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The morbidity of breast cancer (BC) is continuously

increasing. The annual incidence of BC worldwide is


1,000,000 new cases. In Russia, the annual rate of prima
rily diagnosed patients with BC in 1998 was 42,607; in
2010, 57,241. The approximate and standardized BC
morbidity parameters increased within 10 years (1999
2009) by 24.78 and 15.91% per 100,000 of the population,
respectively. In 2010, BC occupied 20.1% of total onco
logical morbidity of the female population of Russia [1,
2]. The high mortality of BC makes the problem of early
BC diagnosis very urgent [3]. The main screening method
of BC diagnosis (mammography) relies on a single exam
ination each two years of female patients older than 45
years [35]. XRay mammography is not recommended
for younger female patients because of a high density of
the glandular triangle of such patients, as well as high
probability of false BC diagnosis, and high Xray sensitiv
ity of breast tissues.
The goal of screening is to implement early BC diag
nosis and to determine which female patients should be
subjected to expensive examination. The radiationfree
electrical impedance tomograph suggested in this work
meets this requirement. This type of mammograph
detects early symptoms of the mammary gland pathology
using the breast impedance distribution anomaly. The
impedance distribution anomaly is based on the structur
al parameters of mammary gland tissue or metabolic
processes in the tissues of interest and in the surrounding
tissues [615]. The use of the electrical impedance
tomography for BC screening in women of all ages is a
very urgent problem.
Goal
The goal of this work was to assess the efficiency of
electrical impedance computer tomography (EICT) in
early BC diagnosis.
Materials and Methods
A total of 117 female patients (apparently healthy,
patients with mastopathy, patients with benign tumors,
and patients with breast cancer) were examined at the
Herzten Research Institute of Oncology for early symp
toms of BC. The age of the patients was 2284 years. The
patients were examined using EICT implemented in the
MEIC electrical impedance computer mammograph
Biomedical Engineering, Vol. 46, No. 4, November, 2012, pp. 154157. Translated from Meditsinskaya Tekhnika, Vol. 46, No. 4, Jul.Aug., 2012, pp. 2528.
Original article submitted May 12, 2012.
154
00063398/12/46040154 2012 Springer Science+Business Media New York
1
Hertzen Research Institute of Oncology, Ministry of Health and
Social Development of the Russian Federation, Moscow, Russia;
Email: maryerm@mail.ru
2
Russian Scientific Center of Roentgenoradiology, Ministry of Health
and Social Development of Russian Federation, Moscow, Russia.
* To whom correspondence should be addressed.
Diagnosis of Breast Cancer Using Electrical Impedance
Tomography
D. D. Pak
1
, N. I. Rozhkova
2
, M. N. Kireeva
2
, M. V. Ermoshchenkova
1
*,
A. A. Nazarov
2
, D. K. Fomin
2
, and N. A. Rubtsova
1
The efficiency of electrical impedance tomography, a new method of breast cancer diagnosis, is considered in this
work. A total of 117 female patients (apparently healthy, patients with mastopathy, patients with benign tumors,
patients with breast cancer) were tested. The method was implemented using an electrical impedance computer
mammograph with special 5.6 software version. Its efficiency was estimated to be 87.39%. Of 75 patients with
breast cancer, 96% were found to have degree III of risk of disease progression; 4%, degree II of disease pro
gression risk. Additional examination was recommended. Electrical impedance mammography was demonstrat
ed to be a noninvasive, safe, comfortable, rapid, and informative method of diagnosis.
Diagnosis of Breast Cancer Using Electrical Impedance Tomography 155
with special 5.6 software version (certificate No.
29/05010303/542003, July 3, 2003; working frequency
50 kHz) [7, 8, 11] (Fig. 1). The number of EICT com
putercontrolled electrodes was 256; the reference elec
trode was connected to the diagnostic unit. The reference
electrode was applied to the patients wrist. The software
of the apparatus provided mammary gland imaging and
image storage. The MEIC mammograph examines the
spatial distribution of impedance (electric conductivity)
over the mammary gland. This data gives information
about BC, chronic cystic mastopathy, mastitis, involu
tion, lactation, etc.
After the medical history was stored in the computer
memory, the breast was palpated and humidified, and a
12cm electrode panel containing 256 electrodes was
applied to the breast (Fig. 2). The position of the appara
tus was varied to maximize the number of the elec
trodeskin contacts. The 20sec test provided image of
the breast (Fig. 3).
The reconstructed image was analyzed in seven
mammary gland axial projections with 0.45.2 cm depth.
The MEIC mammograph software visualizes the electri
cal conductance distribution over the mammary gland
near the electrode. The electric current in the breast pro
vides the spatial distribution of electric potential. The
total test time was 35 sec. This test provides layerby
layer reconstruction (as in classical tomography). Seven
image projections (Fig. 4) are obtained as a result of the
test.
The electroimpedance mammogram (Fig. 4) shows
the right mammary gland image. The BC focus is located
in internal quadrants of the breast. The software calcu
lates the index of the mean electric conductivity, maximal
and minimal electric conductivity, meansquare devia
tion, and the extremum. The software also plots the
curves of the electric conductivity distribution and com
paratively analyses the electric conductivity in the left and
right breasts (%).
The MEIC data are analyzed on the basis of graphi
cal, numerical, and visual characteristics. The informa
tion value of the parameters is estimated in points. The
state of the breast is assessed using the windowed estimate
method, which is based on absolute statistical parameters
of the electric conductivity distribution. Each visual, sta
tistical, graphical, and mathematical parameter is esti
mated in points. The total score corresponds to given
pathology probability. The pathology probability analysis
revealed three degrees of BC risk (Table 1).
Fig. 1. Electrical impedance computer mammograph MEIC

