Pathology Commons^™

Labrad : Vol 48, Issue 1 - July 2023, Aga Khan University Hospital, Karachi

LABRAD

• Editorial
• Articles
• Toxicology In Public Health: Mitigating Risk, Fostering Well-Being
• Predictive And Prognostic Biomarkers in Histopathology
• Cancer Registry and Public Health Surveillance - Role of Pathologists
• Diagnosis of Celiac Disease DQA1*02,05; DQB1*02,03:02 (DQ2&DQ8) in patients
• Magnifying The Clinical Value of Expert Review and Reassessment
• Urine Cytology: A Screening and Surveillance Test
• An Overview of Convalescent Plasma for The Treatment of COVID-19
• Role of Imaging in Public Health Care
• Microsatellite Instability (MSI) Testing
• MRI Liver with Hepatocyte-Specific Contrast Agent
• Basics and Role of Cytopathology
• Bone Tumors: From Timely Diagnosis to Improved Patient Outcome
• Differentiating Between Dengue Fever and Malaria Using The …

Metallic Implant-Related Osteosarcoma, Frawa Mohsin, Mustafa Bin Ali Zubairi, Kulsoom Fatima, Muhammad Asad Diwan

Department of Radiology

Orthopedic metallic prostheses are commonly used in the current practice of orthopedic surgery. Although, biomaterials used in these implants are generally considered to be biologically inert, there have been consequences of foreign body reactions and potential carcinogenesis. Majority of implant-related malignancies are high grade, and develop in bone or soft tissue around the implant site. No clear association has been identified between the biomaterial implanted and the type of sarcoma. We report the case of a 36-year-old male who underwent intramedullary nailing of femur for mid-shaft fracture secondary to trauma and presented with osteogenic sarcoma of femur 14 months later.

Labrad : Vol 47, Issue 2 - December 2022, Aga Khan University Hospital, Karachi

LABRAD

• From the Editor’s Desk
• Case Quiz
• Contrast Enhanced Spectral Mammography Clinical Usefulness of Biochemical Parameters in Prenatal Diagnosis of Down Syndrome In First and Second Trimester
• The Science of Efficiency in a Clinical Laboratory
• Updates in new WHO Blue Book
• Monkeypox vs. COVID-19
• From the Diary of a Researcher- Notes on Understanding Beta-Thalassemia and Metabolic Bone Disease
• Significance of Audit in a Clinical Laboratory
• Microsatellite Instability (MSI) Testing
• Pre-Analytical Variables Affecting Coagulation Testing
• Grading of Soft Tissue Sarcomas
• Recent Updates in 2022 WHO Classification of Thyroid Neoplasms
• MMR and MSI Testing in Malignancies
• Transforming Pedagogical Framework of Pathology through Social …

Simultaneous Onset Of Haematological Malignancy And Covid: An Epicovideha Survey, Chiara Cattaneo, Jon Salmanton-García, Francesco Marchesi, Shaimaa El-Ashwah, Federico Itri, Barbora Weinbergerová, Maria Gomes Da Silva, Michelina Dargenio, Julio Dávila-Valls, Natasha Ali

Department of Pathology and Laboratory Medicine

Background: The outcome of patients with simultaneous diagnosis of haematological malignancies (HM) and COVID-19 is unknown and there are no specific treatment guidelines.
Methods: We describe the clinical features and outcome of a cohort of 450 patients with simultaneous diagnosis of HM and COVID-19 registered in the EPICOVIDEHA registry between March 2020 to February 2022.
Results: Acute leukaemia and lymphoma were the most frequent HM (35.8% and 35.1%, respectively). Overall, 343 (76.2%) patients received treatment for HM, which was delayed for longer than one month since diagnosis in 57 (16.6%). An overall response rate was observed in 140 (40.8%) patients …

Diagnostic Accuracy Of Artificial Intelligence For Detecting Gastrointestinal Luminal Pathologies: A Systematic Review And Meta-Analysis, Om Parkash, Asra Tus Saleha Siddiqui, Uswa Jiwani, Fahad Rind, Zahra Ali Padhani, Arjumand Rizvi, Zahra Hoodbhoy, Jai K. Das

Section of Gastroenterology

Background: Artificial Intelligence (AI) holds considerable promise for diagnostics in the field of gastroenterology. This systematic review and meta-analysis aims to assess the diagnostic accuracy of AI models compared with the gold standard of experts and histopathology for the diagnosis of various gastrointestinal (GI) luminal pathologies including polyps, neoplasms, and inflammatory bowel disease.
Methods: We searched PubMed, CINAHL, Wiley Cochrane Library, and Web of Science electronic databases to identify studies assessing the diagnostic performance of AI models for GI luminal pathologies. We extracted binary diagnostic accuracy data and constructed contingency tables to derive the outcomes of interest: sensitivity and specificity. …

Case Report: Axilla Fibroadenoma - An Atypical Presentation, Safna Naozer Virji, Lubna Mushtaque Vohra, Syeda Sakina Abidi, Romana Idress

Department of Surgery

No abstract provided.

