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A deep learning model for breast ductal carcinoma in situ classification in whole slide images. Virchows Arch 2022; 480:1009-1022. [PMID: 35076741 DOI: 10.1007/s00428-021-03241-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 11/12/2021] [Accepted: 11/20/2021] [Indexed: 02/06/2023]
Abstract
The pathological differential diagnosis between breast ductal carcinoma in situ (DCIS) and invasive ductal carcinoma (IDC) is of pivotal importance for determining optimum cancer treatment(s) and clinical outcomes. Since conventional diagnosis by pathologists using microscopes is limited in terms of human resources, it is necessary to develop new techniques that can rapidly and accurately diagnose large numbers of histopathological specimens. Computational pathology tools which can assist pathologists in detecting and classifying DCIS and IDC from whole slide images (WSIs) would be of great benefit for routine pathological diagnosis. In this paper, we trained deep learning models capable of classifying biopsy and surgical histopathological WSIs into DCIS, IDC, and benign. We evaluated the models on two independent test sets (n= 1382, n= 548), achieving ROC areas under the curves (AUCs) up to 0.960 and 0.977 for DCIS and IDC, respectively.
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Dao KA, Rives AF, Quintana LM, Kritselis MA, Fishman MDC, Sarangi R, Slanetz PJ. BI-RADS 5: More than Cancer. Radiographics 2021; 40:1203-1204. [PMID: 32870767 DOI: 10.1148/rg.2020200054] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- Kimberly A Dao
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Anna F Rives
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Liza M Quintana
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Michael A Kritselis
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Michael D C Fishman
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Rutuparna Sarangi
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
| | - Priscilla J Slanetz
- From the Departments of Radiology (K.A.D., A.F.R., M.D.C.F., R.S., P.J.S.) and Pathology (M.A.K.), Boston University Medical Center, Boston University School of Medicine, 830 Harrison Ave, Moakley Building Ste 1300, Boston, MA 02118; and Department of Pathology, Beth Israel Medical Center, Harvard Medical School, Boston, Mass (L.M.Q.)
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X-ray Dark-Field Imaging (XDFI)-a Promising Tool for 3D Virtual Histopathology. Mol Imaging Biol 2021; 23:481-494. [PMID: 33624229 DOI: 10.1007/s11307-020-01577-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 12/20/2020] [Accepted: 12/22/2020] [Indexed: 10/22/2022]
Abstract
X-ray dark-field imaging (XDFI) utilizing a thin silicon crystal under Laue case enables visualizing three-dimensional (3D) morphological alterations of human tissue. XDFI uses refraction-contrast derived from phase shift rather than absorption as the main X-ray image contrast source to render 2D and 3D images of tissue specimens in unprecedented detail. The unique features of XDFI are its extremely high sensitivity (approximately 1000:1 compared to absorption for soft tissues under X-ray energy of around 20 keV, theoretically) and excellent resolution (8.5 μm) without requiring contrast medium or staining. Thus, XDFI-computed tomography can generate 3D virtual histological images equivalent to those of stained histological sections pathologists observe under low-power light microscopy as far as organs and tissues selected as samples in preliminary studies. This paper reviews the fundamental principles and the potential of XDFI, describes two optical setups for XDFI with examples, illustrates features of XDFI that are salient for histopathology, and presents XDFI examples of refraction-contrast images of atherosclerotic plaques, musculoskeletal tissue, neuronal tissue, and breast cancer specimens. Availability of this X-ray imaging in routine histopathological evaluations of tissue specimens would help guide clinical decision making by highlighting suspicious areas in unstained, thick sections for further sampling and analysis using conventional histopathological techniques. XDFI is a promising tool for 3D virtual histopathology.
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de Sousa X, Ferreira PS, Branco L, Simões J, Gonçalves M, Rigueira MV, Cortez L. Neoplasm of uncertain behaviour of the breast-a retrospective study in a breast unit. Ecancermedicalscience 2018; 12:839. [PMID: 29910836 PMCID: PMC5985751 DOI: 10.3332/ecancer.2018.839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2017] [Indexed: 11/06/2022] Open
Abstract
Introduction Breast lesions include a heterogeneous group of entities with variable clinical behaviour and morphological presentation, mostly classified as benign or malignant, with predictable behaviour. However, there are lesions with clinical, breast imaging and/or biopsy characteristics that do not clarify their nature. These lesions have an uncertain behaviour regarding their malignant potential at diagnosis.We intend to relate the preoperative diagnosis of neoplasm of uncertain behaviour of the breast (NUnBB) regarding the core needle biopsy and the histological result after excisional biopsy. Methods This is a retrospective study of patients submitted to local excision of breast lesions with a perioperative diagnosis of NUnBB, classified as 2383 at 'International Statistical Classification of Diseases and Related Health Problems' (ICD 9), between January 2007 and October 2016 in a breast unit. Results Ninety-two cases with the diagnosis of NUnBB were analysed: 91 females with a mean age of 59 ± 14 years. All were submitted to local excision of breast lesion as ambulatory surgery with the following histology: 64% benign, 3% malignant potential and 33% malignant. Of those who presented malignant results, 69% underwent a surgical re-intervention for local control of the disease. Discussion Regarding the considerable number of malignant lesions at final histology and the high percentage of which are re-operated, NUnBB should be treated with the same priority as a confirmed malignant neoplasm and whenever possible, using the most appropriate surgical technique.
