Value of digital mammography in predicting lymphovascular invasion of breast cancer

Value of digital mammography in predicting lymphovascular invasion of breast cancer | Research Square window.SnipcartSettings = { analytics: { enabled: false } }; (function() { var accessVector = localStorage.getItem('access_vector') || ''; window.dataLayer = window.dataLayer || []; if (accessVector) { window.dataLayer.push({ user: { profile: { profileInfo: { snid: accessVector } } } }); } })(); (function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start':new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0],j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src='https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f);})(window,document,'script','dataLayer','GTM-K279D39R'); Browse Preprints In Review Journals COVID-19 Preprints AJE Video Bytes Research Tools Research Promotion AJE Professional Editing AJE Rubriq About Preprint Platform In Review Editorial Policies Our Team Advisory Board Help Center Sign In Submit a Preprint Cite Share Download PDF Research article Value of digital mammography in predicting lymphovascular invasion of breast cancer Zhuangsheng Liu, Xiaoping Li, Keming Liang, Junhao Chen, Xiangmeng Chen, and 5 more This is a preprint; it has not been peer reviewed by a journal. https://doi.org/ 10.21203/rs.2.18849/v1 This work is licensed under a CC BY 4.0 License Status: Posted Version 1 posted You are reading this latest preprint version Abstract Background : To use digital mammography, a more popular imaging tool, for predicting lymphovascular invasion(LVI) in breast cancer patients preoperatively. Methods: 122 cases of invasive ductal carcinoma diagnosed between May 2017 and September 2018 were collected, which were divided into positive group (n=42) and negative group (n=80) according to the presence or absence of LVI. Results: The differences of these variables(childbearing history, miscarriage history, other breast diseases history, nipple discharge, breast cancer marker CA153, age, ER, PR, HER-2, E-CAD, P53, Ki-67) between LVI positive group and the LVI negative group were not statistically significant, except that of Ki-67 (P=0.012). For the image features of digital mammography, the differences of interstitial edema (P=0.013) and skin thickening (P=0.000) between LVI positive group and negative groups were statistically significant. The differences of other imaging patterns, that is, fibroglandular tissue density, size , solitary/multiple, mass shape, mass margin , subcutaneous fat, axillary adenopathy and so on, between the two groups were not statistically significant. Multiple factor analysis shows that, there are three independent risk factors for predicting LVI occurrence: interstitial edema (OR = 12.610, 95% confidence interval CI: 1.061, 149.922, P=0.045), subcutaneous fat (OR=0.081, 95% confidence interval CI: 0.012, 0.645, P =0.017) and skin thickening (OR=9.041, 95% confidence interval CI: 2.553, 32.022, P=0.001). Conclusion : Interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence. When applying these three imaging patterns together, the specificity of LVI prediction was as high as 98.8%. Nuclear Medicine & Medical Imaging Lymphovascular invasion Breast Cancer Digital mammography Figures Figure 1 Figure 2 Figure 3 1. Background Breast cancer metastasizes through lymphatic and blood vessels, which makes it a major factor for distant metastasis, postoperative recurrence and even death [ 1 ]. Lymphovascular invasion (LVI) is never revealed by preoperative imaging scans. Diagnostic histopathology is needed to reveal lymphovascular invasion of cancer cells. Identification of lymphovascular invasion preoperatively can help predict prognosis of patients with breast cancer, especially those with axillary node-negative breast cancer, and develop adjuvant treatment plans in clinical settings [ 2 , 3 ]. Therefore, preoperative prediction of lymphovascular invasion with imaging devices is of great clinical value. Digital mammography is one of the important imaging tools for breast cancer screening and diagnosis. THERE ARE MANY REPORTS ON THE PREDICTION OF AXILLARY LYMPH NODE METASTASIS[ 4 – 6 ], DIGITAL MAMMOGRAPHY SCREENING[ 7 – 10 ]. However, no study reports on predicting lymphovascular invasion in breast cancer patients based on imaging patterns of digital mammography have been found, except A FEW LITERATURE REPORTED that [ 3 , 11 – 13 ] predicts lymphovascular invasion in breast cancer patients using MRI findings. It is necessary to use digital mammography, a more popular imaging tool, for predicting lymphovascular invasion in breast cancer patients preoperatively, and evaluate its findings in combination with certain biomarkers detected by immunohistochemistry to better foresee the disease progression and develop targeted treatment plan. 2. Methods 2.1 Clinical data This is a single-center retrospective study. All breast cancer cases were obtained from picture archiving and communication system(PACS), so patients' informed consent was not required. THIS RETROSPECTIVE STUDY WAS APPROVED BY OUR HOSPITAL’S ETHICS COMMITTEE. In all collected cases, mammographic lesions were confirmed either by core needle biopsies or by surgical pathology; and all patients underwent digital mammography preoperatively. In this study, 158 cases of invasive ductal carcinoma diagnosed between May 2017 and September 2018 were randomly selected. The inclusion criteria were: (1) patients underwent modified radical mastectomy or breast-conserving surgery + axillary lymph node dissection; (2) diagnosis of invasive breast cancer was confirmed by routine histopathological and immunohistochemical examinations ; (3) previous history of breast tumors and the primary tumors in other locations were excluded; (4) lymphovascular tumor emboli were detected by pathologists using immunohistochemistry. 122 cases were retained, after excluding those with obscure lesions presented by digital mammograms, breastfeeding patients, patients who had underwent lumbar puncture or radiotherapy prior to the diagnosis, and incomplete clinical data. In these eligible cases, all patients were female, aged between 26 and 77 years, with a median age of 45 years. 2 . 