Labrad : Vol 47, Issue 1 - June 2022, Aga Khan University, Karachi

LABRAD

• From the Editor’s Desk
• LABRAD Star Contributors for the Year 2021
• Clinical Relevance of Measuring Thyroid Stimulating Hormone Receptor Antibodies in Pregnancy and Newborns
• Aromatic l-amino Acid Decarboxylase (AADC) Deficiency- An Ultra-rare and Underdiagnosed Neurometabolic Disorder
• Role of Flowcytometry & Kleihauer - Betke Test in Detection and Quantification of Fetomaternal Hemorrhage
• Gestational Trophoblastic Diseases: An Overview
• Acrania-Exencephaly-Anencephaly Sequence/ Spectrum: Radiological Features on Antenatal Screening
• Minimally Invasive Tissue Sampling (MITS) A New Way to Investigate Cause of Death In Resource-constrained Countries
• Laboratory Guideline for Detection, Interpretation and Reporting of Maternal Cell Contamination (MCC) in Prenatal Analysis
• Molecular Analysis of Alpha Thalassemia …

Development And Validation Of Standard And Real Patient Gallstone Library Using Fourier Transform Infra-Red Spectroscopy, Lena Jafri, Muhammad Abbas Abid, Humera Asif, Syed Bilal Hashmi, Hafsa Majid, Farooq Ghani, Sibtain Ahmed, Imran Siddiqui, Aysha Habib

Department of Pathology and Laboratory Medicine

Background: Analysis of the constituents of gallstones using various spectroscopic techniques assists in identification of the pathogenesis of gallstones. In the current study, using Fourier Transform Infra-Red (FTIR) Spectroscopy, a Gallstone Standard Library (GSL) and a Gallstone Real Patients' Library (GRPL) were developed and validated for gallstone composition analysis.
Methods: The study was conducted at the Department of Pathology & Laboratory Medicine, Aga Khan University, Pakistan. Pure standards (cholesterol, calcium carbonate, bilirubin and bile salts) and gallstone specimens were analyzed using FTIR Nicolet iS-5 Spectrometer from Thermo Fisher Scientific, USA. Thermo Scientific™ QCheck™ algorithm, embedded within the OMNIC™ software, was …

Labrad : Vol 46, Issue 4 - October 2021, Aga Khan University Hospital, Karachi

LABRAD

• Role of Barcoding in a Clinical Laboratory to Reduce Pre-Analytical Errors
• Congenital Dyserythropoietic Anemia: The Morphological Diagnosis
• Digital Imaging in Hematology: A New Beginning
• Metabolomics: Identification of Fatty Acid Oxidation (FAO) Disorders
• Next-Generation Sequencing for HLA Genotyping
• Urine Metabolomics to identify Organic Academia
• Next-Generation Sequencing (NGS) of Solid Tumor
• Importance of using Genomic Tool in Microbial Identification
• Radiology Practice in 21st Century: Role of Artificial Intelligence
• Case Quiz
• Best of the Recent Past
• Polaroid

Diagnosis And Management Of Diffuse Large B-Cell Lymphoma: Society Of Medical Oncology, Pakistan Society Of Hematology, And Pakistan Society Of Clinical Oncology Joint Clinical Practice Guideline, Raheel Iftikhar, Muhammad Ayaz Mir, Munira Moosajee, Kamran Rashid, Syed Waqas Bokhari, Ahmed Nadeem Abbasi, Tahir Sultan Shamsi, Mohammad Usman Shaikh, Natasha Bahadur Ali, Salman Adil

