Effect of Anatomical and Physiological Factors on Ultrasonic Breast Imaging Reporting and Data System Score in Iraqi Women Presenting with Breast Lumps

Ahmed Fakhir Hameed; Sameh S. Akkila; Khalida I. Noel; Saad Alshahwani

doi:10.3889/oamjms.2021.7772

Authors

Ahmed Fakhir Hameed Department of Human Anatomy
Sameh S. Akkila Department of Human Anatomy, Mustansiriyah University, College of Medicine, Baghdad, Iraq https://orcid.org/0000-0002-0407-0685
Khalida I. Noel Department of Human Anatomy, Mustansiriyah University, College of Medicine, Baghdad, Iraq https://orcid.org/0000-0001-6135-7087
Saad Alshahwani Department of Human Anatomy, Mustansiriyah University, College of Medicine, Baghdad, Iraq

DOI:

https://doi.org/10.3889/oamjms.2021.7772

Keywords:

Breast lumps, Ultrasound, Breast imaging reporting and data system score, Breast cancer

Abstract

BACKGROUND: Breast lumps are a common presentation that can be assess non-invasively using the ultrasonic examination.

AIM: The study aimed to assess the effect of different anatomical and physiological factors on the outcome of ultrasonic scoring of breast lumps.

METHODS: A total of 60 females presented with a breast lump on ultrasound assessment were randomly selected after their consent at the Clinic for Early Detection of Breast Cancer in Baghdad. The results were expressed according to the ultrasound breast imaging reporting and data system (BI-RADS) scoring.

RESULTS: There was a statistically significant positive correlation between the BI-RADS score with breast size, age, postmenopausal state, and personal or familial history of breast disease. Most cases (46.7%) scored BI-RADS II, followed by scores of III (21.6%), 4 (16.7%), and V (15%). The upper lateral quadrant of the breast was the most commonly affected sites. Marital status, parity, and breastfeeding didn’t have statistically significant influence on the sores.

CONCLUSION: Ultrasonic BI-RADS scoring of breast lumps provides an initial reliable tool for the management of breast disease. Higher scores are associated with increasing breast size, age, postmenopausal state, and personal or familial history of breast disease. Several anatomical, physiological, hereditary, and environmental aspects influence such factors.

Downloads

Download data is not yet available.

Metrics

Metrics Loading ...

Plum Analytics Artifact Widget Block

References

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492 Mid:30207593

Kelly KM, Dean J, Comulada WS, Lee SJ. Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts. Eur Radiol. 2010;20(3):734-42. https://doi.org/10.1007%2Fs00330-009-1588-y PMid:19727744

Smith RA, Cokkindes V, Brooks D, Saslow D, Shah M, Brawley OW. Cancer screening in the United States, 2011: A review of current American cancer society guidelines and issues in cancer screening. CA Cancer J Clin. 2011;61(1):8-30. https://doi.org/10.3322/caac.20096 PMid:21205832

Alwan NA. Tumor characteristics of female breast cancer: Pathological review of mastectomy specimens belonging to Iraqi patients. World J Breast Cancer Res. 2018;1(1):1006.

Alwan NA. Breast Cancer among Iraqi women: Preliminary findings from a regional comparative breast cancer research project. J Glob Oncol. 2016;2(5):255-8. https://doi.org/10.1200/jgo.2015.003087 PMid:28717711

Alwan NA, Tawfeeq F, Maallah M, Sattar S. The stage of breast cancer at the time of diagnosis: Correlation with the clinicopathological findings among Iraqi patients. J Neoplasm 2017;2:1-10. http://doi.org/10.21767/2576-3903.100020

AbdulWahid HM, Khalel EA, Alwan NA. Mammographic, ultrasonographic and pathologic correlations of focal asymmetric breast densities among a sample of Iraqi women. J Contemp Med Sci. 2019;5(3):131-5. https://doi.org/10.22317/jcms.v5i3.602