2 Digital mammography GE (Senographe DS) and IMS (GIOTTO IMAGE) systems were used. Four standard body positions, right craniocaudal(RCC), left craniocaudal(LCC), right mediolateral oblique(RMLO) and left mediolateral oblique(LMLO) were adopted under at automatic exposure conditions. When lesions were found in the axillary tail of Spence and near the cleavage, amplified imaging in these locations was added to fully reveal the lesions. The internal and external oblique flat-panel detector was parallel to the pectoralis major muscle. According to patients’ body shape, the projecting angle ranged from 40 ° to 65 °, and was usually at 60 °. The glands were fully unfolded, and the skin folds under the breasts and upper abdomen were within the mammographic field. 2.3 Image analysis The imaging characteristics of breast cancer lesions were described according to the 5th edition of ACR BI-RADS-X Atlas published in 2013 (breast imaging-reporting and data system) [ 14 ]. The lesions are classified into masses, calcifications, architectural distortion, and asymmetries. The masses can be solitary or multiple, and their shapes are described as round, lobulated, and irregular. Margins of the masses can be described as well circumscribed if they have clear and sharp edges. Also, the margins can be described as obscured if the viewer believes they have clear and sharp edges which are obscured by glands. Margins are described as instinct if they have obscure and speculated edges. In this study group, amorphous and fine polymorphic calcifications were included while excluding typically benign calcification. Architectural distortion is defined as the abnormal deformation of the breast, without being revealed by any clear mass. In such case, history of trauma and surgery must be ruled out. A focal asymmetry is seen in two images, but lacks the outward border or a mass. In this study group, only few cases of architectural distortion and focal asymmetry (both n < 5) on digital mammography were found. Therefore, these cases were ruled out from study samples to avoid inaccuracy of statistical results. And the lesion type was classified as mass and calcification only. The locations of lesion are divided into the upper outer quadrant, the lower outer quadrant, the lower inner quadrant, the upper inner quadrant, the central region and the whole breast. The breast composition were described as: a. almost entirely fatty; b. there are scattered areas of fibroglandular density; c. heterogeneously dense, which may obscure small masses; and d. extremely dense, which lowers the sensitivity of mammography. Associated features included interstitial edema, blurring of subcutaneous fat layer, skin thickening, and axillary adenopathy (lymph nodes measuring > 1 cm in the long axis diameter with absence of hilus). 2 . 4 Pathology Surgically resected breast cancer specimens were fixed in 10% formaldehyde for 24 h, then were dehydrated and embedded in paraffin wax. Sections were prepared. Standard HE staining and streptavidin-peroxidase-biotin (SP) immunohistochemical method were performed. A DAB detection system were performed. Her-2 scoring 3 + was defined as overexpression. For Her-2 scoring 2+, the Her-2 gene amplification was tested by FISH, whose positive result would be defined as overexpression. Ki67 proliferative index (PI) was scored as low expression when 30%, and intermediate expression when it was between 10% and 30% [ 15 ]. The gold standard of this study: lymphovascular invasion is defined as the intravenous tumor emboli and lymphatic tumor emboli detected by immunohistochemistry. These two kinds of tumor emboli were clinically referred to as intralymphovascular tumor emboli due to the difficulty of distinguishing them by pathological sections. The speciments were read by a senior pathologist who has been working on breast cancer for 21 years. 2.5 Statistical analysis The cases were classified into lymphovascular invasion positive group (LVI positive group) and lymphovascular invasion negative group (LVI negative group), according to the clinical and imaging characteristics of invasive ductal carcinoma. Table 1– 3 was completed. The data were analyzed using SPSS Version 19.0 statistical package. The quantitative data was expressed by ± sd. The Independent Two-sample t Test were used for comparison between groups; the count data was expressed by frequency or rate, and the χ2 test or Fisher's method was used, with P < 0.05 indicating that the difference is statistically significant. All count data with 0 s were excluded in statistical analysis, and was listed only. The Nomogram was used to analyze the risk factors of LVI occurrence. The two-tailed was performed with P < 0.05 being considered as statistically significant. 3. Results 3.1 General data and biomarkers 122 breast IDC patients were divided into positive group (n=42) and negative group (n=80) according to the presence or absence of lymphovascular invasion . The classification results of childbearing history, miscarriage history, other breast diseases history, nipple discharge, breast cancer marker CA153, age, ER, PR, HER-2, E-CAD, P53, Ki-67 are shown in Table 1. Due to the absence of nipple discharge (n=0) in the LVI negative group, the nipple-discharge variable was excluded, and was listed only. The differences of the variables between LVI positive group and the LVI negative group were not statistically significant, except that of Ki-67 (P=0.012). 3.2 The image patterns of digital mammography Details are shown in Table 1. The differences of interstitial edema (P=0.013, Fig.1, 2) and skin thickening (P=0.000,Fig. 1,2) between LVI positive group and negative groups were statistically significant. The differences of other imaging patterns, that is, fibroglandular tissue density (P=0.431), size (P=0.094), solitary/multiple (P=0.746), lesions (P=0.8855), location (P=0.879), mass shape (P=0.160), mass margin (P=0.088), boundary (P=0.714), calcification (P=0.279), subcutaneous fat (P=0.697), nipple retraction (P=0.073), axillary adenopathy (P =0.166), between the two groups were not statistically significant. Risk factor analysis: See Table 2. Multiple factor analysis (MFA) shows that, there are three independent risk factors for predicting LVI occurrence: interstitial edema (OR = 12.610, 95% confidence interval CI: 1.061, 149.922, P=0.045), subcutaneous fat (OR=0.081, 95% confidence interval CI: 0.012, 0.645, P =0.017) and skin thickening (OR=9.041, 95% confidence interval CI: 2.553, 32.022, P=0.001). Table 3 shows the sensitivity, specificity, accuracy, PPV and NPV of the above three imaging patterns with LVI predicting values: interstitial edema, subcutaneous fat and skin thickening, and their combined application in LVI predictions. The specificity of LVI prediction was as high as 98.8% when these three imaging patterns were applied together. 