1. Physiological Variation in Vascular Reactivity of Breast Tissue over the Menstrual Cycle Demonstrated by Optical Tomography
Katz MS1, Hardin RE1, Franco NA1, Smeraldi AD2, Klemer DP3, Schmitz CH3, Pei Y3 Graber HL3, Barbour RL3
1Department of Surgery, SUNY Downstate Medical Center
2Department of Vascular Surgery, Staten Island University Hospital
3Department of Pathology, SUNY Downstate Medical Center
Biomedical Optics 2004
Miami Beach, Florida
April 14-17, 2004

2. Optical Tomography Group
Technology Data Analysis Applications
Time series imaging
Time multiplexed DC illumination
Fast reconstruction
Image enhancement techniques
Signal Analysis
Breast Cancer
Limb
Brain
NEC
Quantitative Functional Imaging

3. Breast Cancer Cancer is the second most common cause of death. (22%)
Breast cancer is the most common type of cancer in females. (211,300).
The second most common cause of cancer death in females. (40,110)
Most common cause of cancer death in African-American females.

4. Menstrual Cycle Estrogen Breast Enlargement Ductal Growth Progesterone
Ductal Maturation
Breast Swelling

5. 54% 10 yr survival 84% Clinical Research Follicular Phase Luteal Phase
Badwe et al: First study demonstrating correlation between long term survival and phase of menstruation.
Follicular Phase Luteal Phase
3-12 d. after LMP.
0-2, d. after LMP.
54% 10 yr survival 84%
Badwe RA, Gregory WM, Chaudary MA, Ricahrds MA, Bentley AE, Rubens RD, Fentimen IS, “Timing of Surgery During Menstrual Cycle and Survival of Premenopausal Women with Operable Breast Cancer”, Lancet, 1991,337;1:

6. DYNOT Breast Imager

7. Materials and Methods 5 Pre-menopausal healthy women were enrolled.
Subjects had each breast imaged separately using 25 source x 29 detector array.
Each women was measured 3-4 times during the menstrual cycle.
Subject were followed for 1-3 months.
Subjects were imaged for 1500 consecutive seconds.
500 second baseline (2 time points/second).
Repeat Valsalva maneuver of 40mm Hg for seconds.
200 second rest period.
Data analysis consisted of applying various signal processing routines to the image time series.

8. Criteria for Selection of Provocation
Effects entire breast.
Repeatable.
Serves as a useful discriminator.

9. Valsalva Maneuver

10. Mean Time Series

11. Pre-Menopausal Day 1 Day 12 Day 19 Day 28 Oxy-Hemoglobin Day 1 Day 12
Deoxy-Hemoglobin

12. Pre-Menopausal Day 1 Day 12 Day 19 Day 28 Subject #1 Oxy-Hemoglobin

13. Pre-Menopausal Day 1 Day 12 Day 19 Day 28 Subject #1 Deoxy-Hemoglobin

14. Post Menopausal Day 1 Day 8 Day 14 Day 26 Oxy-Hemoglobin
Deoxy-Hemoglobin

15. Percentage of Variance

16. Percentage of Variance
Day 1
Day 12
Day 19
Day 28
Oxygenated Hemoglobin
Oxy-Hemoglobin

17. Phase 1 Day 1 Day 12 Day 19 Day 28 Oxy-Hemoglobin % of SD Pairs1- 0- 1- 0- 1- 0- 1- 0-
% of SD Pairs
% of SD Pairs
% of SD Pairs
% of SD Pairs

18. Phase 3 Day 1 Day 12 Day 19 Day 28 Oxy-Hemoglobin Deoxy-Hemoglobin
Red-Hemoglobin 1- 0- 1- 0-

19. Phase 4 Day 1 Day 12 Day 19 Day 28 Oxy-Hemoglobin Deoxy-Hemoglobin
Red Hemoglobin 1- 0- 1- 0-

20. Percentage of Variance-GLM
100 50 1

21. Spatial Map of Onset of Maximal Response
Day1
Day12
Right Breast P1
Day19
Left Breast P1
Right Breast N2
Left Breast N2

22. Conclusions
Vascular response of breast to the Valsalva maneuver is mainly coherent and repeatable.
Response profile to Valsalva maneuver varies over the menstrual cycle.
Largest variation in profile is seen with deoxy-hemoglobin whereas largest variation in rate is seen with oxy-hemoglobin.