Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer

October 29, 2019

New research at Case Western Reserve University could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Once a lumpectomy of breast tissue reveals this pre-cancerous tumor, most women have surgery to remove the remainder of the affected tissue and some are given radiation therapy as well, said Anant Madabhushi, the F. Alex Nason Professor II of Biomedical Engineering at the Case School of Engineering.

"Current testing places patients in high risk, low risk and indeterminate risk--but then treats those 'indeterminates' with radiation, anyway," said Madabhushi, whose Center for Computational Imaging and Personalized Diagnostics (CCIPD) conducted the new research. "They err on the side of caution, but we're saying that it appears that it should go the other way--the middle should be classified with the lower risk.

"In short, we're probably over-treating patients," Madabhushi continued. "That goes against prevailing wisdom, but that's what our analysis is finding."

The most common breast cancer

Stage 0 breast cancer is the most common type and known clinically as ductal carcinoma in situ (DCIS), indicating that the cancer cell growth starts in the milk ducts.

About 60,000 cases of DCIS are diagnosed in the United States each year, accounting for about one of every five new breast cancer cases, according to the American Cancer Society. People with a type of breast cancer that has not spread beyond the breast tissue live at least five years after diagnosis, according to the cancer society.

Lead researcher Haojia Li, a graduate student in the CCIPD, used a computer program analyze the spatial architecture, texture and orientation of the individual cells and nuclei from scanned and digitized lumpectomy tissue samples from 62 DCIS patients.

The result: Both the size and orientation of the tumors characterized as "indeterminate" were actually much closer to those confirmed as low risk for recurrence by an expensive genetic test called Oncotype DX.

Li then validated the features that distinguished the low and high risk Oncotype groups in being able to predict the likelihood of progression from DCIS to invasive ductal carcinoma in an independent set of 30 patients.

"This could be a tool for determining who really needs the radiation, or who needs the gene test, which is also very expensive," she said.

The research led by Li was published Oct. 17 in the journal Breast Cancer Research.

Madabhushi established the CCIPD at Case Western Reserve in 2012. The lab now includes nearly 60 researchers. The lab has become a global leader in the detection, diagnosis and characterization of various cancers and other diseases, including breast cancer, by meshing medical imaging, machine learning and artificial intelligence (AI).

Some of the lab's most recent work, in collaboration with New York University and Yale University, has used AI to predict which lung cancer patients would benefit from adjuvant chemotherapy based on tissue slide images.

That advancement was named by Prevention Magazine as one of the top 10 medical breakthroughs of 2018.
-end-
Case Western Reserve University is one of the country's leading private research institutions. Located in Cleveland, we offer a unique combination of forward-thinking educational opportunities in an inspiring cultural setting. Our leading-edge faculty engage in teaching and research in a collaborative, hands-on environment. Our nationally recognized programs include arts and sciences, dental medicine, engineering, law, management, medicine, nursing and social work. About 5,100 undergraduate and 6,200 graduate students comprise our student body. Visit case.edu to see how Case Western Reserve thinks beyond the possible.

Case Western Reserve University

Related Breast Cancer Articles from Brightsurf:

Oncotarget: IGF2 expression in breast cancer tumors and in breast cancer cells
The Oncotarget authors propose that methylation of DVDMR represents a novel epigenetic biomarker that determines the levels of IGF2 protein expression in breast cancer.

Breast cancer: AI predicts which pre-malignant breast lesions will progress to advanced cancer
New research at Case Western Reserve University in Cleveland, Ohio, could help better determine which patients diagnosed with the pre-malignant breast cancer commonly as stage 0 are likely to progress to invasive breast cancer and therefore might benefit from additional therapy over and above surgery alone.

Partial breast irradiation effective treatment option for low-risk breast cancer
Partial breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole breast irradiation for many women with low-risk, early stage breast cancer, according to new clinical data from a national clinical trial involving researchers from The Ohio State University Comprehensive Cancer Center - Arthur G.

Breast screening linked to 60 per cent lower risk of breast cancer death in first 10 years
Women who take part in breast screening have a significantly greater benefit from treatments than those who are not screened, according to a study of more than 50,000 women.

More clues revealed in link between normal breast changes and invasive breast cancer
A research team, led by investigators from Georgetown Lombardi Comprehensive Cancer Center, details how a natural and dramatic process -- changes in mammary glands to accommodate breastfeeding -- uses a molecular process believed to contribute to survival of pre-malignant breast cells.

Breast tissue tumor suppressor PTEN: A potential Achilles heel for breast cancer cells
A highly collaborative team of researchers at the Medical University of South Carolina and Ohio State University report in Nature Communications that they have identified a novel pathway for connective tissue PTEN in breast cancer cell response to radiotherapy.

Computers equal radiologists in assessing breast density and associated breast cancer risk
Automated breast-density evaluation was just as accurate in predicting women's risk of breast cancer, found and not found by mammography, as subjective evaluation done by radiologists, in a study led by researchers at UC San Francisco and Mayo Clinic.

Blood test can effectively rule out breast cancer, regardless of breast density
A new study published in PLOS ONE demonstrates that Videssa® Breast, a multi-protein biomarker blood test for breast cancer, is unaffected by breast density and can reliably rule out breast cancer in women with both dense and non-dense breast tissue.

Study shows influence of surgeons on likelihood of removal of healthy breast after breast cancer dia
Attending surgeons can have a strong influence on whether a patient undergoes contralateral prophylactic mastectomy after a diagnosis of breast cancer, according to a study published by JAMA Surgery.

Young breast cancer patients undergoing breast conserving surgery see improved prognosis
A new analysis indicates that breast cancer prognoses have improved over time in young women treated with breast conserving surgery.

Read More: Breast Cancer News and Breast Cancer Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.