4. Discussion lymphovascular invasion (intralymphovascular tumor emboli) is closely related to the adverse outcome of many malignant tumors [ 16 – 18 ]. As a risk factor for recurrent breast cancer following modified radical mastectomy, lymphovascular tumor emboli, especially lymphatic tumor emboli, has been included in the St Gallen consensus for breast cancer [ 19 ]. Karlsson et al’s [ 20 ] study results showed that the failure rate of chemotherapy in breast cancer patients detected with lymphovascular invasion was higher. Shen et al [ 21 ] showed that lymphovascular tumor emboli can promote local tumor recurrence and distant metastasis. Therefore, lymphovascular tumor emboli is a reliable indicator for the distant metastasis of breast cancer and the assessment of patients’ overall survival. We intended to predict the risk of lymphovascular invasion of the most common invasive ductal carcinoma using various imaging patterns of digital mammography, the most commonly used imaging tool. From the data of this study group, there was no statistical significance of the differences in the age, childbearing history, miscarriage history, family history and other medical history between the LVI positive group and the LVI negative group. Nulliparity, miscarriage, and family history of breast cancer do not increase the LVI occurrence rate in breast cancer patients. First discovered in breast cancer and breast cells, CA153 is a tumor marker with relatively higher specificity for breast cancer diagnosis. With the advancing of breast cancer, the CA153 sensitivity increased from 66–80% [ 22 ]. However, in this study group, there were only 4 (3.3%) CA153 positive cases. While no statistical significance was found in differences of ER, PR, Her-2, E-cad, and P53 between the LVI positive group and the LVI negative group, cases with high expression of Ki-67 (> 30%) in the LVI positive group were more than that in the LVI negative group, which was statistically significant (P = 0.012). Many literatures have also confirmed that Ki-67 is associated with tumor differentiation, lymphovascular invasion, metastasis, and recurrence [ 23 – 25 ]. The data of this study group showed that there is no difference in mammographic background presented by digital mammography and direct patterns of breast cancer, such as mammographic density, location of mass, number, size, shape, margin, boundary, calcification classification, etc., between LVI positive group and LVI negative group. Therefore, the above imaging patterns cannot be used to predict LVI occurrence. Also, heterogeneously dense and extremely dense breast do not increase the risk of LVI occurrence. However, the differences in indirect features such as interstitial edema and breast skin thickening between LVI positive group and LVI negative group were statistically significant (P = 0.013 and 0.000, respectively). In addition, multivariate analysis indicated that interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence (P = 0.045, 0.017 and 0.001, respectively). In clinical work-up, physicians should be highly vigilant about LVI occurrence once the above three imaging patterns are found on digital mammography. Even if lymph node metastasis is negative in sentinel lymph node and axillary lymph node biopsies, possibility that breast cancer cells has infiltrated into surrounding vessels but not yet reached upwards to the axillary lymph nodes should be considered. Accordingly, adjustments in postoperative adjuvant therapy should be considered to reduce risk of recurrence and distant metastasis and thus improve patients’ survival time. We have thought that the axillary lymph nodes shown on digital mammography could be used to predict LVI occurrence. However, this group of study data shows that there is no difference in the size and shape of axillary lymph nodes between the LVI positive group and the LVI negative group (P = 0.166), which might be explained by failure of displaying axillary lymph nodes on the digital mammography image. In addition, lymph node enlargement (> 1 cm) and a full shape does not always mean lymph node metastasis, it may also suggest lymphoid node reactive hyperplasia. Nomogram is a statistical model used for individualized predictive analysis of clinical events. Compared with other predictive statistical methods, Nomogram analysis provides a better individualized prognostic risk assessment in an intuitive, visual way [ 26 ]. This study also established a nomogram model for predicting the risk of LVI occurrence in individuals based on digital mammographic imaging patterns. For example, we can learn from Fig. 3 that, if the patient presents with interstitial edema, subcutaneous fat, and skin thickening, along with Ki-67 high expression, the score will be 95 + 100 + 87 + 48 = 330 points, with the corresponding risk of LVI being 68%. In this way, clinicians can better understand patients’ clinical prognosis, and develop a more effective and targeted therapeutic regime. 5. Conclusions There was a statistically significant difference in Ki-67 between the LVI positive group and the LVI negative group. Interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence (P = 0.045, 0.017, and 0.001, respectively). When applying these three imaging patterns together, the specificity of LVI prediction was as high as 98.8%. Declarations Ethics approval and consent to participate The Ethics Committee of the Affiliated Jiangmen Hospital of Sun Yat-Sen University approved the current study, and the need for signed informed consent was waived. Consent for publication Not applicable. Availability of data and materials The data needed to replicate the current findings are available in the figures and tables of the main article. Because of patient privacy protection, additional study materials are only available upon individual request directed to the corresponding author. Competing interests The authors declare that they have no conflicts of interest regarding the publication of this paper. Funding This work was supported by the National Natural Science Foundation of China (81802918), the science and technology planning project of Jiangmen (2017A4016), and the science and technology planning project of Jiangmen(2015068). These funding are earmarked for cancer research. The funding bodies have no role in study design, collection, analysis, interpretation of data or writing the manuscript. Author contributions ZSL, RQL participated in the study design, evaluated the results and wrote the first and revised manuscript. KML, JHC and XMC participated in the study design and supplied with contrast medium. XPL RGL and XZ carried out the images analysis and revised manuscripts. LLY, WSL participated in the design of the study, redesigned the data analysis. All authors read and approved the final manuscript. Acknowledgment We thank the study team at Jiangmen Central Hospital for their continuous support. Abbreviations LVI: lymphovascular invasion DM: digital mammography DBT: digital breast tomosynthesis CESM: contrast-enhanced digital mammography PACS: picture archiving and communication system RCC : right craniocaudal LCC: left craniocaudal RMLO: right mediolateral oblique LMLO : left mediolateral oblique References W. Wang, A. Belosay, X. Yang, J.A. 