Optical mammography: a new technique for visualizing breast lesions in women presenting non palpable BIRADS 4-5 imaging findings: preliminary results with radiologic-pathologic correlation.
Bottom Line: We experienced an overall sensitivity of 73% and specificity of 38%, the false negative results being mainly small size (<10 mm) infiltrating malignant lesions and ductal carcinoma in situ (DCIS).False positive results were seen in benign proliferative lesions.Absorption is due to haemoglobin and its products, therefore reflecting the angiogenic status of breast tumours.
Affiliation: Institut Gustav Roussy, France.
The purpose of this prospective study is to determine the diagnostic accuracy of near-infrared breast optical absorption imaging in patients with Breast Imaging Reporting and Data System (BIRADS) 4-5 non-palpable lesions scheduled for biopsy, using pathology after core or excisional biopsy as a reference. The patient's breast was positioned onto a panel of red light-emitting diodes (640 nm). A soft membrane was inflated to exert a uniform pressure on the breast. Transmitted light was detected using a CCD camera. The entire acquisition sequence took 1 minute. Image processing generated dynamic images displayed in colour scale, to reveal time-dependent changes in the transmitted light intensity caused by the pressure change. Dynamic curves were classified in two categories: consistently decreasing intensity suspicious for malignancy, and sinusoidal increasing intensity considered as benign. Seventy-eight women consulting for non-palpable breast lesions were initially included in the study. An imaging-histology correlation was obtained for seventy-two patients, the remaining six patients were excluded for technical optical scan reasons. We experienced an overall sensitivity of 73% and specificity of 38%, the false negative results being mainly small size (<10 mm) infiltrating malignant lesions and ductal carcinoma in situ (DCIS). False positive results were seen in benign proliferative lesions. Dynamic optical breast imaging is a novel, low-cost, non-invasive technique yielding a new type of information about the physiology of breast lesions. Absorption is due to haemoglobin and its products, therefore reflecting the angiogenic status of breast tumours.
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Mentions: Optical findings in benign proliferative lesions were different, as in these cases the hypervascularized areas were not as hypoxic as the malignant hypermetabolic tumours that consume a greater amount of oxygen. Early “blush” in benign cases was displayed as red-coloured areas and the calculated dynamic curves were in the positive scale. Case 2 corresponds to a radial scar, seen in mammography as an architectural distortion of the inner breast quadrants (Fig. 4a). The optical signal was positive in the mean of high absorption, but the corresponding area of interest was represented as a red-coloured zone. Dynamic curves were in the positive scale, in accordance with an underlying hypermetabolic but not strongly hypoxic area (Fig. 4b). Interpretation of the optical images indicated a probably benign breast lesion.