Section of Haematology/Oncology

Diffuse large B-cell lymphoma (DLBCL) is the commonest non-Hodgkin lymphoma encountered by hematopathologists and oncologists. Management guidelines for DLBCL are developed and published by countries with high income and do not cater for practical challenges faced in resource-constrained settings. This report by a multidisciplinary panel of experts from Pakistan is on behalf of three major national cancer societies: Society of Medical Oncology Pakistan, Pakistan Society of Hematology, and Pakistan Society of Clinical Oncology. The aim is to develop a practical and standardized guideline for managing DLBCL in Pakistan, keeping in view local challenges, which are similar across most of the …

Labrad : Vol 46, Issue 3 - May 2021, Aga Khan University Hospital, Karachi

LABRAD

• Laboratory Diagnostic Tools for HIV in Neonates and Infants
• Intussusception in Pediatric Patients: Role of Radiology in Diagnosis and Management
• Fecal Calprotectin as an Inflammatory Marker in Inflammatory Bowel Disease
• Spectrum of Tools for the Detection of Enteric Pathogens in A Clinical Laboratory
• Pleuropulmonary Blastoma Type III with Rhabdomyosarcomatous and Chondrsarcomatous Differentiation in a Five year old Child, A rare case
• Radiology Pathology Correlation: Orthopedic Pathology
• Updates in Reporting Wilms Tumor (nephrectomy) Specimen
• Biotinidase Deficiency- a Rare but Easily Treatable Disorder
• Renal Tubular Disorders and Biochemical Diagnostics
• TSH Receptor Antibodies (TRAb) in Neonatal Hyperthyroidism: What We Need to Know
• The …

Concordance Between Clinical And Pathological Response Assessment After Neo-Adjuvant Chemotherapy In Patients With Invasive Lobular Carcinoma, Aisha Shaikh, Muhammad Usman Tariq, Shaista Khan, Romana Idress, Lubna Mushtaque Vohra, Saira Fatima Shaikh, Hira Waheed

Department of Surgery

Background: Neo-adjuvant chemotherapy (NAC) is frequently administered in breast carcinoma patients. The clinical response to NAC guides further treatment. The pathological response is not only an independent prognostic factor, but it also guides further treatment and prognosis.
Objectives: The aim of our study was to find the degree of concordance between clinical and pathological response assessments after NAC in Invasive lobular Carcinoma (ILC) cases by using World Health Organization (WHO) criteria and different pathological systems, respectively. We also tried to identify any useful parameter of clinical assessment that could better correlate with pathologic assessment and provide a better estimation of …

A Multidisciplinary Approach To Triage Patients With Breast Disease During The Covid-19 Pandemic: Experience From A Tertiary Care Center In The Developing World, Abida K. Sattar, Hania Shahzad, Adnan Abdul Jabbar, Azmina Tajdin Valimohammad, Sadaf Khan, Yasmin Vellani, Romana Idrees, Nasir Ali, Imrana Masroor, Humera Saeed, Gulzar S. Lakhani, Nadia Ayoub, Atif Waqar, Muhammad Zia-Ul Islam, Salman Kirmani, Asad Latif, Ather Enam

Section of General Surgery

Background: The COVID-19 pandemic has created a need to prioritize care because of limitation of resources. Owing to the heterogeneity and high prevalence of breast cancers, the need to prioritize care in this vulnerable population is essential. While various medical societies have published recommendations to manage breast disease during the COVID-19 pandemic, most are focused on the Western world and do not necessarily address the challenges of a resource-limited setting.
Aim: In this article, we describe our institutional approach for prioritizing care for patients presenting with breast disease.
Methods and results: The breast disease management guidelines were developed and approved …

The Association Of Chest Radiographic Findings And Severity Scoring With Clinical Outcomes In Patients With Covid-19 Presenting To The Emergency Department Of A Tertiary Care Hospital In Pakistan, Raima Kaleemi, Kiran Hilal, Ainan Arshad, Russell S. Martins, Avinash Nankani, Tanveer Ul Haq, Sundas Basharat, Zeeshan Ansar

Department of Radiology

Introduction: While chest x-rays (CXRs) represent a cost-effective imaging modality for developing countries like Pakistan, their utility for the prognostication of COVID-19 has been minimally explored. Thus, we describe the frequency and distribution of CXR findings, and their association with clinical outcomes of patients with COVID-19.
Methods: All adult (≥ 18 years) patients presenting between 28th February-31st May to the emergency department of a tertiary care hospital in Pakistan, who were COVID-19 positive on RT-PCR with CXR done on presentation, were included. A CXR Severity Score (CXR-SS) of 0-8 was used to quantify the extent of pulmonary infection on CXR, …