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Tables Table.1 Comparison of patient characteristics according to Vascular invasion Characteristics Total VI=0(Negative) VI=1(Positive) P Age 122 49.99(10.17) 48.93(9.34) 0.566 History of giving birth 122 80 42 0.488 No 5 4(5.00) 1(2.38) Yes 117 76(95.00) 41(97.62) History of abortion 122 80 42 0.560 No 86 55(68.75) 31(73.81) Yes 36 25(31.25) 11(26.19) nipple discharge 122 80 42 No 120 80(100.00) 40(95.24) Yes 2 0(0.00) 2(4.76) CA153* 121 79 42 0.514 Negative 117 77(97.47) 40(95.24) Positive 4 2(2.53) 2(4.76) History of related illness 122 80 42 0.488 No 117 76(95.00) 41(97.62) Yes 5 4(5.00) 1(2.38) ER 122 80 42 0.062 Negative 39 21(26.25) 18(42.86) Positive 83 59(73.75) 24(57.14) PR 122 80 42 0.0591 Negative 47 26(32.50) 21(50.00) Positive 75 54(67.50) 21(50.00) HER-2 122 80 42 0.994 Negative 32 21(26.25) 11(26.19) Positive 90 59(73.75) 31(73.81) E-cad* 87 56 31 0.100 Negative 6 2(3.57) 4(12.90) Positive 81 54(96.43) 27(87.10) Ki-67 122 80 42 0.012 Low 27 20(25.00) 7(16.67) Moderate 36 29(36.25) 7(16.67) High 59 31(38.75) 28(66.67) P53 122 80 42 0.126 Negative 40 30(37.50) 10(23.81) Positive 82 50(62.50) 32(76.19) Amount of fibroglandular tissue 122 80 42 0.431 Almost entirely fat/Scattered fibroglandular tissue 49 33(41.25) 16(38.10) Heterogeneous fibroglandular tissue 54 37(46.25) 17(40.48) Extreme fibroglandular tissue 19 10(12.50) 9(21.43) Size(cm) 122 80 42 0.094 No 79 56(70.00) 23(54.76) Yes 43 24(30.00) 19(45.24) Single/multiple 122 80 42 0.746 Single 95 63(78.75) 32(76.19) Multiple 27 17(21.25) 10(23.81) Lesions 122 80 42 0.8855 Mass 65 43(53.75) 22(52.38) Mass/calcification 57 37(46.25) 20(47.62) Location 122 80 42 0.879 Outer upper 73 49(61.25) 24(57.14) Outer lower 5 4(5.00) 1(2.38) Lower inner 15 10(12.50) 5(11.90) Upper inner 15 9(11.25) 6(14.29) Central area 14 8(10.00) 6(14.29) Mass shape 122 80 42 0.160 Lobulated 16 8(10.00) 8(19.05) Irregular 106 72(90.00) 34(80.95) Mass Margin 122 80 42 0.088 Smooth 6 2(2.50) 4(9.52) Rough 116 78(97.50) 38(90.48) Boundary 122 80 42 0.714 Clear 69 47(58.75) 22(52.38) Obscure 27 16(20.00) 11(26.19) Shield 26 17(21.25) 9(21.43) Calcification* 56 36 20 0.279 Vague and amorphous 25 18(50.00) 7(35.00) Fine polymorphous 31 18(50.00) 13(65.00) Interstitial edema 122 80 42 0.013 No 110 76(95.00) 34(80.95) Yes 12 4(5.00) 8(19.05) Subcutaneous fat 122 80 42 0.697 Clear 101 67(83.75) 34(80.95) Muddy 21 13(16.25) 8(19.05) Thicken Skin 122 80 42 0.000 No 86 65(81.25) 21(50.00) Yes 36 15(18.75) 21(50.00) Nipple retraction 122 80 42 0.073 No 98 68(85.00) 30(71.43) Yes 24 12(15.00) 12(28.57) Axillary lymph node enlargement 122 80 42 0.166 No 77 54(67.50) 23(54.76) Yes 45 26(32.50) 19(45.24) * Missing value exists VI ： Vascular invasion Table 2. Univariate and multivariate analysis Factors Univariate analysis Multivariate analysis OR （ 95% CI ） P OR （ 95% CI ） P Interstitial edema 4.471(1.260,15.864) 0.020 12.610(1.061,149.922) 0.045 Subcutaneous fat 1.213(0.458,3.207) 0.698 0.081(0.012,0.645) 0.017 Thicken Skin 4.333(1.899,9.891) 0.000 9.041(2.553,32.022) 0.001 ER 0.475(0.216,1.044) 0.064 1.595(0.252, 10.084) 0.62 PR 0.481(0.224,1.034) 0.061 0.508(0.085,3.035) 0.458 HER-2 1.003(0.429,2.345) 0.994 1.436(0.462,4.466) 0.532 Ki-67 Moderate 0.690(0.209,2.273) 0.541 0.382(0.094,1.551) 0.178 High 2.581(0.948,7.022) 0.063 1.298(0.350,4.809) 0.696 P53 1.920(0.827,4.457) 0.129 2.115(0.739,6.050) 0.163 Amount of fibroglandular tissue Heterogeneous fibroglandular tissue 0.948(0.414,2.179) 0.899 1.439(0.491,4.215) 0.507 Extreme fibroglandular tissue 1.856(0.630,5.469) 0.262 3.773(0.707,20.154) 0.12 Size(cm) 1.928(0.890,4,176) 0.096 0.921(0.294,2.891) 0.889 Nipple retraction 2.267(0.914,5.621) 0.077 1.299(0.281,5.991) 0.738 Single/multiple 1.158(0.476,2.819) 0.746 1.183(0.336,4.165) 0.793 Lesions 1.057(0.500,2.233) 0.885 0.712(0.256,1.979) 0.514 Mass shape 0.472(0.163,1.365) 0.166 0.624(0.128,3.047) 0.56 Margin 0.224(0.043,1.389) 0.112 0.424(0.032,5.630) 0.516 Boundary Obscure 1.469(0.586,3.684) 0.413 1.483(0.439,5.007) 0.526 Shield 1.131(0.436,2.935) 0.800 0.997(0.246,4.043) 0.997 Axillary lymph node enlargement 1.716(0.797,3.694) 0.168 0.909(0.295,2.805) 0.868 E-cad 0.250(0.043,1.452) 0.122 Location Outer lower 0.510(0.054,4.819) 0.557 Lower inner 1.021(0.314,3.320) 0.973 Upper inner 1.361(0.434,4.267) 0.597 Central area 1.531(0.477,4.913) 0.474 Calcification 1.857(0.601,5.734) 0.166 Family history 1.927(0.117,31.602) 0.646 History of giving birth 2.158(0.233,19.947) 0.498 History of abortion 0.781(0.339,1.799) 0.561 CA15-3 1.925(0.261,14.179) 0.52 History of related illness 0.463(0.050,4.284) 0.498 Table 3. Diagnostic performance Methods Sensitivity Specificity Accuracy PPV NPV Interstitial edema 19.0(8/42) 95.0(76/80) 68.9(84/122) 66.7(8/12) 69.1(76/110) Thicken Skin 50.0(21/42) 81.3(65/80) 70.5(86/122) 58.3(21/36) 75.6(65/86) Subcutaneous fat 19.0(8/42) 83.8(67/80) 61.2(75/122) 38.1(8/21) 66.3(67/101) connection 14.3(6/42) 98.8(79/80) 69.7(85/122) 85.7(6/7) 68.7(79/115) Cite Share Download PDF Status: Posted Version 1 posted You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-9467","acceptedTermsAndConditions":true,"allowDirectSubmit":true,"archivedVersions":[],"articleType":"Research article","associatedPublications":[],"authors":[{"id":250162,"identity":"c7a47e03-bedd-4cdf-9d19-004881b0180d","order_by":1,"name":"Zhuangsheng Liu","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Zhuangsheng","middleName":"","lastName":"Liu","suffix":""},{"id":250163,"identity":"fada4368-fc3a-46c1-889d-7b2fddb4f84f","order_by":2,"name":"Xiaoping