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Tumor volume doubling time estimated from digital breast tomosynthesis mammograms distinguishes invasive breast cancers from benign lesions

  • Breast
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Abstract

Objectives

The aim of this study was to determine whether lesion size metrics on consecutive screening mammograms could predict malignant invasive carcinoma versus benign lesion outcome.

Methods

We retrospectively reviewed suspicious screen-detected lesions confirmed by biopsy to be invasive breast cancers or benign that were visible on current and in-retrospect prior screening mammograms performed with digital breast tomosynthesis from 2017 to 2020. Four experienced radiologists recorded mammogram dates, breast density, lesion type, lesion diameter, and morphology on current and prior exams. We used logistic regression models to evaluate the association of invasive breast cancer outcome with lesion size metrics such as maximum dimension, average dimension, volume, and tumor volume doubling time (TVDT).

Results

Twenty-eight patients with invasive ductal carcinoma or invasive lobular carcinoma and 40 patients with benign lesions were identified. The mean TVDT was significantly shorter for invasive breast cancers compared to benign lesions (0.84 vs. 2.5 years; p = 0.0025). Patients with a TVDT of less than 1 year were shown to have an odds ratio of invasive cancer of 6.33 (95% confidence interval, 2.18–18.43). Logistic regression adjusted for age, lesion maximum dimension, and lesion volume demonstrated that shorter TVDT was the size variable significantly associated with invasive cancer outcome.

Conclusion

Invasive breast cancers detected on current and in-retrospect prior screening mammograms are associated with shorter TVDT compared to benign lesions. If confirmed to be sufficiently predictive of benignity in larger studies, lesions visible on mammograms which in comparison to prior exams have longer TVDTs could potentially avoid additional imaging and/or biopsy.

Key Points

• We propose tumor volume doubling time as a measure to distinguish benign from invasive breast cancer lesions.

• Logistic regression results summarized the utility of the odds ratio in retrospective clinical mammography data.

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Abbreviations

DBT:

Digital breast tomosynthesis

IDC:

Invasive ductal carcinoma

ILC:

Invasive lobular carcinoma

TVDT:

Tumor volume doubling time

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Acknowledgements

We would like to thank Benjamin Seiler and Yijun Long for their helpful discussions and the Stanford University Computational Services and Bioinformatics Facility (CSBF) for their software support.

Funding

This work was funded in part by the Department of Defense through the Breast Cancer Research Program under award number W81XWH-18-1-0342 (to S.S.H.); the National Cancer Institute of the National Institutes of Health under award number R25 CA217729 (Canary Cancer Research Education Summer Training Program to K.A. and S.A.); the National Library of Medicine of the National Institutes of Health under award number T15 LM007033 (to K.A.); and the Stanford Office of the Vice Provost for Undergraduate Education (to K.A.).

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Author notes

  1. Andrew Kozlov

    Present address: The University of South Florida Morsani College of Medicine, Tampa, FL, USA

Authors and Affiliations

  1. Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA

    Negar Sadeghipour, Joseph Tseng, Kristen Anderson, Shivani Ayalasomayajula, Andrew Kozlov, Debra Ikeda, Wendy DeMartini & Sharon S. Hori

  2. The Canary Center at Stanford for Cancer Early Detection, Stanford University School of Medicine, Palo Alto, CA, USA

    Negar Sadeghipour, Kristen Anderson, Shivani Ayalasomayajula & Sharon S. Hori

  3. Molecular Imaging Program at Stanford (MIPS), Stanford University School of Medicine, Stanford, CA, USA

    Negar Sadeghipour & Sharon S. Hori

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  1. Negar Sadeghipour
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Correspondence to Sharon S. Hori.

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The scientific guarantor of this publication is Sharon S. Hori.

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The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

Two of the authors have significant statistical expertise.

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• case-control study

• performed at one institution

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Sadeghipour, N., Tseng, J., Anderson, K. et al. Tumor volume doubling time estimated from digital breast tomosynthesis mammograms distinguishes invasive breast cancers from benign lesions. Eur Radiol 33, 429–439 (2023). https://doi.org/10.1007/s00330-022-08966-2

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  • DOI: https://doi.org/10.1007/s00330-022-08966-2

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