Goyal SK, Choudhary D, Beniwal S, Kapoor P, Goyal PK. Retrospective analysis of breast lumps in a given population: An institutional study. Int Surg J. 2016;3(3):1547-50. https://doi.org/10.18203/2349-2902.isj20162745

Elkharbotly A, Farouk HM. Ultrasound elastography improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler. Egypt J Radiol Nuclear Med. 2015;46(4):1231-9. https://doi.org/10.1016/j.ejrnm.2015.06.005

Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: A comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer. 2011;5:43-52. https://doi.org/10.4137/bcbcr.s6128 PMid:21494401

Spak DA, Plaxco JS, Santiago L, Dryden MJ, Dogan BE. BI-RADS® fifth edition: A summary of changes. Diagn Interv Imaging. 2017;98(3):179-90. https://doi.org/10.1016/j.diii.2017.01.001 PMid:28131457

Kontos D, Winham SJ, Oustimov A, Pantalone L, Hsieh MK, Gastounioti A, et al. Radiomic phenotypes of mammographic parenchymal complexity: Toward augmenting breast density in breast cancer risk assessment. Radiology. 2018;290(1):41-9. https://doi.org/10.1148/radiol.2018180179 PMid:30375931

Bland KI, Copeland EM, Klimberg VS, Gradishar WJ. The Breast: Comprehensive Management of Benign and Malignant Diseases. Netherlands: Elsevier Inc.; 2017. https://doi.org/10.1016/C2014-0-01946-6

Shah R, Alhawaj AF. Physiology, breast milk. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020.

Kurian AW, Griffith KA, Hamilton AS, Ward KC, Morrow M, Katz SJ, et al. Genetic testing and counseling among patients with newly diagnosed breast cancer. JAMA. 2017;317(5):531-4. https://doi.org/10.1001/jama.2016.16918 PMid:28170472

Picon-Ruiz M, Morata-Tarifa C, Valle-Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA Cancer J Clin. 2017;67(5):378-97. https://doi.org/10.3322/caac.21405 PMid:28763097

Li X, Guo X. Progressive fat necrosis after breast augmentation with autologous lipotransfer: A cause of long-lasting high Fever and axillary lymph node enlargement. Aesthetic Plast Surg. 2015;39(3):386-90. https://doi.org/10.1007/s00266-015-0480-1 PMid:25846899

Lu M, Qiu J, Wang G, Dai X. Mechanical analysis of breast-bra interaction for sports bra design. Mater Today Commun. 2016;6:28-36. https://doi.org/10.1016%2Fj.mtcomm.2015.11.005

Siddharth R, Gupta D, Narang R, Singh P. Knowledge, attitude and practice about breast cancer and breast self-examination among women seeking out-patient care in a teaching hospital in central India. Indian J Cancer. 2016;53(2):226. https://doi.org/10.4103/0019-509x.197710 PMid:28071615

Nahar N, Iqbal M, Rahman KM, Arif NU, Rahman MM, Naheen T, et al. Rate of distribution of breast lump in different quadrants with their cytological findings in both sex. J Natl Inst Neurosci Bangladesh. 2019;5(1):69-71. https://doi.org/10.3329/jninb.v5i1.42173

Lee AH. Why is carcinoma of the breast more frequent in the upper outer quadrant? A case series based on needle core biopsy diagnoses. Breast. 2005;14(2):151-2. https://doi.org/10.1016/j.breast.2004.07.002 PMid:15767185

Alwan NA, Kerr D, Al-Okati D, Pezella F, Tawfeeq FN. Comparative study on the clinicopathological profiles of breast cancer among Iraqi and British patients. Open Public Health J. 2018;11(1):177- 91. https://doi.org/10.2174/1874944501811010177

Van Maele-Fabry G, Lombaert N, Lison D. Dietary exposure to cadmium and risk of breast cancer in postmenopausal women: A systematic review and meta-analysis. Environ Int. 2016;86:1-3. https://doi.org/10.1016/j.envint.2015.10.003 PMid:26479829