Li","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xiaoping","middleName":"","lastName":"Li","suffix":""},{"id":250164,"identity":"37480b9f-5832-4ad7-9efb-3e68f26ba4fc","order_by":3,"name":"Keming Liang","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Keming","middleName":"","lastName":"Liang","suffix":""},{"id":250165,"identity":"f9d6e9b5-ff80-4fae-a565-e9ada2258d44","order_by":4,"name":"Junhao Chen","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Junhao","middleName":"","lastName":"Chen","suffix":""},{"id":250166,"identity":"faf7175c-f9e8-4417-acc6-f80f8623648a","order_by":5,"name":"Xiangmeng Chen","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xiangmeng","middleName":"","lastName":"Chen","suffix":""},{"id":250167,"identity":"065cbd74-6a93-4d84-9d38-8382484ceb62","order_by":6,"name":"Ruqiong Li","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ruqiong","middleName":"","lastName":"Li","suffix":""},{"id":250168,"identity":"ee888739-9e4f-4458-9d1c-439edb6ecb84","order_by":7,"name":"Ronggang Li","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Ronggang","middleName":"","lastName":"Li","suffix":""},{"id":250169,"identity":"9a4cee22-029a-420e-811b-6a94dfb9c796","order_by":8,"name":"Xin Zhang","email":"","orcid":"","institution":"Jiangmen Central Hospital","correspondingAuthor":false,"prefix":"","firstName":"Xin","middleName":"","lastName":"Zhang","suffix":""},{"id":250170,"identity":"a516a63b-e612-4e3b-82a6-110875090599","order_by":9,"name":"Lilei Yi","email":"","orcid":"","institution":"Foshan Hospital of Traditional Chinese Medicine","correspondingAuthor":false,"prefix":"","firstName":"Lilei","middleName":"","lastName":"Yi","suffix":""},{"id":250171,"identity":"2c992496-5ce7-4633-99a5-edc0651a538d","order_by":10,"name":"Wansheng Long","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAAArElEQVRIiWNgGAWjYBACxgbmBgaGChsefv4GorUwApWeSZORnHGABHsYGNsO2xg0JBCpgXnawTbJH2zneQwYDjB++JhDjB2zE9ukeXhu85gzNzBLztxGpJbbDBK3eSwbDrAx8xKr5eYPg3M8BgcSSNBygyfhAGla2n/zHEjmkZxxsJk4vxjOTj5s+POfnT0/f/PBDx+J0tKAsLABpyoUIE+cslEwCkbBKBjRAADesTfQEQtKTwAAAABJRU5ErkJggg==","orcid":"https://orcid.org/0000-0002-1331-1858","institution":"Jiangmen Central Hospital","correspondingAuthor":true,"prefix":"","firstName":"Wansheng","middleName":"","lastName":"Long","suffix":""}],"badges":[],"createdAt":"2019-12-11 14:35:58","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.2.18849/v1","doiUrl":"https://doi.org/10.21203/rs.2.18849/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":266779,"identity":"7c62722b-eb6f-426e-a230-268af7a8251a","added_by":"auto","created_at":"2019-12-16 23:11:38","extension":"jpg","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":52637,"visible":true,"origin":"","legend":"Female, 58 years old, VI positive. The MLO position (Fig. A) and CC position (Fig. B) of digital mammography showed an irregular upper mass with blurred boundaries in the upper outer quadrant of the right breast. Also, interstitial edema(black arrow), blurring of subcutaneous fat layer(yellow arrow), skin thickening(red arrow), and axillary adenopathy(white arrow) were shown in the right breast.","description":"","filename":"figure1.jpg","url":"https://assets-eu.researchsquare.com/files/aeb9eebf-dae7-4df5-a18e-991352ccb8ab/v1/figure1.jpg"},{"id":266780,"identity":"7f5aa2c4-8fdb-409b-9b99-e5e2c950bb5b","added_by":"auto","created_at":"2019-12-16 23:11:38","extension":"jpg","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":54915,"visible":true,"origin":"","legend":"Female, 47 years old, VI negative. The MLO position (Fig. A) and the CC position (Fig. B) of the digital mammography showed a circular mass with smooth edges and clear boundaries in the upper outer quadrant of the right breast, and accompanying patterns such as interstitial edema and skin thickening were not seen.","description":"","filename":"figure2.jpg","url":"https://assets-eu.researchsquare.com/files/aeb9eebf-dae7-4df5-a18e-991352ccb8ab/v1/figure2.jpg"},{"id":266781,"identity":"7af268c1-0f36-4b3d-85b3-46e1557c5f3a","added_by":"auto","created_at":"2019-12-16 23:11:39","extension":"jpg","order_by":3,"title":"Figure 3","display":"","copyAsset":false,"role":"figure","size":65929,"visible":true,"origin":"","legend":"Nomogram of imaging patterns and tumor markers in this study group used for predicting risk of VI occurrence.","description":"","filename":"Fig.3.jpg","url":"https://assets-eu.researchsquare.com/files/aeb9eebf-dae7-4df5-a18e-991352ccb8ab/v1/Fig.3.jpg"},{"id":13483103,"identity":"eb8e9ed1-f661-4198-bfdc-75defdb270d0","added_by":"auto","created_at":"2021-09-16 21:52:09","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":435098,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-9467/v1/399b98cf-42df-4c5d-b603-f6533c74bbf5.pdf"}],"financialInterests":"","formattedTitle":"Value of digital mammography in predicting lymphovascular invasion of breast cancer","fulltext":[{"header":"1. Background","content":" \u003cp\u003eBreast cancer metastasizes through lymphatic and blood vessels, which makes it a major factor for distant metastasis, postoperative recurrence and even death [\u003cspan citationid=\"CR1\" class=\"CitationRef\"\u003e1\u003c/span\u003e]. Lymphovascular invasion (LVI) is never revealed by preoperative imaging scans. Diagnostic histopathology is needed to reveal lymphovascular invasion of cancer cells. Identification of lymphovascular invasion preoperatively can help predict prognosis of patients with breast cancer, especially those with axillary node-negative breast cancer, and develop adjuvant treatment plans in clinical settings [\u003cspan citationid=\"CR2\" class=\"CitationRef\"\u003e2\u003c/span\u003e, \u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e]. Therefore, preoperative prediction of lymphovascular invasion with imaging devices is of great clinical value.