Association between quantitative and qualitative image features of contrast-enhanced mammography and molecular subtypes of breast cancer

Wang, Simin; Wang, Zhenxun; Li, Ruimin; You, Chao; Mao, Ning; Wang, Zhongyi; Xie, Haizhu; Gu, Yushen

doi:10.21037/qims-21-589

Cited by 14 publications

(10 citation statements)

References 43 publications

(48 reference statements)

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“…Higher values indicate high conspicuity within homogenous BPE. In a CEM study conducted by Wang et al, 39 using a total of 151 patients with 160 malignant lesions, reported a higher standard deviation of lesion density with non-luminal and HER2-enriched breast cancers. The RDE and CNR were not associated with molecular subtypes.…”

Section: Discussionmentioning

confidence: 99%

CEM radiomics for distinguishing lesion from background parenchymal enhancement in patients with invasive breast cancer

Varghese

Perkins²,

Cen³

et al. 2023

18th International Symposium on Medical Information Processing and Analysis

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In this IRB approved retrospective study 41 women with biopsy-proven invasive breast cancers (IBC) were imaged using contrast-enhanced mammography (CEM), prior to any treatment. Size-matched regions of interest (ROIs) were manually contoured by an experienced breast radiologist on the CEM capturing the breast lesion and breast parenchymal enhancement (BPE), respectively. Radiomics analysis was performed using LifEx software and 109 radiomics metrics spanning 6 different texture families were extracted from each ROI. Predictive models of lesion malignancy were developed using multiple classifiers and used to subclassify breast cancers based on their hormone receptor status. The 10fold cross validation was used to construct the decision classifier and performance was assessed. CEM radiomics models based on Random Forest, Real Adaboost, and ElasticNet classifiers achieved an AUC of 0.83, 0.82 and 0.74, respectively in discriminating malignant breast lesions from varying amounts of BPE. Accounting for the varying levels of BPE, revealed a reduction in AUC-based prediction of lesion vs. BPE as the qualitative assessment of BPE increased from minimal to moderate (AUCs of 0.89 vs 0.74). Further analyses of the IBC based on their hormone receptor status showed that triple negative breast lesions showed statistically significant differences in multiple radiomics metrics compared to ER+ PR+ HER2-and HER2+. The predicted probability of the radiomics model was significantly different across three receptor-based subtypes and between high and low nuclear grade breast cancers. CEM Radiomics demonstrated good discrimination (AUC>0.8) of malignant breast lesions despite varying BPE levels and supports breast lesion subtyping.

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Section: Discussionmentioning

confidence: 99%

CEM radiomics for distinguishing lesion from background parenchymal enhancement in patients with invasive breast cancer

Varghese

Perkins²,

Cen³

et al. 2023

18th International Symposium on Medical Information Processing and Analysis

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“…HER2 overexpression accounts for 20 out of 100 breast cancer cases, and it is associated with lower survival rates [5,6]. In the last two decades, since the molecular subtyping has become the standard of care in breast cancer management, the role of imaging has been to attempt to find specific imaging features that correlate to certain molecular subtypes with the intention to improve patient survival through prompt diagnosis and treatment [4]. CESM is well tolerated by patients, and its use in clinical practice has increased in the last few years [32].…”

Section: Discussionmentioning

confidence: 99%

“…Breast cancer is the most common cancer and the leading cause of cancer-related death in women [1]. The prognosis of breast cancer is impacted by several factors including tumor grade, axillary lymph node status and molecular subtypes all of which are vital in treatment planning with molecular subtypes being the most crucial [2][3][4]. Human epidermal growth factor receptor 2 (HER2) overexpression is seen in one out of five invasive breast cancer cases, which is linked to a lower survival rate [5,6].…”

Section: Introductionmentioning

confidence: 99%

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Mammographic and contrast-enhanced spectral mammography imaging findings of HER2-positive cancers according to hormone receptor status

