MAMMOGRAPHIC PARENCHYMAL PATTERNS IN SOLID BREAST TUMORS

Saba Sohail; Sunaina Anwar; Nasreen Naz Memon; Misbah Talpur

MAMMOGRAPHIC PARENCHYMAL PATTERNS IN SOLID BREAST TUMORS

Saba Sohail, Sunaina Anwar, Nasreen Naz Memon, Misbah Talpur

Abstract

ABSTRACT

Objective: to determine the frequency of various breast parenchymal patterns on mammography and an association of the presence of a solid tumor with any pattern

Study design: analytical descriptive study

Duration and Setting: January 2009 to September 2010, at Radiology Department, Dow University of Health Sciences/Civil Hospital Karachi

Methods: Adult females diagnosed with single solid breast lesion placed in BIRADS category II-VI on mammography and ultrasound, were included. The parenchymal pattern of breast was classified into predominantly fatty (N1), < 25% glandular (P1), >25% glandular (P2) and very dense glandular tissue (DY) according to Wolffe’s classification. Those with multiple lumps, ductal dilatation, chemo or radiation therapy to breast, or recent hormonal or contraceptive use were excluded. The overall data was described as measures of central tendency and dispersion. Significance of association was determined using chi square test at P<0.05.

Results: There were a total of 76 patients with mean age of 47.6± 10.45 years; 74 (97.4%) were married with average parity of 4.5 ± 2.8 and 64 (84.2%) had lactated. Lesions included 65 (82.2%) carcinomas, 10 (10.5%) fibro adenomas and 01 (1.3%) lipoma. The distribution of parenchymal patterns was found to be 22.4% N1, 44.7% P1, 26.3% P2 and 6.6% DY patterns. There was a strong association of P1 and P2 patterns with solid breast lesions (p=0.024). The overall association of carcinoma with P1 and DY patterns was also significant (p= 0.041).

Conclusion:

Scattered fibro glandular and heterogeneously dense mammographic parenchyma had a strong association with presence of solid malignant lesion in breast. These findings are incongruous with the reported patterns from the West and may represent inherent oncogenic characteristic in Pakistani ladies.

Key words:

Mammography, breast parenchyma, parenchymal pattern, solid lesion, carcinoma, Wolffe’s classification

Full Text:

PDF

References

REFERENCES:

Badar F, Faruqui ZS, Ashraf A, Najamuddin. Third world issues in Breast cancer detection. J Pak Med Assoc 2007; 57: 137-9.

Usmani S, Niaz K, Maseeh-uz-Zaman, Kamal S, Niyaz K, Mehboob J et al. Role of 99mTC MIBI scintimammography and X-Ray mammography in the diagnosis of locoregional recurrence of breast cancer. J Pak Med Assoc 2007; 57: 172-4.

Ahmed R, Ali SM. Role of imaging in diagnosis of cancer of breast. J Coll Physicians Surg Pak 2005; 15: 238-41.

Masroor I. Prediction of benignity or malignancy of a lesion using BIRADS. J Coll Physicians Surg Pak 2005; 15: 686-8.

Brisson J, Diorio C, Masse B. Wolfe parenchymal pattern and percentages to breast with mammographic densities. Redundant or complementary classifications? Cancer Epidemiol Biomarkers prev. 2003; 12: 728-32.

Martin LJ, Boyd NF. Mammographic density. Potential mechanisms of breast cancer risk associated with mammographic density: hypotheses based on epidemiological evidence. Breast Cancer Research 2008, 10:201 doi: 10.1186/bcr1831

Wolfe JN. Breast patterns as an index of risk for developing breast cancer. Am J Roentgenol 1976; 126: 1130- 9.

Sickles EA. Wolfe mammographic parenchymal pattern and Breast Cancer risk. Am J Roentgenol 2007;188:301-3

He W, Juette A, Denton ER, Oliver A, Martí R, Zwiggelaar R. A Review on Automatic Mammographic Density and Parenchymal Segmentation. Int J Breast Cancer. 2015; 2015: 276217. doi: 10.1155/2015/276217.

Li H, Giger ML, Lan L, Janardanan J, Sennett CA. Comparative analysis of image-based phenotypes of mammographic density and parenchymal patterns in distinguishing between BRCA1/2 cases, unilateral cancer cases, and controls. J Med Imaging (Bellingham). 2014 ;1(3):031009. doi: 10.1117/1.JMI.1.3.031009.

Abdul Ghaffar, Ghulam Qadir Buledi, Muhammad Imran.

Role of ultrasound in Dense Breast Tissue (Bi Rads Breast Density Category 3-4) on Mammogram

J Surg Pak ; 2006;11(4):163-6

Masroor I, Ahmed MN , Pasha S. .

To evaluate the role of sonography as an adjunct to mammography in women with dense breasts

J Pak Med Assoc 2009;59(5):298-301

Oza AM, Boyd NF. Mammographic parenchymal patterns: a marker of breast cancer risk. Epidemiologic Reviews 1993; 15; 196-208

Gosh K, Vachon CM, Pankratz VS, Viekant RA, Anderson SS, Brandt KR, et al. J Natl Cancer Inst 2010; 102: 1716-1723

Zheng Y1, Keller BM1, Ray S1, Wang Y1, Conant EF1, Gee JC1, et al. Parenchymal texture analysis in digital mammography: A fully automated pipeline for breast cancer risk assessment. Med Phys. 2015 Jul;42(7):4149-60. doi: 10.1118/1.4921996.

Gastounioti A, Oustimov A1, Keller BM1, Pantalone L1, Hsieh MK1, Conant EF et al. Breast parenchymal patterns in processed versus raw digital mammograms: A large population study toward assessing differences in quantitative measures across image representations. Med Phys. 2016 Nov;43(11):5862.

Refbacks

There are currently no refbacks.