Kotsopoulos J, Huzarski T, Gronwald J, Moller P, Lynch HT, Neuhausen SL, et al. Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: A case-control study. Breast Cancer Res Treat. 2016;155(2):365-73. https://doi.org/10.1007/s10549-016-3685-3 PMid:26780555

Brinton LA, Brogan DR, Coates RJ, Swanson CA, Potischman N, Stanford JL. Breast cancer risk among women under 55 years of age by joint effects of usage of oral contraceptives and hormone replacement therapy. Menopause. 2018;25(11):1195-200. https://doi.org/10.1097/GME.0000000000001217 PMid:30358713

Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: Individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019;394(10204):1159-68. https://doi.org/10.1016/S0140-6736(19)31709-X

Shiovitz S, Korde LA. Genetics of breast cancer: A topic in evolution. Ann Oncol. 2015;26(7):1291-9. https://doi.org/10.1093%2Fannonc%2Fmdv022 Mid:25605744

Hameed AF, Ibraheem MM, Ahmed BS. C-MYC and BCL2 expression in normal tissue around proliferative breast conditions in relation to ER, PR in a sample of Iraqi women. UK J Pharm Biosci. 2018;6(3):1-6. https://doi.org/10.20510/ukjpb/6/i3/173544

Noel KI, Ahmed ZO, Khamees NH. Comparison of biparietal diameter (BPD) and estimated fetal weight (EFW) in single and multiple pregnancies during third trimester of gestation in a sample of Iraqi women. Biochem Cell Arch. 2020;2:4549-54.

Unar-Munguía M, Torres-Mejía G, Colchero MA, Gonzalez de Cosio T. Breastfeeding mode and risk of breast cancer: A dose-response meta-analysis. J Hum Lactation. 2017;33(2):422-34. https://doi.org/10.1177/0890334416683676 PMid:28196329

Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global Cancer Statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. https://doi.org/10.3322/caac.21492 Mid:30207593 DOI: https://doi.org/10.3322/caac.21492

Kelly KM, Dean J, Comulada WS, Lee SJ. Breast cancer detection using automated whole breast ultrasound and mammography in radiographically dense breasts. Eur Radiol. 2010;20(3):734-42. https://doi.org/10.1007%2Fs00330-009-1588-y PMid:19727744 DOI: https://doi.org/10.1007/s00330-009-1588-y

Smith RA, Cokkindes V, Brooks D, Saslow D, Shah M, Brawley OW. Cancer screening in the United States, 2011: A review of current American cancer society guidelines and issues in cancer screening. CA Cancer J Clin. 2011;61(1):8-30. https://doi.org/10.3322/caac.20096 PMid:21205832 DOI: https://doi.org/10.3322/caac.20096

Alwan NA. Tumor characteristics of female breast cancer: Pathological review of mastectomy specimens belonging to Iraqi patients. World J Breast Cancer Res. 2018;1(1):1006.

Alwan NA. Breast Cancer among Iraqi women: Preliminary findings from a regional comparative breast cancer research project. J Glob Oncol. 2016;2(5):255-8. https://doi.org/10.1200/jgo.2015.003087 PMid:28717711 DOI: https://doi.org/10.1200/JGO.2015.003087

Alwan NA, Tawfeeq F, Maallah M, Sattar S. The stage of breast cancer at the time of diagnosis: Correlation with the clinicopathological findings among Iraqi patients. J Neoplasm 2017;2:1-10. http://doi.org/10.21767/2576-3903.100020 DOI: https://doi.org/10.21767/2576-3903.100020

AbdulWahid HM, Khalel EA, Alwan NA. Mammographic, ultrasonographic and pathologic correlations of focal asymmetric breast densities among a sample of Iraqi women. J Contemp Med Sci. 2019;5(3):131-5. https://doi.org/10.22317/jcms.v5i3.602