Localizing An Occult Insulinoma By Selective Calcium Arterial Stimulation Test: First Ever Experience And A New Dimension To Diagnosis In Pakistan, Muhammad Owais Rashid, Sumerah Jabeen, Zareen Kiran,, Khurram Minhas, Muhammad Azeemuddin, Najmul Islam

Section of Diabetes, Endocrinology and Metabolism

Insulinomas are rare, usually benign, solitary tumours accounting for 60% of islet cell tumours. These tumours can be difficult to localize preoperatively due to their small size. We present a challenging case of a 40 year old male with frequent hypoglycaemic spells and endogenous hypoglycaemia who presented as a diagnostic dilemma. Patient had an occult insulinoma with inconclusive CT Abdomen, MRI Abdomen and Octreotide scan. The final localization of the tumour was made by selective arterial calcium stimulation testing (SCAT), done for the first time in Pakistan at Aga Khan University Hospital. This was followed by successful distal pancreatectomy as …

Labrad : Vol 46, Issue 2 - June 2020, Aga Khan University Hospital, Karachi

LABRAD

• Pathophysiology of Lung Injury in Context with Novel Coronavirus 2019
• Imaging in COVID-19 Pandemic: Salient Features
• Qualitative Real-Time RT-PCR For Detection of SARS-Cov-2 RNA
• Coagulopathy and Anticoagulants in COVID-19
• AKUH Blood Bank During SARS-COV-2 Outbreak
• Significance of COVID-19 Whole Genome Sequencing
• Convalescent Plasma Therapy for COVID-19
• COVID-19: An Alarm Bell for Healthcare System in Pakistan!
• Emergency Online Undergraduate Medial Education During COVID 19
• Adopting Virtual Teaching During the Pandemic-An Overview of the Utility of ‘Microsoft Teams’ from an Educator’s Perspectiv
• The Best of the Recent Past
• Polaroid

Outcome Of Non-Malignant Papillary Lesions Of The Breast On Core Biopsy: An Experience From A Tertiary Care Center In Pakistan, Kulsoom Fatima, Shaista Afzal Saeed, Muhammad Usman Tariq

Department of Radiology

Background: Papillary lesions of the breast constitute a heterogeneous group ranging from non-malignant papillomas to papillary carcinoma. While surgical excision is recommended for atypical papilloma or papillary DCIS/ carcinoma on core biopsy, controversy persists in the management of benign papillomas which are diagnosed with core needle biopsy (CNB) since there are variable reported rates for tumor upgrade. The purpose of this study was to determine the outcome of papillary lesions of the breast diagnosed at image-guided CNB, after surgical excision or follow-up, and to identify potential predictors of high-risk lesions/malignancy on imaging.
Materials and methods: We retrospectively identified 52 non-malignant …

Breast Imaging Chameleon: Pseudoangiomatous Stromal Hyperplasia Presenting As Breast Malignancy, Rabail Raza, Kulsoom Fatima, Muhammad Usman Tariq

Department of Radiology

Pseudoangiomatous stromal hyperplasia (PASH) is a benign mesenchymal proliferative lesion of the breast, often an incidental finding on breast biopsy specimens and rarely presents as a palpable lump. The case being reported is interesting as a lactating female presented with gross left breast enlargement due to a huge firm mass with skin thickening and palpable left axillary lymph nodes. A provisional diagnosis of left breast malignancy was made and the patient extensively worked up with ultrasound, CT scan, bone scan and core biopsy. The histopathology, however, revealed PASH of the breast. There was no invasive or in situ malignancy. The …

Labrad : Vol 46, Issue 1 - March 2020, Aga Khan University Hospital, Karachi

LABRAD

• Role of Immunofluorescence Studies in the Diagnosis of Autoimmune Disorders
• Cystathionine Beta-Synthase Deficiency
• Treatment of Factor VIII Inhibitor
• Effective Internal Communication in Laboratories
• Digital Breast Tomosynthesis
• Overview of Common Myeloproliferative Neoplasms
• Clinical Significance of free Androgen Index (FAI)
• Radiology Quiz
• The Best of the Past
• Section Of Histopathology: Newer Horizons
• A Webinar Series ‘Rare Links’
• A Look into the Eye can Unleash Vital Diagnostic Pearls for 32 Rare Disorders
• Lab & Rad Mesh up for the Early Recognition of Rare Disorders
• Polaroid

Urinary Bladder Metastasis From Breast Cancer: A Rare Cause Of Hematuria, Samuel Gitau, Allan Njau, Sitna Mwanzi

Imaging & Diagnostic Radiology, East Africa

Breast cancer is the most common cancer in women globally as well as in Kenya. The most common sites of metastases reported include the bones, liver and lung. Metastasis to the urinary bladder is relatively uncommon with only a few case reports in literature. It can therefore be easily overlooked as a cause of hematuria in these patients. We describe a rare case of a patient with breast cancer who presented with urinary bladder metastasis as a late complication of her illness.

