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Pape R, Zheng X, Cowling C, West C, Carstens A, Kostidis M, Bowmast H. Exploring the impact of the female thoracic size, breast size and image receptor angles on the volume of missing breast tissue in mammographic imaging. Radiography (Lond) 2025; 31:102936. [PMID: 40187186 DOI: 10.1016/j.radi.2025.102936] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2025] [Revised: 03/11/2025] [Accepted: 03/18/2025] [Indexed: 04/07/2025]
Abstract
INTRODUCTION Optimal positioning in mammography and subsequent image quality can be impacted by thorax variability, breast size and the chosen image receptor (IR) angles. This study aims to explore the impact of the female thoracic size, breast size and IR angle on the volume of missing breast tissue (MBT) in mammographic imaging. METHODS Sixty-three images were recorded: one craniocaudal (CC) at an IR angle of 0° for three sized breast phantoms attached to three sized thoracic models; and six mediolateral obliques (MLOs) at IR angles of 30°, 40°, 45°, 50°, 55°, 60° for three sized breast phantoms attached to three sized thorax models. Breast size was determined using the posterior nipple line (PNL) measurement and were recorded in millimetres. Breast volume was recorded in cubic centimetres. RESULTS The breast size and breast tissue volume of a small thorax and large breasts was better visualised with increasing IR angles. Optimal MLO IR angles were determined for the combined average thorax with average breast at 55° and large thorax with large breast at 40° with minimum MBT values of 51.33 cm3 and 75.07 cm3, respectively. Female thoracic size, IR angle, and breast size are significant (p < 0.01) and have a positive impact on the volume of MBT. CONCLUSION Optimal MLO IR angles were determined for the three breast phantoms attached to three thoracic models. Female thoracic size positively impacts the volume of MBT and in terms of clinical practice it is vital to adjust the MLO IR angle to ensure maximum breast tissue coverage. IMPLICATIONS FOR PRACTICE These findings can be modelled in current clinical practice on women presented for mammography examinations with varying thorax and breast sizes, allowing optimal IR angle selection and therefore resulting in improved breast tissue inclusion and subsequently a more accurate breast cancer diagnosis.
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Affiliation(s)
- R Pape
- School of Dentistry and Medical Sciences, Discipline of Medical Radiation Science, Faculty of Science and Health, Charles Sturt University, Locked Bag 588, Building 30, Boorooma Street, Wagga Wagga, NSW, 2678, Australia.
| | - X Zheng
- School of Dentistry and Medical Sciences, Discipline of Medical Radiation Science, Faculty of Science and Health, Charles Sturt University, Locked Bag 588, Building 30, Boorooma Street, Wagga Wagga, NSW, 2678, Australia
| | - C Cowling
- Department of Medical Imaging and Radiation Sciences, School of Primary and Allied Health Care, Medicine, Nursing and Health Sciences, Monash University, Wellington Road, Clayton, Victoria, Australia
| | - C West
- Faculty of Science and Health, School of Nursing, Paramedicine and Healthcare Sciences, Charles Sturt University, Bathurst Campus, 353 Panorama Avenue, MITCHELL, NSW, 2795, Australia
| | - A Carstens
- School of Animal, Environment and Veterinary Sciences, Veterinary School, Charles Sturt University, Locked Bag 588, Wagga Wagga, NSW, 2678, Australia; Companion Animal Clinical Studies, Faculty of Veterinary Science, University of Pretoria, Onderstepoort, South Africa
| | - M Kostidis
- Austin Health, Repatriation Hospital Campus, 300 Waterdale Road, Heidelberg Heights, Victoria, Australia
| | - H Bowmast
- Department of Anatomy and Medical Imaging, Faculty of Medical and Health Sciences, The University of Auckland, Auckland, New Zealand
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Behrens AS, Huebner H, Häberle L, Stamminger M, Zint D, Heindl F, Emons J, Hack CC, Nabieva N, Uder M, Wetzl M, Wunderle M, Beckmann MW, Fasching PA, Ohlmeyer S. Comparative assessment of breast volume using a smartphone device versus MRI. Breast Cancer 2025; 32:166-176. [PMID: 39546156 PMCID: PMC11872976 DOI: 10.1007/s12282-024-01647-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2023] [Accepted: 10/29/2024] [Indexed: 11/17/2024]
Abstract
BACKGROUND Assessment of breast volume has a relevance for aesthetic surgery and for the prevention and prediction of breast diseases. This study investigated breast volume measurements using a three-dimensional (3D) body surface scanner integrated in a smartphone device in comparison with magnetic resonance imaging (MRI) scans. METHODS Breast volume was assessed for 22 women who underwent routine MRI imaging. 3D surface images were acquired using a smartphone's digital texture camera (iPhone 11 Pro Max, Apple, California, USA, 2019). Breast volumes were manually outlined and calculated by two independent investigators using a 3D software tool (Meshmixer 3.5, Autodesk, Inc., 2018). Volume assessments from MRI images were performed by a radiologist using Syngo.via (Siemens Healthcare, Erlangen, Germany, VB50). The agreement between both methods and the inter-observer agreement was calculated with the concordance correlation coefficients and analysed with Bland-Altman plots. RESULTS The mean breast volume as determined by MRI volumetry was 771.0 ml on the left side and 763.9 ml on the right side. Utilizing the 3D body surface volume assessment method, the mean breast volume was measured as 660.3 ml (observer A) and 616.8 ml (observer B) on the left side, and 701.9 ml (observer A) and 638.6 ml (observer B) on the right side. Although a high correlation was observed, differences in volume measurements appeared more pronounced in cases of larger breast volume. CONCLUSIONS Smartphone-based 3D assessment of breast volume sufficiently agreed with MRI-based breast volume. This new technique could be used for cosmetic breast assessments in a surgical context and possibly in breast cancer risk studies assessing breast volume as outcome parameters.
