P5-08-02: Mammographic Breast Texture Predicts Benign Biopsy Results and Composition.
Authors: Duewer FW , Kerlikowske K , Tlsty T , Fan B , Parvin B , Ma L , Shepherd J 
Published: June 2012

Purpose: Investigate the relationship between pathology diagnosis, biopsy composition, and breast texture measured in digital mammogram in women who have had previous benign findings in their breast. The long-term goal of this project is to determine whether or not global breast texture is associated with tissue composition and biopsy results. Such a finding would be of interest because it would provide evidence that mammography images contain information related to breast biology beyond average density.

Materials and Methods: A total of 124 women who had previously received benign biopsies underwent an additional dual-energy/low dose full-field digital mammography (DXA) scan of the unaffected breast. Three measures of breast density (percent dense area (PD), percent fibroglandular volume (%FGV), absolute fibroglandular volume (FGV) from mammogram, 15 biopsy types including apocrine metaplasia and non-secretory pituitary adenoma, and four tissue compositions (collagen percent area, fat percent area, ductal percent area, epithelial percent area) were estimated from biopsies for each participant. In addition 45 breast texture features were measured on each screening image taken during the dual-energy mammography using custom software. Tissue composition at the biopsy location was estimated based on the average percent area of stained collagen, fat, ductal, and epithelial from up to 3 slides taken from the biopsy. Pathology results from the three slides were taken to indicate the tissue type.

Results: Neither mammographic percent density, %FGV, nor FGV showed significant association with either biopsy type or tissue composition. However, some of breast texture features were significantly associated with tissue type and tissue composition. The strongest associations were found between collagen percent area and the neighborhood gray tone difference matrix texture strength (R=0.26, P=0.005) and ductal percent area and the gray level contrast matrix homogeneity (GLCM HOM) (R=-0.30, P=0.001). When classified according to biopsy type, the univariate association between ductal percent area and GLCM HOM for apocrine metaplasia increased. (R=-0.55, P=0.007)

Conclusion: 10 breast texture features of the unaffected breast were significantly associated with local tissue composition and biopsy type. Further study will be required to determine whether this association is related to masking effects related to breast complexity or changes in breast biology driving changes in breast morphology.

CLINICAL RELEVANCE The use of texture measures as biomarkers of variations in breast biology is potentially clinically significant. This work indicates that texture measures are associated with some biological outcomes. It is possible that this work could be used to improve diagnostic utility of computer-aided diagnosis by weighting the probability of various benign outcomes according to the measured breast texture.

Citation Information: Cancer Res 2011;71(24 Suppl):Abstract nr P5-08-02.