학술논문
Towards defining morphologic parameters of normal parous and nulliparous breast tissues by artificial intelligence
Document Type
Academic Journal
Author
Ogony, Joshua; de Bel, Thomas; Radisky, Derek C.; Kachergus, Jennifer; Thompson, E. Aubrey; Degnim, Amy C.; Ruddy, Kathryn J.; Hilton, Tracy; Stallings-Mann, Melody; Vachon, Celine; Hoskin, Tanya L.; Heckman, Michael G.; Vierkant, Robert A.; White, Launia J.; Moore, Raymond M.; Carter, Jodi; Jensen, Matthew; Pacheco-Spann, Laura; Henry, Jill E.; Storniolo, Anna Maria; Winham, Stacey J.; van der Laak, Jeroen; Sherman, Mark E.
Source
Breast Cancer Research. July 11, 2022, Vol. 24 Issue 1
Subject
Language
English
ISSN
1465-5411
Abstract
Author(s): Joshua Ogony[sup.1], Thomas de Bel[sup.2,3], Derek C. Radisky[sup.4], Jennifer Kachergus[sup.4], E. Aubrey Thompson[sup.4], Amy C. Degnim[sup.5], Kathryn J. Ruddy[sup.6], Tracy Hilton[sup.1], Melody Stallings-Mann[sup.4], Celine Vachon[sup.7], Tanya L. Hoskin[sup.1], Michael [...]
Background Breast terminal duct lobular units (TDLUs), the source of most breast cancer (BC) precursors, are shaped by age-related involution, a gradual process, and postpartum involution (PPI), a dramatic inflammatory process that restores baseline microanatomy after weaning. Dysregulated PPI is implicated in the pathogenesis of postpartum BCs. We propose that assessment of TDLUs in the postpartum period may have value in risk estimation, but characteristics of these tissues in relation to epidemiological factors are incompletely described. Methods Using validated Artificial Intelligence and morphometric methods, we analyzed digitized images of tissue sections of normal breast tissues stained with hematoxylin and eosin from donors [less than or equai to] 45 years from the Komen Tissue Bank (180 parous and 545 nulliparous). Metrics assessed by AI, included: TDLU count; adipose tissue fraction; mean acini count/TDLU; mean dilated acini; mean average acini area; mean 'capillary' area; mean epithelial area; mean ratio of epithelial area versus intralobular stroma; mean mononuclear cell count (surrogate of immune cells); mean fat area proximate to TDLUs and TDLU area. We compared epidemiologic characteristics collected via questionnaire by parity status and race, using a Wilcoxon rank sum test or Fisher's exact test. Histologic features were compared between nulliparous and parous women (overall and by time between last birth and donation [recent birth: [less than or equai to] 5 years versus remote birth: > 5 years]) using multivariable regression models. Results Normal breast tissues of parous women contained significantly higher TDLU counts and acini counts, more frequent dilated acini, higher mononuclear cell counts in TDLUs and smaller acini area per TDLU than nulliparas (all multivariable analyses p < 0.001). Differences in TDLU counts and average acini size persisted for > 5 years postpartum, whereas increases in immune cells were most marked [less than or equai to] 5 years of a birth. Relationships were suggestively modified by several other factors, including demographic and reproductive characteristics, ethanol consumption and breastfeeding duration. Conclusions Our study identified sustained expansion of TDLU numbers and reduced average acini area among parous versus nulliparous women and notable increases in immune responses within five years following childbirth. Further, we show that quantitative characteristics of normal breast samples vary with demographic features and BC risk factors. Keywords: Breast cancer, Involution, Postpartum, Risk, Epidemiology, Terminal duct lobular units
Background Breast terminal duct lobular units (TDLUs), the source of most breast cancer (BC) precursors, are shaped by age-related involution, a gradual process, and postpartum involution (PPI), a dramatic inflammatory process that restores baseline microanatomy after weaning. Dysregulated PPI is implicated in the pathogenesis of postpartum BCs. We propose that assessment of TDLUs in the postpartum period may have value in risk estimation, but characteristics of these tissues in relation to epidemiological factors are incompletely described. Methods Using validated Artificial Intelligence and morphometric methods, we analyzed digitized images of tissue sections of normal breast tissues stained with hematoxylin and eosin from donors [less than or equai to] 45 years from the Komen Tissue Bank (180 parous and 545 nulliparous). Metrics assessed by AI, included: TDLU count; adipose tissue fraction; mean acini count/TDLU; mean dilated acini; mean average acini area; mean 'capillary' area; mean epithelial area; mean ratio of epithelial area versus intralobular stroma; mean mononuclear cell count (surrogate of immune cells); mean fat area proximate to TDLUs and TDLU area. We compared epidemiologic characteristics collected via questionnaire by parity status and race, using a Wilcoxon rank sum test or Fisher's exact test. Histologic features were compared between nulliparous and parous women (overall and by time between last birth and donation [recent birth: [less than or equai to] 5 years versus remote birth: > 5 years]) using multivariable regression models. Results Normal breast tissues of parous women contained significantly higher TDLU counts and acini counts, more frequent dilated acini, higher mononuclear cell counts in TDLUs and smaller acini area per TDLU than nulliparas (all multivariable analyses p < 0.001). Differences in TDLU counts and average acini size persisted for > 5 years postpartum, whereas increases in immune cells were most marked [less than or equai to] 5 years of a birth. Relationships were suggestively modified by several other factors, including demographic and reproductive characteristics, ethanol consumption and breastfeeding duration. Conclusions Our study identified sustained expansion of TDLU numbers and reduced average acini area among parous versus nulliparous women and notable increases in immune responses within five years following childbirth. Further, we show that quantitative characteristics of normal breast samples vary with demographic features and BC risk factors. Keywords: Breast cancer, Involution, Postpartum, Risk, Epidemiology, Terminal duct lobular units