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Novel Insights into Breast Cancer Imaging
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Novel Insights into Breast Cancer Imaging

A special issue of Journal of Clinical Medicine (ISSN 2077-0383). This special issue belongs to the section "Obstetrics & Gynecology".

Deadline for manuscript submissions: closed (30 September 2021) | Viewed by 17056

Special Issue Editor

Dr. Nebojsa Durić

E-Mail Website
Guest Editor
Karmanos Cancer Institute, Wayne State University, Detroit, MI, USA
Interests: breast cancer; ultrasound tomography; breast cancer risk; treatment monitoring

Special Issue Information

Dear Colleagues,

Breast cancer is the most common cancer in women worldwide, with nearly 2 million new cases diagnosed each year. It is also a leading cause of cancer-related deaths with more than 500,000 women succumbing to the disease each year. Morbidity and mortality rates have been declining slowly as treatments have improved, but a major breakthrough remains elusive. While, mammography is available in many countries, its effectiveness it limited because increasing breast density drives breast cancer risk while lowering sensitivity. In other words, mammography is least effective for those who need it the most. There is a need, therefore, for new insights into screening methods and robust density-based risk assessments. Also needed are new imaging approaches to help manage breast cancer once it is diagnosed.

We are seeking submissions of recently performed imaging research across the spectrum of breast cancer management, including risk assessment, diagnosis, screening, treatment monitoring, and treatment planning. Review articles will also be considered. Your peer-reviewed contribution will be published in a Special Issue of the Journal of Clinical Medicine (JCM) entitled “Novel insights into breast cancer imaging”.

We truly hope you will join us in this effort to build an exciting JCM issue devoted to this topic.

Sincerely,

Dr. Nebojsa Durić
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Journal of Clinical Medicine is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • breast cancer
  • breast imaging
  • screening
  • diagnostic imaging
  • breast density
  • risk assessment
  • mammography
  • treatment planning
  • treatment monitoring

Published Papers (6 papers)

