Microcalcifications (MCs), detected by mammography breast screening, are responsible for finding 90% of the cases of Ductal Carcinoma In Situ (DCIS), which is an early form of cancer. Further, the description of the morphology and distribution of the microcalcifications as defined in the BI-RADS Atlas* and indicates the risk of malignancy.
MCs associated with cancer are small rounded crystals of calcium hydroxyapatite (HA) less than 500-microns across that absorb radiation and appear as white flecks in mammography and are present in about half of breast malignancies. The morphology of the MCs is a significant indicator of the probability of the presence of cancer. Currently, MCs are only reliably seen by mammography, which is an X-ray technique.
Calcium oxalate MCs (Type 1 ) is also present in the breast and appears to be a reliable criterion in favor of the benign nature of a lesion. Calcium hydroxyapatite MCs (HA or Type II) is analogous to bone and induces mitogenesis and upregulation of gene expression, and occurs in benign and malignant lesions. Mammography cannot distinguish Type I MCs from Type II MCs.
In B-mode (grayscale) ultrasound, MCs send large echoes back to the transducer and are also seen as white dots. These dots, however, are easily obscured in the hyper-acoustic areas in breast tissue and can not be reliably detected.
A great amount of research has been carried out to detect MCs in the breast by ultrasonic methods by many universities because it is low-cost, real-time, can be used on a patient of any age as often as required, is ionization-free, and today is ubiquitous. So far, however, all methods have failed.
An engineer at UltraVision Corporation has discovered a unique method of reliably detecting MCs. The algorithm has been well tested in phantoms with clusters of 50-200 micron diameter HA MCs mixed with scatterers (corn starch), and it returns only the strong signals only from the MCs. The algorithm has also found every MCs implanted in chicken breast and pork breasts.
The image below is a benign MCs present in a human breast cyst identified initially by mammography. So far, the method has no false positives and has detected every known MCs either in a breast or placed in a phantom.
In a different breast, we again find three MCs in a cyst.
Figure 3 shows a patient with implants where the implant was replaced because of silicon leakage over ten years ago. The replacement has now developed MCs on its surface. In the contralateral breast, no leakage occurred, and MCs have not been found.
The next goal of our research is to differentiate the types of MCs by their acoustic impedances and densities, from 40-200 microns in diameter.
Anyone having an interest in participating with our research, is urged to contact us.
- The American College of Radiography has developed a Breast Imaging -Reporting and Data System (BIRADS) as the standard system to give descriptors and prognoses for mammogram findings.