.
Fig. 2. MEIC 5.6 electrode panel setting on the surface of the
breast.
Fig. 3. Monitor window: scanning process.
156 Pak et al.
The EICT diagnosis of each patient requires addi
tional examination. Fortytwo female patients with
mastopathy or benign mammary gland tumors were sub
jected to additional comprehensive diagnosis. Seventy
five female patients with primary BC IIII symptoms were
subjected to the same examination.
The comprehensive diagnosis included ultrasonic
scanning and Xray digital mammography (with due
regard to patients age).
Results
The relative error of the EICT diagnosis was larger
than the statistically confident level. However, the win
dowed estimate method allowed this disadvantage to be
avoided and BC risk to be determined. This fact is due to
some specific features of the integral estimate. The differ
ential diagnosis results obtained using the EICT method
are given in Table 2.
The EICTmediated diagnostic efficiency was 98%.
The results of clinical testing of the electrical impedance
computer mammograph with the 5.6 software revealed
that of 75 BC patients 96% (72 patients) had progression
risk degree III and 4% (3 patients) had progression risk
degree II. Additional examination was recommended.
False positive diagnosis was observed in 12.61% of the
patients. Strict continuous observation of these patients
No. 1 (4 mm) No. 2 (11 mm) No. 3 (18 mm) No. 4 (25 mm) No. 5 (32 mm) No. 6 (39 mm) No. 7 (46 mm)
Date: 04.03.2005 7:27, Comment: right center
Mean = 0.45
MSD = 0.17
Min = 0.02
Max = 0.91
Extremum = 0.38
Mean = 0.37
MSD = 0.19
Min = 0.11
Max = 0.82
Extremum = 0.30
Mean = 0.34
MSD = 0.18
Min = 0.08
Max = 0.71
Extremum = 0.21
Mean = 0.30
MSD = 0.17
Min = 0.01
Max = 0.71
Extremum = 0.21
Mean = 0.27
MSD = 0.15
Min = 0.02
Max = 0.69
Extremum = 0.19
Mean = 0.24
MSD = 0.14
Min = 0.02
Max = 0.74
Extremum = 0.16
Mean = 0.22
MSD = 0.13
Min = 0.04
Max = 0.67
Extremum = 0.16
Fig. 4. Seven planes of scanning image of the breast.
TABLE 1. Pathology Probability Inherent in Different States of
Mammary Gland Tissues
Recommendation
0
1
2
3
Norm
Biannual planned examination
Complete mammography
High risk of pathology. Urgent
examination
Percentage of mammary
gland pathology as calcu
lated from the EICT test
Risk
degree
<33%
3344%
4555% or left/right ratio
above 10
>55%
TABLE 2. Probability of Pathological Changes for Different Mammary Gland Tissue States
Mammary gland pathology
Mean probability of pathology
estimated using EICT, %
Deviation from mean value, %
Number of female patients
Norm
30.5
10.9
6
Diffuse fibrouscystic mastopathy
42
12.3
Diffuse fibrous mastopathy
44.5
14.5
Fat involution
53.75
5.0
15
Cancer
59.5
12.0
75 21
Diagnosis of Breast Cancer Using Electrical Impedance Tomography 157
was recommended. Thus, the efficiency of the EICT
method was 87.39%.
Conclusions
The electrical impedance computer mammograph
provides BC screening. Tumors are detected in the EICT
images as zones with abnormal electric conductivity.
According to EICT, the BC percentage is propor
tional to the pathology risk. The BC risk of degree III was
observed in 96% of the patients.
The EICT method implemented in the MEIC appa
ratus is a noninvasive and radiationfree method of mam
mography. The electrical impedance mammography was
demonstrated to be a safe, comfortable, rapid, and
informative method of diagnosis.
The efficiency of the EICT method in BC screening
was 87.39%.
Recommendation
The EICT method is recommended for primary BC
screening and for monitoring BC therapy efficacy.
Additional clinical, ultrasonic, and Xray mammograph
ic examinations are required in cases of anomalous
impedance tomograms.
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