A Bottom-Up Review of Image Analysis Methods for Suspicious Region Detection in Mammograms.

Breast cancer is one of the most common death causes amongst women all over the world. Early detection of breast cancer plays a critical role in increasing the survival rate. Various imaging modalities, such as mammography, breast MRI, ultrasound and thermography, are used to detect breast cancer. Though there is a considerable success with mammography in biomedical imaging, detecting suspicious areas remains a challenge because, due to the manual examination and variations in shape, size, other mass morphological features, mammography accuracy changes with the density of the breast. Furthermore, going through the analysis of many mammograms per day can be a tedious task for radiologists and practitioners. One of the main objectives of biomedical imaging is to provide radiologists and practitioners with tools to help them identify all suspicious regions in a given image. Computer-aided mass detection in mammograms can serve as a second opinion tool to help radiologists avoid running into oversight errors. The scientific community has made much progress in this topic, and several approaches have been proposed along the way. Following a bottom-up narrative, this paper surveys different scientific methodologies and techniques to detect suspicious regions in mammograms spanning from methods based on low-level image features to the most recent novelties in AI-based approaches. Both theoretical and practical grounds are provided across the paper sections to highlight the pros and cons of different methodologies. The paper's main scope is to let readers embark on a journey through a fully comprehensive description of techniques, strategies and datasets on the topic

Nuclear morphometry, apoptotic and mitotic indices, and tubular differentiation in Libyan breast cancer

Aims of this study were to evaluate the relations of nuclear morphometry, mitotic and apoptotic indices, and tubular differentiation with clinicopathological features and survival rate in Libyan women. The data were compared with corresponding results on Finnish, and Nigerian female breast cancer patients. Histological samples of breast cancer (BC) from 131 patients were retrospectively studied. Mitotic activity indices (MAI and SMI), apoptotic index (AI), and fraction of fields with tubular differentiation (FTD) were estimated. Samples were also studied by computerized nuclear morphometry, such as mean nuclear area (MNA). Demographic and clinicopathological features were analyzed from 234 patients. The Libyan BC was dominantly premenopausal, and aggressive in behavior. There were statistically significant correlations between the mean nuclear area, fraction of fields with tubular differentiation, apoptotic index and proliferative indices, and most clinicopathological features. The highest significances were shown between lymph node status and the proliferative and apoptotic indices (p=0.003 with SMI, and p=0.005 with AI). There were significant associations between clinical stage and SMI and AI (p=0.002 and 0.009, respectively). The most significant associations with grade were observed with MNA and FTD (p<0.0001 and 0.001, respectively). The proliferative differences between Libyan, Nigerian and Finnish populations were prominent. These indices in Libyan were lower than in Nigerian, but higher than in Finnish patients. The Libyan patients’ AI is slightly higher than in Nigeria, but much higher than in Finland. The differences between countries may be associated with the known variation in the distribution of genetic markers in these populations. The results also indicated that morphometric factors can be reliable prognostic indicators in Libyan BC patients.Tämän työn tarkoituksena on arvioida tumamorfometrian, mitoosi- ja apoptoosi-indeksien ja tubulaarisen differentaation suhdetta libyalaisten rintasyöpäpotilaiden kliinispatologisiin piirteisiin ja eloonjäämiseen. Tietoja verrattiin suomalaisiin ja nigerialaisiin rintasyöpää sairastavien naisten tietoihin. Työssä tutkittiin 131 potilaan histologisia rintasyöpänäytteitä retrospektiivisesti. Mitoosiaktiviteetti-indeksit (MAI ja SMI), apop¬toottinen indeksi (AI) ja niiden mikroskooppikenttien osuus, joissa todettiin tubulaarista differentaatiota (FTD) arvioitiin. Myös kasvainsolujen keskimääräinen ala (MAI) arvioitiin tietokoneistettua morfometriaa käyttäen. Libyan rintasyöpäpotilaiden demografisia ja kliinispatologisia piirteitä analysoitiin 234 potilaasta. Libyan rintasyöpä (BC) on etupäässä premenopausaalista ja käyttäytymiseltään agressiivista. MNA, FTD, AI, MAI ja SMI olivat selvästi korrelaatiossa useimpiin kliinispatologisiin tietoihin. Merkittävin suhde todettiin imusolmukestatuksen ja proliferaatioindeksien ja apoptoottisen indeksin välillä (SMI p=0.003, AI p= 0.009). Histologinen gradus korreloi parhaiten MNA:n (p=0.001) ja FTD:n (p=0.001) kanssa. Kasvainten proliferaatioindeksit Libyassa, Nigeriassa ja Suomessa olivat selvästi erilaisia. Libyan indeksit olivat matalampia kuin Nigerian indeksit, mutta korkeampia kuin Suomen indeksit. AI oli hieman matalampi kuin Nigeriassa, mutta selvästi korkeampi kuin Suomessa. Erot maiden välillä voivat liittyä populaatioiden geneettisiin eroihin. Tulokset myös osoittavat, että morfometrisia tekijöitä voidaan käyttää libyalaisten rintasyöpäpotilaiden ennustetekijöinä.Institute of BiomedicineSiirretty Doriast

Expression and Clinicopathologic Correlation of Basal Cytokeratins in Breast Cancer

INTRODUCTION: Treatment for breast cancer is based on the expression of the immunomarkers such as ER, PR and HER2/neu. Cases which are negative to all the three immunomarkers, are called Triple Negative Breast Cancers (TNBC) and they have a poor prognosis. Recent studies have shown that some of the TNBCs express cytokeratins CK 5/6 (subcategorizing them as basal-like breast cancers) and these respond well to anthracycline-based chemotherapy. AIM AND OBJECTIVES: To study the expression of basal cytokeratins CK 5/6 in breast carcinomas reported in our centre and to correlate with histological type, grade, size, clinical features and ER, PR and HER2/neu status. METHODS: Tissues of 44 cases of breast carcinoma diagnosed between June 2009 and May 2014 were retrieved. Immunohistochemical staining for CK 5/6 was done and it was correlated with parameters such as histopathological type, grade, size, invasion and ER, PR and HER2/neu status. RESULTS: Eight of the breast carcinomas (18%) were categorized as Triple Negative Breast Cancers (TNBC) as they were negative for ER, PR and HER2/neu. Four of the TNBCs (50%), were positive for CK 5/6. Significant statistical correlation was observed between the size of the tumour and positive CK 5/6 expression. All CK 5/6 positive cases were of high grade. CONCLUSION: The routine use of CK 5/6 is recommended in all cases of TNBCs, as 50% of them are positive for these markers. Patients in this subcategory could benefit from anthracycline-based chemotherapy