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Affiliation(s)
- Xavier de Sousa
- General Surgery Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Pedro Santos Ferreira
- Breast Unit, General Surgery Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Luís Branco
- Breast Unit, General Surgery Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Jorge Simões
- Breast Unit, Obstetrics and Gynaecology Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Matilde Gonçalves
- Pathology Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Manuel Vítor Rigueira
- Breast Unit, General Surgery Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
| | - Luís Cortez
- General Surgery Department, Setúbal Hospital Centre, São Bernardo Hospital, 2910-446 Setúbal, Portugal
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Efared B, Sidibé IS, Abdoulaziz S, Hammas N, Chbani L, El Fatemi H. Tubular Adenoma of the Breast: A Clinicopathologic Study of a Series of 9 Cases. Clin Med Insights Pathol 2018; 11:1179555718757499. [PMID: 29449780 PMCID: PMC5808954 DOI: 10.1177/1179555718757499] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2017] [Accepted: 01/10/2018] [Indexed: 11/15/2022] Open
Abstract
Tubular adenoma of the breast is one of the most rare benign neoplasms, accounting for only 0.13% to 1.7% of all breast benign tumors. Little is known about this rare neoplasm as the current literature offers only some case reports or a few number of small series. The aim of our study is to provide some clinicopathologic features of the breast tubular adenoma. We retrospectively analyzed at our department of pathology all cases of breast tubular adenomas confirmed by immunohistochemistry over a period of 9 years (2009-2017). Nine cases of breast tubular adenoma have been recorded, with an average age of 31.44 years. Five tumors were located at the right side (55.55%), and most cases had suspicious aspects on imaging techniques (6 cases out of 9). The diagnosis has been made on 5 resected specimens (lumpectomy) and on 4 core needle biopsies. The tumor size ranged from 0.9 to 7 cm (mean size of 3.08 cm) and had well-circumscribed margins with elastic consistency. The histopathologic analysis showed a typical pattern of proliferating round and uniform tubules lined by regular epithelial cells surrounded by myoepithelial cells, packed in a small amount of stroma, highlighted by CD34 immunostaining. Tubular adenoma is a rare breast benign neoplasm of young premenopausal women. The radiologic aspects are often worrisome and only the histopathologic analysis can achieve the correct definitive diagnosis by excluding all potential differential diagnoses.
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Affiliation(s)
- Boubacar Efared
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Ibrahim S Sidibé
- Department of Pathology, Hassan II University Hospital, Fès, Morocco
| | - Souley Abdoulaziz
- Department of Radiology, Hassan II University Hospital, Fès, Morocco
| | - Nawal Hammas
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Laila Chbani
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
| | - Hinde El Fatemi
- Department of Pathology, Hassan II University Hospital, Fès, Morocco.,Faculty of Medicine and Pharmacology, Sidi Mohamed Ben Abdellah University, Fès, Morocco
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Lippi G, Mattiuzzi C, Montagnana M. BRCA population screening for predicting breast cancer: for or against? ANNALS OF TRANSLATIONAL MEDICINE 2017; 5:275. [PMID: 28758101 DOI: 10.21037/atm.2017.06.71] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The pathogenesis of breast cancer, the most frequent female malignancy, entails both genetic and acquired risk factors. Among the various oncogenetic mutations, those involving the BReast Cancer 1 (BRCA1) and BReast Cancer 2 (BRCA2) genes are associated with an extremely high risk of developing breast cancer, with a penetration approximating 70% in women with a positive family history for this malignancy. This important evidence elicits some pragmatic considerations, such as the clinical effectiveness of screening for the most penetrant BRCA mutations in women with or without a positive familial history, but also raises important issues related to the most appropriate clinical management of these patients. Despite it seems now almost certain that BRCA testing should be offered to women with a positive familial history for breast cancer, the balance between advantages and limitations of a population screening remains largely debated. Whatever conclusion can be reach at this point in time must be accurately weighed against at least four different perspectives, which include the low prevalence of these mutations in the general population, the relatively lower risk of developing breast cancer in women without a familial history for this malignancy, the direct and indirect cost of genetic testing and, last but not least, the many potential psychological and clinical consequences in patients receiving a positive test result. Many of these still unresolved issues will be tentatively discussed in this article.
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Affiliation(s)
- Giuseppe Lippi
- Section of Clinical Biochemistry, University of Verona, Verona, Italy
| | - Camilla Mattiuzzi
- Service of Clinical Governance, Provincial Agency for Sanitary Services, Trento, Italy
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