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Research

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12 pages, 6476 KiB  
Article
Rapid Reductions in Breast Density following Tamoxifen Therapy as Evaluated by Whole-Breast Ultrasound Tomography
by Gretchen L. Gierach, Mark Sak, Shaoqi Fan, Ruth M. Pfeiffer, Maya Palakal, Cody Ramin, Lisa Bey-Knight, Michael S. Simon, David Gorski, Haythem Ali, Peter Littrup, Mark E. Sherman and Nebojsa Duric
J. Clin. Med. 2022, 11(3), 792; https://doi.org/10.3390/jcm11030792 - 1 Feb 2022
Cited by 5 | Viewed by 1756
Abstract
Purpose: Women whose mammographic breast density declines within 12–18 months of initiating tamoxifen for chemoprevention or adjuvant treatment show improved therapeutic responses compared with those whose density is unchanged. We tested whether measuring changes in sound speed (a surrogate of breast density) using [...] Read more.
Purpose: Women whose mammographic breast density declines within 12–18 months of initiating tamoxifen for chemoprevention or adjuvant treatment show improved therapeutic responses compared with those whose density is unchanged. We tested whether measuring changes in sound speed (a surrogate of breast density) using ultrasound tomography (UST) could enable rapid identification of favorable responses to tamoxifen. Methods: We evaluated serial density measures at baseline and at 1 to 3, 4 to 6, and 12+ months among 74 women (aged 30–70 years) following initiation of tamoxifen for clinical indications, including an elevated risk of breast cancer (20%) and diagnoses of in situ (39%) or invasive (40%) breast carcinoma, enrolled at Karmanos Cancer Institute and Henry Ford Health System (Detroit, MI, USA). For comparison, we evaluated an untreated group with screen negative mammography and frequency-matched on age, race, and menopausal status (n = 150), at baseline and 12 months. Paired t-tests were used to assess differences in UST sound speed over time and between tamoxifen-treated and untreated patients. Results: Sound speed declined steadily over the 12 month period among patients receiving tamoxifen (mean (SD): −3.0 (8.2) m/s; p = 0.001), whereas density remained unchanged in the untreated group (mean (SD): 0.4 (7.1) m/s; p = 0.75 (relative change between groups: p = 0.0009)). In the tamoxifen group, we observed significant sound speed reductions as early as 4–6 months after tamoxifen initiation (mean (SD): −2.1 (6.8) m/s; p = 0.008). Sound speed reductions were greatest among premenopausal patients (P-interaction = 0.0002) and those in the middle and upper tertiles of baseline sound speed (P-interaction = 0.002). Conclusions: UST can image rapid declines in sound speed following initiation of tamoxifen. Given that sound speed and mammographic density are correlated, we propose that UST breast imaging may capture early responses to tamoxifen, which in turn may have utility in predicting therapeutic efficacy. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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15 pages, 3781 KiB  
Article
Current and Future Directions of Breast MRI
by Margaret Houser, David Barreto, Anita Mehta and Rachel F. Brem
J. Clin. Med. 2021, 10(23), 5668; https://doi.org/10.3390/jcm10235668 - 30 Nov 2021
Cited by 11 | Viewed by 3261
Abstract
Magnetic resonance imaging (MRI) is the most sensitive exam for detecting breast cancer. The American College of Radiology recommends women with 20% or greater lifetime risk of developing breast cancer be screened annually with MRI. However, other high-risk populations would also benefit. Hartmann [...] Read more.
Magnetic resonance imaging (MRI) is the most sensitive exam for detecting breast cancer. The American College of Radiology recommends women with 20% or greater lifetime risk of developing breast cancer be screened annually with MRI. However, other high-risk populations would also benefit. Hartmann et al. reported women with atypical hyperplasia have nearly a 30% incidence of breast cancer at 25-year follow-up. Women with dense breast tissue have up to a 4-fold increased risk of breast cancer when compared to average-risk women; their cancers are more likely to be mammographically occult. Because multiple cohorts of women are at high risk for developing breast cancer, there has been a movement to develop an abbreviated MRI (abMRI) protocol to expand the availability of MRI screening. Studies on abMRI effectiveness have been promising, with Weinstein et al. demonstrating a cancer detection rate of 27.4/1000 in women with dense breasts after a negative digital breast tomosynthesis. Breast MRI is also used to evaluate the extent of disease as part of preoperative assessment in women with newly diagnosed breast cancer, and to assess a patient’s response to neoadjuvant chemotherapy. This paper aims to explore the current uses of MRI and propose future indications and directions. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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9 pages, 964 KiB  
Article
The Potential Role of the Fat–Glandular Interface (FGI) in Breast Carcinogenesis: Results from an Ultrasound Tomography (UST) Study
by Nebojsa Duric, Mark Sak and Peter J. Littrup
J. Clin. Med. 2021, 10(23), 5615; https://doi.org/10.3390/jcm10235615 - 29 Nov 2021
Cited by 3 | Viewed by 1496
Abstract
This study explored the relationship between the extent of the fat–glandular interface (FGI) and the presence of malignant vs. benign lesions. Two hundred and eight patients were scanned with ultrasound tomography (UST) as part of a Health Insurance Portability and Accountability Act (HIPAA)-compliant [...] Read more.
This study explored the relationship between the extent of the fat–glandular interface (FGI) and the presence of malignant vs. benign lesions. Two hundred and eight patients were scanned with ultrasound tomography (UST) as part of a Health Insurance Portability and Accountability Act (HIPAA)-compliant study. Segmentation of the sound speed images, employing the k-means clustering method, was used to help define the extent of the FGI for each patient. The metric, α, was defined as the surface area to volume ratio of the segmented fibroglandular volume and its mean value across patients was determined for cancers, fibroadenomas and cysts. ANOVA tests were used to assess significance. The means and standard deviations of α for cancers, fibroadenomas and cysts were found to be 4.0 ± 2.0 cm−1, 3.1 ± 1.7 cm−1 and 2.3 ± 0.9 cm−1, respectively. The differences were statistically significant (p < 0.001). The separation between the groups increased when α was measured on only the image slice where the finding was most prominent, with values for cancers, fibroadenomas and cysts of 5.4 ± 3.6 cm−1, 3.6 ± 2.3 cm−1 and 2.4 ± 1.5 cm−1, respectively. Of the three types of masses studied, cancer was associated with the most extensive FGIs, suggesting a potential role for the FGI in carcinogenesis, a subject for future studies. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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16 pages, 4310 KiB  
Article
Multicenter Study of Whole Breast Stiffness Imaging by Ultrasound Tomography (SoftVue) for Characterization of Breast Tissues and Masses
by Peter J. Littrup, Nebojsa Duric, Mark Sak, Cuiping Li, Olivier Roy, Rachel F. Brem, Linda H. Larsen and Mary Yamashita
J. Clin. Med. 2021, 10(23), 5528; https://doi.org/10.3390/jcm10235528 - 25 Nov 2021
Cited by 11 | Viewed by 1955
Abstract
We evaluated whole breast stiffness imaging by SoftVue ultrasound tomography (UST), extracted from the bulk modulus, to volumetrically map differences in breast tissues and masses. A total 206 women with either palpable or mammographically/sonographically visible masses underwent UST scanning prior to biopsy as [...] Read more.
We evaluated whole breast stiffness imaging by SoftVue ultrasound tomography (UST), extracted from the bulk modulus, to volumetrically map differences in breast tissues and masses. A total 206 women with either palpable or mammographically/sonographically visible masses underwent UST scanning prior to biopsy as part of a prospective, HIPAA-compliant multicenter cohort study. The volumetric data sets comprised 298 masses (78 cancers, 105 fibroadenomas, 91 cysts and 24 other benign) in 239 breasts. All breast tissues were segmented into six categories, using sound speed to separate fat from fibroglandular tissues, and then subgrouped by stiffness into soft, intermediate and hard components. Ninety percent of women had mammographically dense breasts but only 11.2% of their total breast volume showed hard components while 69% of fibroglandular tissues were softer. All smaller masses (<1.5 cm) showed a greater percentage of hard components than their corresponding larger masses (p < 0.001). Cancers had significantly greater mean stiffness indices and lower mean homogeneity of stiffness than benign masses (p < 0.05). SoftVue stiffness imaging demonstrated small stiff masses, mainly due to cancers, amongst predominantly soft breast tissues. Quantitative stiffness mapping of the whole breast and underlying masses may have implications for screening of women with dense breasts, cancer risk evaluations, chemoprevention and treatment monitoring. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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Review