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Affiliation(s)
- Annika S Behrens
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
- Department of Gynecology, Erlangen University Hospital, University Breast Center for Franconia, Comprehensive Cancer Center Erlangen, European Metropolitan Area Nuremberg (CCC ER-EMN), Friedrich Alexander University of Erlangen-Nuremberg, Unversitätsstrasse 21-23, 91054, Erlangen, Germany.
| | - Hanna Huebner
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Lothar Häberle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
- Biostatistics Unit, Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marc Stamminger
- Department of Computer Science, Visual Computing Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Daniel Zint
- Department of Computer Science, Visual Computing Lab, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Felix Heindl
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Julius Emons
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Carolin C Hack
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Naiba Nabieva
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Michael Uder
- Department of Radiology, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias Wetzl
- Department of Radiology, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Marius Wunderle
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Matthias W Beckmann
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Peter A Fasching
- Department of Gynecology and Obstetrics, Comprehensive Cancer Center Erlangen-EMN (CCC ER-EMN), Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
| | - Sabine Ohlmeyer
- Department of Radiology, Erlangen University Hospital, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany
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Estler A, Zanderigo E, Wessling D, Grözinger G, Steinmacher S, Daigeler A, Jorge C, Santos Stahl A, Feng YS, Schipperges V, Nikolaou K, Stahl S. Quantification of Breast Volume According to age and BMI: A Three-Dimensional MRI Analysis of 400 Women. Aesthetic Plast Surg 2023; 47:1713-1724. [PMID: 36418548 DOI: 10.1007/s00266-022-03167-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Accepted: 10/30/2022] [Indexed: 11/25/2022]
Abstract
OBJECTIVE Breast size alteration is the most common aesthetic surgical procedure worldwide. This study aimed to assess the correlation between breast volume and BMI or age. MATERIALS AND METHODS The analyses were conducted utilizing 400 patients selected by a retrospective review of the archives at our institution. Epidemiological data and medical history were assessed. Adjusting for the age and BMI of patient from previously described cohorts, we calculated mean breast volumes per side and differences from the upper and lower percentiles to the mean volumes. RESULTS The patients had a median BMI of 23.5 (range: 14.7-45.6) and a median age of 51 (range: 24-82). The average total breast volume increased strongly with BMI (r=0.834, p<0.01) and moderately with age (r=0.305, p<0.01). Within a BMI range of 18-24, breast volumes in the 8th and 18th percentile differ on average by about 50 ml. One BMI unit increase in women with breast sizes in the 10th percentile accounts for a breast volume difference of about 30 ml. CONCLUSION BMI strongly correlates with breast size. To achieve natural results, preoperative consultation and planning of aesthetic and reconstructive breast surgery must recognize BMI as a major determinant of average breast size. LEVEL OF EVIDENCE IV This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .
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Affiliation(s)
- Arne Estler
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Baden-Württemberg, Germany.
| | - Eloisa Zanderigo
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Baden-Württemberg, Germany
| | - Daniel Wessling
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Baden-Württemberg, Germany
| | - Gerd Grözinger
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Baden-Württemberg, Germany
| | - Sahra Steinmacher
- Department of Women´s Health, University Hospital of Tübingen, Calwerstr. 7, 72076, Tübingen, Germany
| | - Adrien Daigeler
- Department of Plastic Hand and Reconstructive Surgery BG Trauma Centre Tübingen, Schnarrenbergstr 95, 72076, Tübingen, Germany
| | - Cristina Jorge
- Department of General-, Visceral-, Vascular-, and Paediatric Surgery, Saarland University Medical Centre, Kirrberger Straße, 66421, Homburg, Saarland, Germany
| | | | - You-Shan Feng
- Institute for Clinical Epidemiology and Applied Biometrics, Medical University of Tübingen, Tübingen, Germany
| | - Vincent Schipperges
- Institute of Medical Bioinformatics and Systems Medicine (IBSM), University Hospital Freiburg, Freiburg, Germany
| | - Konstantin Nikolaou
- Department of Diagnostic and Interventional Radiology, University Hospital of Tübingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Baden-Württemberg, Germany
| | - Stéphane Stahl
- CenterPlast private practice, Bahnhofstr. 36, 66111, Saarbrücken, Germany
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Munir A, Huws AM, Khawaja S, Khan S, Holt S, Sharaiha Y. Automated Breast Volume Assessment Derived From Digital Breast Tomosynthesis Images Compared to Mastectomy Specimen Weight and Its Applications in Cosmetic Optimisation. Cureus 2021; 13:e19642. [PMID: 34926087 PMCID: PMC8673690 DOI: 10.7759/cureus.19642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/12/2021] [Indexed: 11/06/2022] Open
Abstract
Background: Estimating the size and volume of the breast preoperatively is an important step in surgical planning for many breast procedures such as immediate implant-based breast reconstructions and reduction mammoplasties. Breast volume estimation helps in appropriate implant selection preoperatively. Objectives: The aim of this study was to objectively evaluate the estimation of breast weight by automatic volumetric breast assessment in digital breast tomosynthesis (DBT) using Quantra™ 2.2 Breast Density Assessment Software (Hologic Inc., Marlborough, Massachusetts, United States).
