Mammographic image segmentation and risk classification based on mammographic parenchymal patterns and geometric moments

Breast image pre-processing for mammographic tissue segmentation

During mammographic image acquisition, a compression paddle is used to even the breast thickness in order to obtain optimal image quality. Clinical observation has indicated that some mammograms may exhibit abrupt intensity change and low visibility of tissue structures in the breast peripheral areas. Such appearance discrepancies can affect image interpretation and may not be desirable for computer aided mammography, leading to incorrect diagnosis and/or detection which can have a negative impact on sensitivity and specificity of screening mammography. This paper describes a novel mammographic image pre-processing method to improve image quality for analysis. An image selection process is incorporated to better target problematic images. The processed images show improved mammographic appearances not only in the breast periphery but also across the mammograms. Mammographic segmentation and risk/density classification were performed to facilitate a quantitative and qualitative evaluation. When using the processed images, the results indicated more anatomically correct segmentation in tissue specific areas, and subsequently better classification accuracies were achieved. Visual assessments were conducted in a clinical environment to determine the quality of the processed images and the resultant segmentation. The developed method has shown promising results. It is expected to be useful in early breast cancer detection, risk-stratified screening, and aiding radiologists in the process of decision making prior to surgery and/or treatment.

A Review on Automatic Mammographic Density and Parenchymal Segmentation

Breast cancer is the most frequently diagnosed cancer in women. However, the exact cause(s) of breast cancer still remains unknown. Early detection, precise identification of women at risk, and application of appropriate disease prevention measures are by far the most effective way to tackle breast cancer. There are more than 70 common genetic susceptibility factors included in the current non-image-based risk prediction models (e.g., the Gail and the Tyrer-Cuzick models). Image-based risk factors, such as mammographic densities and parenchymal patterns, have been established as biomarkers but have not been fully incorporated in the risk prediction models used for risk stratification in screening and/or measuring responsiveness to preventive approaches. Within computer aided mammography, automatic mammographic tissue segmentation methods have been developed for estimation of breast tissue composition to facilitate mammographic risk assessment. This paper presents a comprehensive review of automatic mammographic tissue segmentation methodologies developed over the past two decades and the evidence for risk assessment/density classification using segmentation. The aim of this review is to analyse how engineering advances have progressed and the impact automatic mammographic tissue segmentation has in a clinical environment, as well as to understand the current research gaps with respect to the incorporation of image-based risk factors in non-image-based risk prediction models.

Mammographic density-a review on the current understanding of its association with breast cancer

There has been considerable recent interest in the genetic, biological and epidemiological basis of mammographic density (MD), and the search for causative links between MD and breast cancer (BC) risk. This report will critically review the current literature on MD and summarize the current evidence for its association with BC. Keywords 'mammographic dens*', 'dense mammary tissue' or 'percent dens*' were used to search the existing literature in English on PubMed and Medline. All reports were critically analyzed. The data were assigned to one of the following aspects of MD: general association with BC, its relationship with the breast hormonal milieu, the cellular basis of MD, the generic variations of MD, and its significance in the clinical setting. MD adjusted for age, and BMI is associated with increased risk of BC diagnosis, advanced tumour stage at diagnosis and increased risk of both local recurrence and second primary cancers. The MD measures that predict BC risk have high heritability, and to date several genetic markers associated with BC risk have been found to also be associated with these MD risk predictors. Change in MD could be a predictor of the extent of chemoprevention with tamoxifen. Although the biological and genetic pathways that determine and perhaps modulate MD remain largely unresolved, significant inroads are being made into the understanding of MD, which may lead to benefits in clinical screening, assessment and treatment strategies. This review provides a timely update on the current understanding of MD's association with BC risk.