Elkassas

Helal

Mikhael

et al. 2022

Egypt J Radiol Nucl Med

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Background Breast cancer is the leading cause of cancer-related mortality in women. Human epidermal growth factor receptor 2 (HER2) overexpression is seen in 20 out of 100 invasive breast cancers. Among HER2+ patients, two distinct hormone receptor (HR) subtypes can be defined: HR-positive (HR+) and HR-negative (HR−) each of which with unique therapeutic response and survival pattern. Contrast-enhanced spectral mammography (CESM) is an emerging novel imaging modality that offers diagnostic performance comparable to contrast-enhanced MRI. The purpose of this retrospective study was to describe the CESM features of HER2+ breast cancers according to hormone receptor status and to assess whether specific mammographic and CESM imaging features can differentiate between HER2+/HR+ and HER2+/HR− breast cancers potentially aiding treatment planning in HER2+ breast cancer patients. Results A total of 61 patients were included. Twenty-nine cases (47.5%) were HER2+/HR+ and 32 cases (52.5%) were HER2+/HR−. No statistically significant difference was found between mammographic imaging presentations and hormonal status. HR- were more likely to be multifocal (P 0.018), rounded or oval (P 0.008), circumscribed (P 0.004), and with associated non-mass enhancement (NME) (P < 0.001). HR+ cancers showed a tendency for irregular shape (P 0.008), spiculated outline (P 0.004), and heterogeneous (P 0.021) or ring (P 0.046) enhancement. Conclusions HER2+ tumors have different demographic, pathologic and imaging features according to the hormone receptor status. Because the two subtypes of HER2 breast cancer have different clinical outcomes, CESM imaging features can potentially enhance patient outcome by accelerating the diagnosis and treatment.

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“…A total of 151 female BC patients with 160 malignant lesions are examined within a retrospective double-center study between November 2017 and April 2020 using contrast-enhanced mammography and immunohistochemistry of several molecular subtypes [3]. There is association between a higher standard deviation of lesion density and non-luminal (p = 0.004) and HER2enriched BC (p = 0.006).…”

Section: Introductionmentioning

confidence: 99%

Immunohistochemical Marker Patterns in Female Breast Cancer

Yaneva

Dimitrova

Ivanov

et al. 2022

Open Access Maced J Med Sci

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BACKGROUND: Breast cancer (BC) represents the most common cancer in women worldwide and in Bulgaria. Its great medico-social importance determines the intensive complex research devoted to BC prevention, early diagnosis and management. AIM: The objective of the present investigation is to reveal some essential peculiarities of four main immunohistochemical markers used in the diagnosis of molecular subtypes of female BC. MATERIALS AND METHODS: During the period between December 1, 2017 and November 30, 2020, we examined a total of 128 randomly selected female BC patients operated on in Marko Markov Specialized Hospital for Active Treatment of Oncological Diseases of Varna, Bulgaria. We analyze BC molecular types and four immunohistochemical markers in BC patients. The expression of estrogen (ER) and progesterone (PR) receptors is assessed in mammary gland biopsies and surgical specimens by using the indirect immunoperoxidase method with EnVision™ FLEX MiniKit, that of HER2 with HercepTest™ and that of Ki-67 proliferation index with Leica Aperio Scan Scope AT2 device. The positivity and negativity of these receptors in single molecular subtypes is evaluated. RESULTS: The luminal B HER2-positive and the luminal B HER2-negative subtypes are most common - in 36.72% and 35.16% of the cases, respectively. TNBC subtype is established in 11.72%) the luminal A - in 8.59% and the non-luminal HER2-positive subtype - in 7.81% of the cases. The positive expression is statistically significantly more common in ER (t=8.972; p<0.0001) and PR (t=2.828; p<0.01), while the negative expression insignificantly prevails in HER2. CONCLUSION: Our immunohistochemical results in female BC patients prove the role of single receptor expression for the proper and timely decision making about the necessity and benefit of additional chemotherapy in selected surgically treated cases.

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Association between quantitative and qualitative image features of contrast-enhanced mammography and molecular subtypes of breast cancer

Cited by 14 publications

References 43 publications

CEM radiomics for distinguishing lesion from background parenchymal enhancement in patients with invasive breast cancer

CEM radiomics for distinguishing lesion from background parenchymal enhancement in patients with invasive breast cancer

Mammographic and contrast-enhanced spectral mammography imaging findings of HER2-positive cancers according to hormone receptor status

Immunohistochemical Marker Patterns in Female Breast Cancer

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