Utility Of Ultrasound And Mammography In Detection Of Negative Axillary Nodal Metastasis In Breast Cancer, Anam Khan, Imrana Masroor, Kumail Khandwala, Summar Un-Nisa Abbasi, Muhammad Usman Tariq

Department of Radiology

Objective: The status of axillary lymph nodes is one of the most important prognostic factors in patients with breast cancer. A precise noninvasive evaluation of axillary lymph node status preoperatively, although challenging, is vital for optimization of the treatment plan for patients. The objective of our study was to assess the utility of ultrasound and mammography in detecting the absence of axillary lymph nodal metastasis in patients of breast cancer, taking histopathology as gold standard.
Methods: A cross-sectional study was conducted in the Department of Radiology, Aga Khan University Hospital, Karachi. All female patients between 20 and 95 years of …

Labrad : Vol 45, Issue 3 - October 2019, Aga Khan University Hospital, Karachi

LABRAD

• Therapeutic Drug Monitoring for Antibiotics in Infections
• Biomarkers of Sepsis
• Serum Procalcitonin Level - Marker of Bacterial Infection
• Bone Marrow Findings in Malaria
• Antibiogram: A Clinicians’ Reference for Antibiotic Selection
• Laboratory Diagnosis of Meningitis
• Detection of Pneumocystis Jirovecii by PCR
• Microbiology Quiz
• Radiology Pathology Correlation- Orthopedic Pathology
• Role of Imaging in the Diagnosis and Management of Hepatic Abscess
• The Best of the Past
• Microbiology Quiz’s Answer
• Polaroid

Labrad : Vol 45, Issue 2 - July 2019, Aga Khan University Hospital, Karachi

LABRAD

• Novel Molecular Technique for Identifying Respiratory Tract Pathogens
• Role of Serum Galactomannan (GM) Assay in Diagnosing Invasive Aspergillosis (IA)
• Factor VIII Inhibitor – A Diagnostic Approach
• PET/CT Hybrid Imaging Technology at Aga Khan University Hospital
• Diagnostic Tests for Von Willebrand Disease
• Iron Deficiency Anemia
• Sweat Testing for Diagnosis of Cystic Fibrosis
• Flow Cytometric Identification of Abnormal B-Cells
• Direct Immunofluorescence in Bullous Skin Disorders
• Radiology-Pathology Correlation; Orthopedic Pathology
• Fecal Elastase: A Marker For Exocrine Pancreatic Function
• Edward Syndrome: Rare Autosomal Aneuploidy
• Sirolimus in Renal Transplant
• Latest Trends in Clinical Laboratory Science Technology
• Radiology-Neuropathology Correlation
• Nuchal Translucency Scan
• Bio-risk Management System in …

Labrad : Vol 45, Issue 1 - February 2019, Aga Khan University Hospital, Karachi

LABRAD

• Cardiac Manifestation of Inherited Metabolic Disorders
• Utility of Plasma Homocysteine in Identifying Inherited Metabolic Disorders (IMDs)
• Chediak-Higashi Syndrome, an Inherited Disorder in Phagocytic Function
• Radiology-Pathology Correlation Rare Diseases of Bone
• Dried Blood Spot (DBS) Sampling: A Method for Blood Collection without Venipuncture
• Newborn Screening Program for Congenital Hypothyroidism
• Rare Disease in Dermatopathology
• Screening for Carbohydrate Metabolism Disorders by Sugar Chromatography in Urine
• Hypophosphatasia a Rare Skeletal Disorder

Labrad : Vol 44, Issue 3 - December 2018, Aga Khan University Hospital, Karachi

LABRAD

• CD20 Negative B-Cell Lymphomas
• Quantification of Monoclonal Protein
• A Quick Guide to Immunofixation Electrophoresis
• Autologous Bone Marrow Transplantation at AKU
• Judicious Use of Immunohistochemistry & Ancillary Techniques in Precise Categorization of Lymphoproliferative Disorders

