We have been developing an optical mammography prototype consisting of a multi-channel time-resolved spectroscopy system for breast cancer screening. The system utilizes the time-correlated single photon counting method, and the detector modules and the signal processing circuits were custom-made to obtain a high signal to noise ratio and high temperature stability with a high temporal resolution. Pulsed light generated by a Ti: Sapphire laser was irradiated to the breast, and the transmitted light was collected by optical fibers placed on the surface of a hemispherical gantry filled with an optical matching fluid. To reconstruct a 3D image of the breast, we employed a method using a time-resolved photon path distribution based on the assumption that scattering and absorption are independent of each other. We verified the possibility of human breast imaging by using a three-dimensional phantom model, which provides a simulation of human breast cancer, in the gantry. The clinical study was also started in January 2007. In a comparative study with conventional modalities, the breast cancers were detected as regions of optically higher absorption. Moreover, the results suggest that optical mammography is useful in monitoring the effects of chemotherapy.

Diabetic mastopathy is a rare benign condition associated with long-standing diabetes mellitus and presents with breast lumps. This report describes two cases in which diffusion-weighted images (DWI) on magnetic resonance imaging were quite different from each other. In case 1, there were hyperintense lesions on DWI, and surgically removed specimens revealed ductitis with marked lymphocytic infiltration. In case 2, no abnormal intensity was depicted on DWI, and biopsy specimens showed dense stromal fibrosis with mild perivascular lymphocytic infiltration that corresponded to previous reports. Although it is reported that diabetic mastopathy is composed of dense fibrous tissue with low cellularity that results in no hyperintense lesion on DWI, in cases with marked lymphocytic infiltration, strong hyperintensity can be seen on DWI mimicking malignant breast tumors.

Lymphocytic mastopathy or diabetic mastopathy is a benign breast disease characterized by dense fibrosis, lobular atrophy, and aggregates of lymphocytes in a periductal and perilobular distribution. The condition usually affects women with a long history of diabetes mellitus (DM) and also those with autoimmune disorders. While the pathogenesis is unknown, a particular type of class II human leukocyte antigen has been associated with this disease. Herein, we report a case of diabetic mastopathy which clinically and radiologically mimicked primary breast neoplasms. The patient was a 74-year-old woman with a 31-year history of DM type II who presented with multiple firm lumps in bilateral breasts. Findings from mammography, ultrasonography, and magnetic resonance imaging of the breasts revealed an abnormal appearance which suspiciously resembled malignancy. An aspiration cytology specimen showed atypical accumulation of lymphoid cells, leading us to suspect lymphoma. Histology of an excisional biopsy showed the characteristic appearance of lymphocytic mastopathy, which predominantly consisted of B-lymphocytes. Autoantibodies in her serum reacted positively against her ductal epithelium as well as other diabetic and nondiabetic breast ductal cells. An antigen absorption test with insulin revealed attenuating intensity according to insulin concentration. These anti-insulin antibodies produced in the DM patient may cause ductitis because of antigen cross-reactivity.

Objectives: To analyze optical parameters of cancer before and after chemotherapy in breast cancer patients.Patients and Methods: Absorption coefficient (µa) and reduced scattering coefficient (µs') of cancer and contra-lateral normal region before and after chemotherapy were measured by using TRS-20SH (Hamamatsu Photonics K.K.). A pulsed laser of 760, 800, and 830 nm wave-length was irradiated at multiple sites in both breasts with time-resolved spectroscopy method and scattered light was analyzed by photon diffusion equation. A total of ten breast cancer patients who underwent neoadjuvant chemotherapy participated in the trial. Written informed consent was obtained from all of the patients.Results: Absorption coefficient (µa, 1/cm) of breast cancer was significantly higher than that of contra-lateral normal region before chemotherapy. In 800 nm wave-length, absorption coefficient of breast cancer decreased significantly after chemotherapy (before:0.0927, after;0.0498, p=0.002). Although absorption coefficient of contra-lateral normal region also decreased (before:0.0561, after;0.0437, p=0.006), cancer showed more significant decrease than contra-lateral normal region (cancer:-43.1%, normal region;-19.0%, P<0.01). Figure 1. Absorption coefficient (pa, cm-1), at 800rim (cancer-normal) Similar results were observed in 760 and 830 nm wave-length. There was no difference in reduced scattering coefficient (µs') between before and after chemotherapy in both breast cancer and contra-lateral normal region. Conclusion: The absorption coefficient of cancer was significantly higher than that of contra-lateral normal region before chemotherapy and decreased significantly after chemotherapy. Citation Information: Cancer Res 2010;70(24 Suppl):Abstract nr P2-05-02.

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