\u003c/p\u003e \u003cp\u003eDigital mammography is one of the important imaging tools for breast cancer screening and diagnosis. THERE ARE MANY REPORTS ON THE PREDICTION OF AXILLARY LYMPH NODE METASTASIS[\u003cspan additionalcitationids=\"CR5\" citationid=\"CR4\" class=\"CitationRef\"\u003e4\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR6\" class=\"CitationRef\"\u003e6\u003c/span\u003e], DIGITAL MAMMOGRAPHY SCREENING[\u003cspan additionalcitationids=\"CR8 CR9\" citationid=\"CR7\" class=\"CitationRef\"\u003e7\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR10\" class=\"CitationRef\"\u003e10\u003c/span\u003e]. However, no study reports on predicting lymphovascular invasion in breast cancer patients based on imaging patterns of digital mammography have been found, except A FEW LITERATURE REPORTED that [\u003cspan citationid=\"CR3\" class=\"CitationRef\"\u003e3\u003c/span\u003e, \u003cspan additionalcitationids=\"CR12\" citationid=\"CR11\" class=\"CitationRef\"\u003e11\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR13\" class=\"CitationRef\"\u003e13\u003c/span\u003e] predicts lymphovascular invasion in breast cancer patients using MRI findings.\u003c/p\u003e \u003cp\u003eIt is necessary to use digital mammography, a more popular imaging tool, for predicting lymphovascular invasion in breast cancer patients preoperatively, and evaluate its findings in combination with certain biomarkers detected by immunohistochemistry to better foresee the disease progression and develop targeted treatment plan.\u003c/p\u003e "},{"header":"2. Methods","content":" \u003cdiv id=\"Sec3\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e2.1 Clinical data\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThis is a single-center retrospective study. All breast cancer cases were obtained from picture archiving and communication system(PACS), so patients' informed consent was not required. THIS RETROSPECTIVE STUDY WAS APPROVED BY OUR HOSPITAL\u0026rsquo;S ETHICS COMMITTEE. In all collected cases, mammographic lesions were confirmed either by core needle biopsies or by surgical pathology; and all patients underwent digital mammography preoperatively. In this study, 158 cases of invasive ductal carcinoma diagnosed between May 2017 and September 2018 were randomly selected. The inclusion criteria were: (1) patients underwent modified radical mastectomy or breast-conserving surgery\u0026thinsp;+\u0026thinsp;axillary lymph node dissection; (2) diagnosis of invasive breast cancer was confirmed by routine histopathological and immunohistochemical examinations ; (3) previous history of breast tumors and the primary tumors in other locations were excluded; (4) lymphovascular tumor emboli were detected by pathologists using immunohistochemistry. 122 cases were retained, after excluding those with obscure lesions presented by digital mammograms, breastfeeding patients, patients who had underwent lumbar puncture or radiotherapy prior to the diagnosis, and incomplete clinical data. In these eligible cases, all patients were female, aged between 26 and 77 years, with a median age of 45\u0026nbsp;years.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec4\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e2\u003c/span\u003e.\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e2 Digital mammography\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eGE (Senographe DS) and IMS (GIOTTO IMAGE) systems were used. Four standard body positions, right craniocaudal(RCC), left craniocaudal(LCC), right mediolateral oblique(RMLO) and left mediolateral oblique(LMLO) were adopted under at automatic exposure conditions. When lesions were found in the axillary tail of Spence and near the cleavage, amplified imaging in these locations was added to fully reveal the lesions. The internal and external oblique flat-panel detector was parallel to the pectoralis major muscle. According to patients\u0026rsquo; body shape, the projecting angle ranged from 40 \u0026deg; to 65 \u0026deg;, and was usually at 60 \u0026deg;. The glands were fully unfolded, and the skin folds under the breasts and upper abdomen were within the mammographic field.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec5\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e2.3 Image analysis\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eThe imaging characteristics of breast cancer lesions were described according to the 5th edition of ACR BI-RADS-X Atlas published in 2013 (breast imaging-reporting and data system) [\u003cspan citationid=\"CR14\" class=\"CitationRef\"\u003e14\u003c/span\u003e]. The lesions are classified into masses, calcifications, architectural distortion, and asymmetries. The masses can be solitary or multiple, and their shapes are described as round, lobulated, and irregular. Margins of the masses can be described as well circumscribed if they have clear and sharp edges. Also, the margins can be described as obscured if the viewer believes they have clear and sharp edges which are obscured by glands. Margins are described as instinct if they have obscure and speculated edges. In this study group, amorphous and fine polymorphic calcifications were included while excluding typically benign calcification. Architectural distortion is defined as the abnormal deformation of the breast, without being revealed by any clear mass. In such case, history of trauma and surgery must be ruled out. A focal asymmetry is seen in two images, but lacks the outward border or a mass. In this study group, only few cases of architectural distortion and focal asymmetry (both n\u0026thinsp;\u0026lt;\u0026thinsp;5) on digital mammography were found. Therefore, these cases were ruled out from study samples to avoid inaccuracy of statistical results. And the lesion type was classified as mass and calcification only.\u003c/p\u003e \u003cp\u003eThe locations of lesion are divided into the upper outer quadrant, the lower outer quadrant, the lower inner quadrant, the upper inner quadrant, the central region and the whole breast. The breast composition were described as: a. almost entirely fatty; b. there are scattered areas of fibroglandular density; c. heterogeneously dense, which may obscure small masses; and d. extremely dense, which lowers the sensitivity of mammography. Associated features included interstitial edema, blurring of subcutaneous fat layer, skin thickening, and axillary adenopathy (lymph nodes measuring\u0026thinsp;\u0026gt;\u0026thinsp;1\u0026nbsp;cm in the long axis diameter with absence of hilus).\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec6\" class=\"Section2\"\u003e \u003ch2\u003e\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e2\u003c/span\u003e.