Labrad : Vol 44, Issue 2 - September 2018, Aga Khan University Hospital, Karachi

LABRAD

• Inappropriate Requesting Of Glycated Haemoglobin (HBA1c) By Clinicians
• Fecal Calprotectin (S100a8/S100a9)
• Fecal Pancreatic Elastase: A Test for Pancreatic Insufficiency
• Radiology Pathology Correlation
• Myelodysplastic Syndromes (MDS)
• WHO Classification of Head and Neck Tumours: An Update
• Plasma Metanephrines in Diagnosis of Pheochromocytoma
• Megaloblastic Anemia
• Aplastic AnemiaTransfusion Associated Circulatory Overload (Taco): A Severe But Preventable Transfusion Reaction

Labrad : Vol 44, Issue 1 - July 2018, Aga Khan University Hospital, Karachi

LABRAD

• How to Investigate a Bleeding Disorder
• Nucleic Acid Testing at AKUH
• Lab Diagnosis of von Willebrand Disease
• Ristocetin Cofactor Activity
• All You Need to Know About Thrombophilia Screening
• Utility of ADAMTS-13 Assay
• Homocysteine as a Risk Factor of Thrombosis
• Detection of Heparin/Platelet Factor 4 Antibodies
• Anti-factor Xa Assay

Unicameral Bone Cysts: Current Concepts, Shahryar Noordin, Salim Allana, Masood Umer, Mujahid Jamil, Kiran Hilal, Nasir Ud Din

Section of Orthopaedic Surgery

Unicameral bone cysts (UBC) or simple/solitary bone cysts are benign fluid filled cavities that enlarge over time, resulting in thinning of the bone. Usually these cysts are reported in the metaphyseal areas of long bones with open physes. 85% of UBCs occur almost exclusively in children and adolescents. UBCs are more aggressive in the first decade of life and correspondingly the recurrence rate for these patients is four times that for adolescents. The proximal humerus and femur account for almost 90% of these cases. UBCs are classified as active when they are within 1 cm of the physis and latent …

Metachronous Renal Ewing Sarcoma/Primitive Neuroectodermal Tumour In A Survivor Of Burkitt Lymphoma, Kumail Khandwala, Kiran Hilal, Zehra Fadoo, Khurram Minhas

Department of Radiology

We present a case of a 14-year-old girl who was diagnosed with Burkitt lymphoma in 2014. She was managed with chemotherapy and remained in remission for 3 years. On her surveillance imaging in 2017, a left-sided renal neoplastic mass was incidentally discovered. She underwent nephrectomy and pathology of the resected specimen revealed small cell tumour of the kidney with features favouring renal Ewing sarcoma/primitive neuroectodermal tumour. Molecular genetic analysis by fluorescence in situ hybridisation was performed which showed translocation of 22q12, thereby confirming the diagnosis. This is a rare secondary malignancy and an unusual association. This case highlights the importance …

Mammographic Breast Density And Breast Cancer Molecular Subtypes: The Kenyan-African Aspect, Asim Jamal, Maeve Mullooly, Shahin Sayed, Rose Ndumia, Innocent Abayo, James Orwa, Ronald Wasike, Zahir Moloo, Gretchen L. Gierach

Internal Medicine, East Africa

Introduction: Data examiningmammographic breast density (MBD) among patients in Sub-Saharan Africa are sparse.We evaluated how MBD relates to breast cancer characteristics in Kenyan women undergoing diagnostic mammography.

Methods: This crosssectional study included women with pathologically confirmed breast cancers (𝑛 = 123). Pretreatment mammograms of the unaffectedbreast were assessed to estimate absolute dense area (cm2), nondense area (cm2), and percent density (PD). Relationships between density measurements and clinical characteristics were evaluated using analysis of covariance.

Results: Median PD and dense area were 24.9% and 85.3 cm2. Higher PD and dense area were observed in younger women (𝑃 < 0.01). Higher dense and nondense areas were observed in obese women (𝑃-trend < 0.01). Estrogen receptor (ER) positive patients (73%) had higher PD and dense area than ER-negative patients (𝑃 ≤ 0.02). Triple negative breast cancer (TNBC) patients (17%) had lower PD and dense area (𝑃 ≤ 0.01) compared with non-TNBCs. No associations were observed between MBD and tumor size and grade.

Conclusions: Our findings show …