introduction  Colorectal cancer survivors remain at risk for breast cancer. Thus, it is important to determine if screening mammography rates are reduced by the diagnosis and treatment of incident colorectal cancer. Methods  Mammography rates among 7,666 67–79 year-old stage 0-III colorectal cancer survivors were compared with rates among 36,433 age-, race/ethnicity-, SEER area-matched women controlling for pre-diagnosis mammography, stage, chemotherapy, income, co-morbidities, treatment in teaching hospital, number of physician visits, and gynecologist visits. Results  In the first 2 years after diagnosis, the survivors’ rate (49.7/100) was 4.2% higher than the controls’ (47.6/100), p < 0.001. It was 7.5% higher in the next 2 years, 54.5/100 versus 49.7/100, p < 0.001. The higher rates resulted from significantly greater rates among survivors without prior mammography, 30.9/100, compared with their controls (25.3/100) in the first 2 years, for example (O.R. = 1.23, 95% C.I. = 1.15–1.32). The strongest predictors of post-diagnosis mammography were pre-diagnosis mammography (O.R. = 5.76, 95% C.I. = 5.19–6.38), visiting a gynecologist (O.R. = 1.83, 95% C.I. = 1.55–2.16), chemotherapy (O.R. = 1.61, 95% C.I. = 1.40–1.86), and more than nine physician visits. Increasing Charlson scores and cancer stage were associated with lower mammography rates. Discussion/Conclusions  Overall, the competing demands of cancer diagnosis and treatment did not reduce mammography rates, and these events were associated with increased rates among previous non-users. Implications for cancer survivors  The low mammography rate among survivors with no history of a prior mammogram means that the physicians treating these women must emphasize the need for such care.     

MRI对乳腺X线摄影中含成簇微钙化病变的诊断

目的：探讨乳腺磁共振成像对乳腺X线摄影中含成簇微钙化病变的鉴别诊断价值。方法：搜集行乳腺钙化灶立体定位下活检术或术前钩丝定位局切活检术的97例病例,所有患者术前均行乳腺X线摄影和MRI检查且病灶钙化表现为成簇微钙化灶,分析含不同形态成簇微钙化病变的MRI表现及其鉴别诊断价值,并与组织病理学结果进行对照。结果：病灶总数为97个,其中病理结果为良性者73个（75.3%）,恶性24个（24.7%）。良恶性病变乳腺X线上表现均以无定形钙化为主者,分别占57.5%（42/73）、37.5%（9/24）。MRI对含成簇微钙化的恶性病灶诊断的阳性预测值72.4%（21/29）高于乳腺X线摄影28.9%（22/76）（P=0.000）。MRI对含成簇无定形钙化的恶性病灶诊断的阳性预测值66.7%（8/12）高于乳腺X线摄影17.6%（9/51）（P=0.002）。MRI上节段性强化诊断恶性病变的阳性预测值为100.0%（9/9）;无强化对诊断含成簇钙化病变的阴性预测值为100.0%（9/9）。含成簇微钙化的恶性病变早期强化率平均值为109.6%±78.5%,高于良性病变62.8%±25.9%（P=0.000）。结论：MRI对含成簇微钙化特别是无定形成簇微钙化的乳腺病变具有较好的鉴别诊断价值。     

Which Phantom Is Better for Assessing the Image Quality in Full-Field Digital Mammography?: American College of Radiology Accreditation Phantom versus Digital Mammography Accreditation Phantom

Objective

To compare between the American College of Radiology (ACR) accreditation phantom and digital mammography accreditation phantom in assessing the image quality in full-field digital mammography (FFDM).

Materials and Methods

In each week throughout the 42-week study, we obtained phantom images using both the ACR accreditation phantom and the digital mammography accreditation phantom, and a total of 42 pairs of images were included in this study. We assessed the signal-to-noise ratio (SNR) in each phantom image. A radiologist drew a square-shaped region of interest on the phantom and then the mean value of the SNR and the standard deviation were automatically provided on a monitor. SNR was calculated by an equation, measured mean value of SNR-constant coefficient of FFDM/standard deviation. Two breast radiologists scored visible objects (fibers, specks, and masses) with soft-copy images and calculated the visible rate (number of visible objects/total number of objects). We compared SNR and the visible rate of objects between the two phantoms and calculated the k-coefficient for interobserver agreement.

Results

The SNR of the ACR accreditation phantom ranged from 42.0 to 52.9 (Mean, 47.3 ± 2.79) and that of Digital Phantom ranged from 24.8 to 54.0 (Mean, 44.1 ± 9.93) (p = 0.028). The visible rates of all three types of objects were much higher in the ACR accreditation phantom than those in the digital mammography accreditation phantom (p < 0.05). Interobserver agreement for visible rates of objects on phantom images was fair to moderate agreement (k-coefficients: 0.34-0.57).

Conclusion

The ACR accreditation phantom is superior to the digital mammography accreditation phantom in terms of SNR and visibility of phantom objects. Thus, ACR accreditation phantom appears to be satisfactory for assessing the image quality in FFDM.     

农村地区乳腺癌筛查中乳腺X线检查的作用及结果分析

目的探讨乳腺X线检查在农村地区乳腺癌及乳腺良性病变防治工作中的作用。方法对7225名年龄在35～69岁的当地妇女进行普查,经临床医生检查触及肿块者（共547例）进行乳腺X线检查。结果 547例X线检查报告中,考虑乳腺癌3例（3/547）,可疑恶性3例（3/547）,乳腺纤维腺瘤25例（25/547）,囊肿20例（20/547）,导管扩张症4例（4/547）,脂肪瘤2例（2/547）,要求随访28例（28/547）。病理所见浸润性导管癌5例,导管内癌1例,纤维腺瘤20例,囊肿15例,导管扩张症4例,乳腺增生症4例,脂肪瘤2例。结论乳腺X线检查利于较早发现乳腺癌,提高乳腺癌的早期诊断率及早期治疗率,提高农村妇女对乳腺疾病的认识,利于农村地区乳腺癌防治工作的开展。