\u003cspan type=\"Bold\" class=\"Bold\" name=\"Emphasis\"\u003e4 Pathology\u003c/span\u003e\u003c/h2\u003e \u003cp\u003eSurgically resected breast cancer specimens were fixed in 10% formaldehyde for 24\u0026nbsp;h, then were dehydrated and embedded in paraffin wax. Sections were prepared. Standard HE staining and streptavidin-peroxidase-biotin (SP) immunohistochemical method were performed. A DAB detection system were performed. Her-2 scoring 3\u0026thinsp;+\u0026thinsp;was defined as overexpression. For Her-2 scoring 2+, the Her-2 gene amplification was tested by FISH, whose positive result would be defined as overexpression. Ki67 proliferative index (PI) was scored as low expression when \u0026lt;\u0026thinsp;10%, high expression when \u0026gt;\u0026thinsp;30%, and intermediate expression when it was between 10% and 30% [\u003cspan citationid=\"CR15\" class=\"CitationRef\"\u003e15\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe gold standard of this study: lymphovascular invasion is defined as the intravenous tumor emboli and lymphatic tumor emboli detected by immunohistochemistry. These two kinds of tumor emboli were clinically referred to as intralymphovascular tumor emboli due to the difficulty of distinguishing them by pathological sections. The speciments were read by a senior pathologist who has been working on breast cancer for 21\u0026nbsp;years.\u003c/p\u003e \u003c/div\u003e \u003cdiv id=\"Sec7\" class=\"Section2\"\u003e \u003ch2\u003e2.5 Statistical analysis\u003c/h2\u003e \u003cp\u003eThe cases were classified into lymphovascular invasion positive group (LVI positive group) and lymphovascular invasion negative group (LVI negative group), according to the clinical and imaging characteristics of invasive ductal carcinoma. Table\u0026nbsp;1\u0026ndash;\u003cspan refid=\"Tab1\" class=\"InternalRef\"\u003e3\u003c/span\u003e was completed. The data were analyzed using SPSS Version 19.0 statistical package. The quantitative data was expressed by \u0026plusmn;\u0026thinsp;sd. The Independent Two-sample t Test were used for comparison between groups; the count data was expressed by frequency or rate, and the χ2 test or Fisher's method was used, with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 indicating that the difference is statistically significant. All count data with 0\u0026nbsp;s were excluded in statistical analysis, and was listed only. The Nomogram was used to analyze the risk factors of LVI occurrence. The two-tailed was performed with P\u0026thinsp;\u0026lt;\u0026thinsp;0.05 being considered as statistically significant.\u003c/p\u003e"},{"header":"3. Results","content":"\u003cp\u003e\u003cstrong\u003e3.1 General data and biomarkers\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003e122 breast IDC patients were divided into positive group (n=42) and negative group (n=80) according to the presence or absence of lymphovascular invasion . The classification results of childbearing history, miscarriage history, other breast diseases history, nipple discharge, breast cancer marker CA153, age, ER, PR, HER-2, E-CAD, P53, Ki-67 are shown in Table 1. Due to the absence of nipple discharge (n=0) in the LVI negative group, the nipple-discharge variable was excluded, and was listed only. The differences of the variables between LVI positive group and the LVI negative group were not statistically significant, except that of Ki-67 (P=0.012).\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003e3.2 The image patterns\u003c/strong\u003e\u003cstrong\u003eof digital mammography\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eDetails are shown in Table 1. The differences of interstitial edema (P=0.013, Fig.1, 2) and skin thickening (P=0.000,Fig. 1,2) between LVI positive group and negative groups were statistically significant. The differences of other imaging patterns, that is, fibroglandular tissue density (P=0.431), size (P=0.094), solitary/multiple (P=0.746), lesions (P=0.8855), location (P=0.879), mass shape (P=0.160), mass margin (P=0.088), boundary (P=0.714), calcification (P=0.279), subcutaneous fat (P=0.697), nipple retraction (P=0.073), axillary adenopathy (P =0.166), between the two groups were not statistically significant.\u003c/p\u003e\n\u003cp\u003eRisk factor analysis: See Table 2. Multiple factor analysis (MFA) shows that, there are three independent risk factors for predicting LVI occurrence: interstitial edema (OR = 12.610, 95% confidence interval CI: 1.061, 149.922, P=0.045), subcutaneous fat (OR=0.081, 95% confidence interval CI: 0.012, 0.645, P =0.017) and skin thickening (OR=9.041, 95% confidence interval CI: 2.553, 32.022, P=0.001).\u003c/p\u003e\n\u003cp\u003eTable 3 shows the sensitivity, specificity, accuracy, PPV and NPV of the above three imaging patterns with LVI predicting values: interstitial edema, subcutaneous fat and skin thickening, and their combined application in LVI predictions. The specificity of LVI prediction was as high as 98.8% when these three imaging patterns were applied together.\u003c/p\u003e"},{"header":"4. Discussion","content":" \u003cp\u003elymphovascular invasion (intralymphovascular tumor emboli) is closely related to the adverse outcome of many malignant tumors [\u003cspan additionalcitationids=\"CR17\" citationid=\"CR16\" class=\"CitationRef\"\u003e16\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR18\" class=\"CitationRef\"\u003e18\u003c/span\u003e]. As a risk factor for recurrent breast cancer following modified radical mastectomy, lymphovascular tumor emboli, especially lymphatic tumor emboli, has been included in the St Gallen consensus for breast cancer [\u003cspan citationid=\"CR19\" class=\"CitationRef\"\u003e19\u003c/span\u003e]. Karlsson et al\u0026rsquo;s [\u003cspan citationid=\"CR20\" class=\"CitationRef\"\u003e20\u003c/span\u003e] study results showed that the failure rate of chemotherapy in breast cancer patients detected with lymphovascular invasion was higher. Shen et al [\u003cspan citationid=\"CR21\" class=\"CitationRef\"\u003e21\u003c/span\u003e] showed that lymphovascular tumor emboli can promote local tumor recurrence and distant metastasis. Therefore, lymphovascular tumor emboli is a reliable indicator for the distant metastasis of breast cancer and the assessment of patients\u0026rsquo; overall survival. We intended to predict the risk of lymphovascular invasion of the most common invasive ductal carcinoma using various imaging patterns of digital mammography, the most commonly used imaging tool.