Abstract
Breast cancer conservative treatment (BCCT), due to its proven oncological safety, is considered, when feasible, the gold standard of breast cancer treatment. However, aesthetic results are heterogeneous and difficult to evaluate in a standardized way, due to the lack of reproducibility of the subjective methods usually applied. The objective assessment methods, considered in the past as being less capable of evaluating all aspects of BCCT, are nowadays being preferred to overcome the drawbacks of the subjective evaluation. A recent computer-aided medical system was developed to objectively and automatically evaluate the aesthetic result of BCCT. In this system, the detection of the breast contour on the digital photograph of the patient is a necessary step to extract the features Subsequently used in the evaluation process. In this paper an algorithm based on the shortest path on a graph is proposed to detect automatically the breast contour. The proposed method extends an existing semi-automatic algorithm for the same purpose. A comprehensive comparison with manually-drawn contours reveals the strength of the proposed method.

Abstract
Rationale and Objectives: Computer-aided detection and diagnosis (CAD) systems have been developed in the past two decades to assist radiologists in the detection and diagnosis of lesions seen on breast imaging exams, thus providing a second opinion. Mammographic databases play an important role in the development of algorithms aiming at the detection and diagnosis of mammary lesions. However, available databases often do not take into consideration all the requirements needed for research and study purposes. This article aims to present and detail a new mammographic database. Materials and Methods: Images were acquired at a breast center located in a university hospital (Centro Hospitalar de S. Joao [CHSJ], Breast Centre, Porto) with the permission of the Portuguese National Committee of Data Protection and Hospital's Ethics Committee. MammoNovation Siemens full-field digital mammography, with a solid-state detector of amorphous selenium was used. Results: The new database-INbreast-has a total of 115 cases (410 images) from which 90 cases are from women with both breasts affected (four images per case) and 25 cases are from mastectomy patients (two images per case). Several types of lesions (masses, calcifications, asymmetries, and distortions) were included. Accurate contours made by specialists are also provided in XML format. Conclusion: The strengths of the actually presented database-INbreast-relies on the fact that it was built with full-field digital mammograms (in opposition to digitized mammograms), it presents a wide variability of cases, and is made publicly available together with precise annotations. We believe that this database can be a reference for future works centered or related to breast cancer imaging.

Abstract

Abstract

Abstract
Locally advanced breast cancer (LABC) constitutes a heterogeneous entity that includes advanced-stage primary tumours, cancers with extensive nodal involvement and inflammatory breast carcinomas. Although the definition of LABC can be broadened to include some large operable breast tumours, we use this term to strictly refer to inoperable cancers that are included in the above-mentioned categories. The prognosis of such tumours is often unfavourable; despite aggressive treatment, many patients eventually develop distant metastases and die from the disease. Advances in systemic therapy, including radiation treatment, surgical techniques and the development of new targeted agents have significantly improved clinical outcomes for patients with this disease. Notwithstanding these advances, LABC remains an important clinical problem, particularly in developing countries and those without widely adapted breast cancer awareness programmes. The optimal management of LABC requires a multidisciplinary approach, a well-coordinated treatment schedule and close cooperation between medical, surgical and radiation oncologists. In this Review, we discuss the current state of the art and possible future treatment strategies for patients with LABC.

Abstract