Goyal SK, Choudhary D, Beniwal S, Kapoor P, Goyal PK. Retrospective analysis of breast lumps in a given population: An institutional study. Int Surg J. 2016;3(3):1547-50. https://doi.org/10.18203/2349-2902.isj20162745 DOI: https://doi.org/10.18203/2349-2902.isj20162745

Elkharbotly A, Farouk HM. Ultrasound elastography improves differentiation between benign and malignant breast lumps using B-mode ultrasound and color Doppler. Egypt J Radiol Nuclear Med. 2015;46(4):1231-9. https://doi.org/10.1016/j.ejrnm.2015.06.005 DOI: https://doi.org/10.1016/j.ejrnm.2015.06.005

Kayar R, Civelek S, Cobanoglu M, Gungor O, Catal H, Emiroglu M. Five methods of breast volume measurement: A comparative study of measurements of specimen volume in 30 mastectomy cases. Breast Cancer. 2011;5:43-52. https://doi.org/10.4137/bcbcr.s6128 PMid:21494401 DOI: https://doi.org/10.4137/BCBCR.S6128

Spak DA, Plaxco JS, Santiago L, Dryden MJ, Dogan BE. BI-RADS® fifth edition: A summary of changes. Diagn Interv Imaging. 2017;98(3):179-90. https://doi.org/10.1016/j.diii.2017.01.001 PMid:28131457 DOI: https://doi.org/10.1016/j.diii.2017.01.001

Kontos D, Winham SJ, Oustimov A, Pantalone L, Hsieh MK, Gastounioti A, et al. Radiomic phenotypes of mammographic parenchymal complexity: Toward augmenting breast density in breast cancer risk assessment. Radiology. 2018;290(1):41-9. https://doi.org/10.1148/radiol.2018180179 PMid:30375931 DOI: https://doi.org/10.1148/radiol.2018180179

Bland KI, Copeland EM, Klimberg VS, Gradishar WJ. The Breast: Comprehensive Management of Benign and Malignant Diseases. Netherlands: Elsevier Inc.; 2017. https://doi.org/10.1016/C2014-0-01946-6 DOI: https://doi.org/10.1016/C2014-0-01946-6

Shah R, Alhawaj AF. Physiology, breast milk. In: StatPearls. Treasure Island, FL: StatPearls Publishing; 2020.

Kurian AW, Griffith KA, Hamilton AS, Ward KC, Morrow M, Katz SJ, et al. Genetic testing and counseling among patients with newly diagnosed breast cancer. JAMA. 2017;317(5):531-4. https://doi.org/10.1001/jama.2016.16918 PMid:28170472 DOI: https://doi.org/10.1001/jama.2016.16918

Picon-Ruiz M, Morata-Tarifa C, Valle-Goffin JJ, Friedman ER, Slingerland JM. Obesity and adverse breast cancer risk and outcome: Mechanistic insights and strategies for intervention. CA Cancer J Clin. 2017;67(5):378-97. https://doi.org/10.3322/caac.21405 PMid:28763097 DOI: https://doi.org/10.3322/caac.21405

Li X, Guo X. Progressive fat necrosis after breast augmentation with autologous lipotransfer: A cause of long-lasting high Fever and axillary lymph node enlargement. Aesthetic Plast Surg. 2015;39(3):386-90. https://doi.org/10.1007/s00266-015-0480-1 PMid:25846899 DOI: https://doi.org/10.1007/s00266-015-0480-1

Lu M, Qiu J, Wang G, Dai X. Mechanical analysis of breast-bra interaction for sports bra design. Mater Today Commun. 2016;6:28-36. https://doi.org/10.1016%2Fj.mtcomm.2015.11.005 DOI: https://doi.org/10.1016/j.mtcomm.2015.11.005

Siddharth R, Gupta D, Narang R, Singh P. Knowledge, attitude and practice about breast cancer and breast self-examination among women seeking out-patient care in a teaching hospital in central India. Indian J Cancer. 2016;53(2):226. https://doi.org/10.4103/0019-509x.197710 PMid:28071615 DOI: https://doi.org/10.4103/0019-509X.197710