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19 pages, 6074 KiB  
Review
Ultrasound and Photoacoustic Imaging of Breast Cancer: Clinical Systems, Challenges, and Future Outlook
by Karl Kratkiewicz, Alexander Pattyn, Naser Alijabbari and Mohammad Mehrmohammadi
J. Clin. Med. 2022, 11(5), 1165; https://doi.org/10.3390/jcm11051165 - 22 Feb 2022
Cited by 24 | Viewed by 4474
Abstract
Presently, breast cancer diagnostic methods are dominated by mammography. Although drawbacks of mammography are present including ionizing radiation and patient discomfort, not many alternatives are available. Ultrasound (US) is another method used in the diagnosis of breast cancer, commonly performed on women with [...] Read more.
Presently, breast cancer diagnostic methods are dominated by mammography. Although drawbacks of mammography are present including ionizing radiation and patient discomfort, not many alternatives are available. Ultrasound (US) is another method used in the diagnosis of breast cancer, commonly performed on women with dense breasts or in differentiating cysts from solid tumors. Handheld ultrasound (HHUS) and automated breast ultrasound (ABUS) are presently used to generate reflection images which do not contain quantitative information about the tissue. This limitation leads to a subjective interpretation from the sonographer. To rectify the subjective nature of ultrasound, ultrasound tomography (UST) systems have been developed to acquire both reflection and transmission UST (TUST) images. This allows for quantitative assessment of tissue sound speed (SS) and acoustic attenuation which can be used to evaluate the stiffness of the lesions. Another imaging modality being used to detect breast cancer is photoacoustic tomography (PAT). Utilizing much of the same hardware as ultrasound tomography, PAT receives acoustic waves generated from tissue chromophores that are optically excited by a high energy pulsed laser. This allows the user to ideally produce chromophore concentration maps or extract other tissue parameters through spectroscopic PAT. Here, several systems in the area of TUST and PAT are discussed along with their advantages and disadvantages in breast cancer diagnosis. This overview of available systems can provide a landscape of possible intersections and future refinements in cancer diagnosis. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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12 pages, 2791 KiB  
Review
Cone-Beam Breast Computed Tomography: Time for a New Paradigm in Breast Imaging
by Avice M. O'Connell, Thomas J. Marini and Daniel T. Kawakyu-O'Connor
J. Clin. Med. 2021, 10(21), 5135; https://doi.org/10.3390/jcm10215135 - 31 Oct 2021
Cited by 13 | Viewed by 3245
Abstract
It is time to reconsider how we image the breast. Although the breast is a 3D structure, we have traditionally used 2D mammography to perform screening and diagnostic imaging. Mammography has been continuously modified and improved, most recently with tomosynthesis and contrast mammography, [...] Read more.
It is time to reconsider how we image the breast. Although the breast is a 3D structure, we have traditionally used 2D mammography to perform screening and diagnostic imaging. Mammography has been continuously modified and improved, most recently with tomosynthesis and contrast mammography, but it is still using modifications of compression 2D mammography. It is time to consider 3D imaging for this 3D structure. Cone-beam breast computed tomography (CBBCT) is a revolutionary modality that will assist in overcoming the limitations of current imaging for dense breast tissue and overlapping structures. It also allows easy administration of contrast material for functional imaging. With a radiation dose on par with diagnostic mammography, rapid 10 s acquisition, no breast compression, and true high-resolution isotropic imaging, CBBCT has the potential to usher in a new era in breast imaging. These advantages could translate into lower morbidity and mortality from breast cancer. Full article
(This article belongs to the Special Issue Novel Insights into Breast Cancer Imaging)
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