Methods: Breast specimen weight after mastectomy and volume estimated by Quantra software were recorded. Results: Volume assessment obtained from Quantra software showed a high correlation with actual mastectomy specimen weight, with Pearson’s correlation coefficients of 0.952. Conclusions: The automated DBT-derived breast volume using the Quantra software is a simple and practical method to assess breast size and weight preoperatively.
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Affiliation(s)
- Asma Munir
- Breast Surgery, Prince Philip Hospital, Llanelli, GBR
| | - Anita M Huws
- Breast Surgery, Prince Philip Hospital, Llanelli, GBR
| | - Saira Khawaja
- Breast Surgery, Prince Philip Hospital, Llanelli, GBR
| | - Sohail Khan
- Breast Surgery, Prince Philip Hospital, Llanelli, GBR
| | - Simon Holt
- Breast Surgery, Prince Philip Hospital, Llanelli, GBR
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Preuss J, Nezich R, Lester L, Poh S, Saunders C, Taylor D. Cosmetic outcomes following wide local excision of impalpable breast cancer: is radioguided occult lesion localization using iodine-125 seeds better than hookwire localization? ANZ J Surg 2021; 91:1759-1765. [PMID: 33844409 DOI: 10.1111/ans.16756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2021] [Revised: 03/02/2021] [Accepted: 03/08/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND Hookwire localization (HWL) is the gold standard for localizing impalpable tumours for breast conserving surgery. An alternative technique, radioguided occult lesion localization using iodine-125 seeds (ROLLIS), has been associated with lower re-excision rates. This paper investigates if cosmetic outcomes differ in women undergoing breast conserving surgery with HWL or ROLLIS. METHODS Women who had ROLLIS or HWL guided excision for impalpable breast cancer within a multicentre randomized controlled trial (RCT) (ANZCTR 12613000655741) were recruited. Exclusions were level 2 oncoplasty and mastectomy. Cosmetic outcome was calculated using BCCT.core, the Hopwood Body Image Scale and estimated percentage breast volume excised. Chi-squared analysis was used to determine the difference between the intervention groups. RESULTS Analysis was performed for 123 participants (66 ROLLIS and 57 HWL). The cosmetic outcome determined by BCCT.core for all participants was good with no significant difference between the ROLLIS and HWL groups. When reviewing the number of patients who experienced either a good or excellent result, there was a significantly higher number of patients in the ROLLIS group (n = 53, 82%) compared to the HWL group (n = 42, 74%, P = 0.02. There were no differences in Hopwood Body Image Scale or estimated percentage breast volume excised between groups. There was a reduction in the frequency of re-excision in the ROLLIS group (n = 3, 4.5%) versus HWL group (n = 8, 14%); however, this was not significant (P = 0.06). CONCLUSION Pre-operative localization of impalpable breast lesions using either ROLLIS or HWL resulted in a good cosmetic outcome with no significant difference between localization techniques.
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Affiliation(s)
- James Preuss
- Department of Anaesthesia, Sir Charles Gairdner Hospital, Nedlands, Western Australia, Australia
| | - Rikki Nezich
- School of Physics, University of Western Australia, Crawley, Perth, Western Australia, Australia.,Department of Medical Technology and Physics, Sir Charles Gairdner Hospital, Nedlands, Perth, Western Australia, Australia
| | - Leanne Lester
- Department of Sports Science Exercise and Health, School of Human Sciences, The University of Western Australia, Crawley, Perth, Western Australia, Australia
| | - Shawn Poh
- School of Medicine, University College Dublin, Dublin, Ireland
| | - Christobel Saunders
- Division of Surgery, Medical School, University of Western Australia, Crawley, Perth, Western Australia, Australia.,Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia
| | - Donna Taylor
- Division of Surgery, Medical School, University of Western Australia, Crawley, Perth, Western Australia, Australia.,Breast Clinic, Royal Perth Hospital, Perth, Western Australia, Australia.,BreastScreen WA, Perth, Western Australia, Australia
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