Nahar N, Iqbal M, Rahman KM, Arif NU, Rahman MM, Naheen T, et al. Rate of distribution of breast lump in different quadrants with their cytological findings in both sex. J Natl Inst Neurosci Bangladesh. 2019;5(1):69-71. https://doi.org/10.3329/jninb.v5i1.42173 DOI: https://doi.org/10.3329/jninb.v5i1.42173

Lee AH. Why is carcinoma of the breast more frequent in the upper outer quadrant? A case series based on needle core biopsy diagnoses. Breast. 2005;14(2):151-2. https://doi.org/10.1016/j.breast.2004.07.002 PMid:15767185 DOI: https://doi.org/10.1016/j.breast.2004.07.002

Alwan NA, Kerr D, Al-Okati D, Pezella F, Tawfeeq FN. Comparative study on the clinicopathological profiles of breast cancer among Iraqi and British patients. Open Public Health J. 2018;11(1):177- 91. https://doi.org/10.2174/1874944501811010177 DOI: https://doi.org/10.2174/1874944501811010177

Van Maele-Fabry G, Lombaert N, Lison D. Dietary exposure to cadmium and risk of breast cancer in postmenopausal women: A systematic review and meta-analysis. Environ Int. 2016;86:1-3. https://doi.org/10.1016/j.envint.2015.10.003 PMid:26479829 DOI: https://doi.org/10.1016/j.envint.2015.10.003

Kotsopoulos J, Huzarski T, Gronwald J, Moller P, Lynch HT, Neuhausen SL, et al. Hormone replacement therapy after menopause and risk of breast cancer in BRCA1 mutation carriers: A case-control study. Breast Cancer Res Treat. 2016;155(2):365-73. https://doi.org/10.1007/s10549-016-3685-3 PMid:26780555 DOI: https://doi.org/10.1007/s10549-016-3685-3

Brinton LA, Brogan DR, Coates RJ, Swanson CA, Potischman N, Stanford JL. Breast cancer risk among women under 55 years of age by joint effects of usage of oral contraceptives and hormone replacement therapy. Menopause. 2018;25(11):1195-200. https://doi.org/10.1097/GME.0000000000001217 PMid:30358713 DOI: https://doi.org/10.1097/GME.0000000000001217

Collaborative Group on Hormonal Factors in Breast Cancer. Type and timing of menopausal hormone therapy and breast cancer risk: Individual participant meta-analysis of the worldwide epidemiological evidence. Lancet. 2019;394(10204):1159-68. https://doi.org/10.1016/S0140-6736(19)31709-X DOI: https://doi.org/10.1016/S0140-6736(19)31709-X

Shiovitz S, Korde LA. Genetics of breast cancer: A topic in evolution. Ann Oncol. 2015;26(7):1291-9. https://doi.org/10.1093%2Fannonc%2Fmdv022 Mid:25605744 DOI: https://doi.org/10.1093/annonc/mdv022

Hameed AF, Ibraheem MM, Ahmed BS. C-MYC and BCL2 expression in normal tissue around proliferative breast conditions in relation to ER, PR in a sample of Iraqi women. UK J Pharm Biosci. 2018;6(3):1-6. https://doi.org/10.20510/ukjpb/6/i3/173544 DOI: https://doi.org/10.20510/ukjpb/6/i3/173544

Noel KI, Ahmed ZO, Khamees NH. Comparison of biparietal diameter (BPD) and estimated fetal weight (EFW) in single and multiple pregnancies during third trimester of gestation in a sample of Iraqi women. Biochem Cell Arch. 2020;2:4549-54.

Unar-Munguía M, Torres-Mejía G, Colchero MA, Gonzalez de Cosio T. Breastfeeding mode and risk of breast cancer: A dose-response meta-analysis. J Hum Lactation. 2017;33(2):422-34. https://doi.org/10.1177/0890334416683676 PMid:28196329 DOI: https://doi.org/10.1177/0890334416683676