\u003c/p\u003e \u003cp\u003eFrom the data of this study group, there was no statistical significance of the differences in the age, childbearing history, miscarriage history, family history and other medical history between the LVI positive group and the LVI negative group. Nulliparity, miscarriage, and family history of breast cancer do not increase the LVI occurrence rate in breast cancer patients. First discovered in breast cancer and breast cells, CA153 is a tumor marker with relatively higher specificity for breast cancer diagnosis. With the advancing of breast cancer, the CA153 sensitivity increased from 66\u0026ndash;80% [\u003cspan citationid=\"CR22\" class=\"CitationRef\"\u003e22\u003c/span\u003e]. However, in this study group, there were only 4 (3.3%) CA153 positive cases. While no statistical significance was found in differences of ER, PR, Her-2, E-cad, and P53 between the LVI positive group and the LVI negative group, cases with high expression of Ki-67 (\u0026gt;\u0026thinsp;30%) in the LVI positive group were more than that in the LVI negative group, which was statistically significant (P\u0026thinsp;=\u0026thinsp;0.012). Many literatures have also confirmed that Ki-67 is associated with tumor differentiation, lymphovascular invasion, metastasis, and recurrence [\u003cspan additionalcitationids=\"CR24\" citationid=\"CR23\" class=\"CitationRef\"\u003e23\u003c/span\u003e\u0026ndash;\u003cspan citationid=\"CR25\" class=\"CitationRef\"\u003e25\u003c/span\u003e].\u003c/p\u003e \u003cp\u003eThe data of this study group showed that there is no difference in mammographic background presented by digital mammography and direct patterns of breast cancer, such as mammographic density, location of mass, number, size, shape, margin, boundary, calcification classification, etc., between LVI positive group and LVI negative group. Therefore, the above imaging patterns cannot be used to predict LVI occurrence. Also, heterogeneously dense and extremely dense breast do not increase the risk of LVI occurrence. However, the differences in indirect features such as interstitial edema and breast skin thickening between LVI positive group and LVI negative group were statistically significant (P\u0026thinsp;=\u0026thinsp;0.013 and 0.000, respectively). In addition, multivariate analysis indicated that interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence (P\u0026thinsp;=\u0026thinsp;0.045, 0.017 and 0.001, respectively). In clinical work-up, physicians should be highly vigilant about LVI occurrence once the above three imaging patterns are found on digital mammography. Even if lymph node metastasis is negative in sentinel lymph node and axillary lymph node biopsies, possibility that breast cancer cells has infiltrated into surrounding vessels but not yet reached upwards to the axillary lymph nodes should be considered. Accordingly, adjustments in postoperative adjuvant therapy should be considered to reduce risk of recurrence and distant metastasis and thus improve patients\u0026rsquo; survival time.\u003c/p\u003e \u003cp\u003eWe have thought that the axillary lymph nodes shown on digital mammography could be used to predict LVI occurrence. However, this group of study data shows that there is no difference in the size and shape of axillary lymph nodes between the LVI positive group and the LVI negative group (P\u0026thinsp;=\u0026thinsp;0.166), which might be explained by failure of displaying axillary lymph nodes on the digital mammography image. In addition, lymph node enlargement (\u0026gt;\u0026thinsp;1\u0026nbsp;cm) and a full shape does not always mean lymph node metastasis, it may also suggest lymphoid node reactive hyperplasia.\u003c/p\u003e \u003cp\u003eNomogram is a statistical model used for individualized predictive analysis of clinical events. Compared with other predictive statistical methods, Nomogram analysis provides a better individualized prognostic risk assessment in an intuitive, visual way [\u003cspan citationid=\"CR26\" class=\"CitationRef\"\u003e26\u003c/span\u003e]. This study also established a nomogram model for predicting the risk of LVI occurrence in individuals based on digital mammographic imaging patterns. For example, we can learn from Fig.\u0026nbsp;\u003cspan refid=\"Fig3\" class=\"InternalRef\"\u003e3\u003c/span\u003e that, if the patient presents with interstitial edema, subcutaneous fat, and skin thickening, along with Ki-67 high expression, the score will be 95\u0026thinsp;+\u0026thinsp;100\u0026thinsp;+\u0026thinsp;87\u0026thinsp;+\u0026thinsp;48\u0026thinsp;=\u0026thinsp;330 points, with the corresponding risk of LVI being 68%. In this way, clinicians can better understand patients\u0026rsquo; clinical prognosis, and develop a more effective and targeted therapeutic regime.\u003c/p\u003e \u003cp\u003e \u003c/p\u003e "},{"header":"5. Conclusions","content":" \u003cp\u003eThere was a statistically significant difference in Ki-67 between the LVI positive group and the LVI negative group. Interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence (P\u0026thinsp;=\u0026thinsp;0.045, 0.017, and 0.001, respectively). When applying these three imaging patterns together, the specificity of LVI prediction was as high as 98.8%.\u003c/p\u003e "},{"header":"Declarations","content":"\u003ch3\u003eEthics approval and consent to participate\u003c/h3\u003e\n\u003cp\u003eThe Ethics Committee of the Affiliated Jiangmen Hospital of Sun Yat-Sen University approved the current study, and the need for signed informed consent was waived.\u003c/p\u003e\n\u003ch3\u003eConsent for publication\u003c/h3\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch3\u003eAvailability of data and materials\u003c/h3\u003e\n\u003cp\u003eThe data needed to replicate the current findings are available in the figures and tables of the main article. Because of patient privacy protection, additional study materials are only available upon individual request directed to the corresponding author.\u003c/p\u003e\n\u003ch3\u003eCompeting interests\u003c/h3\u003e\n\u003cp\u003eThe authors declare that they have no conflicts of interest regarding the publication of this paper.\u003c/p\u003e\n\u003ch3\u003eFunding\u003c/h3\u003e\n\u003cp\u003eThis work was supported by the National Natural Science Foundation of China (81802918), the science and technology planning project of Jiangmen (2017A4016), and the science and technology planning project of Jiangmen(2015068). These funding are earmarked for cancer research. The funding bodies have no role in study design, collection, analysis, interpretation of data or writing the manuscript.\u003c/p\u003e\n\u003ch3\u003eAuthor contributions\u003c/h3\u003e\n\u003cp\u003eZSL, RQL participated in the study design, evaluated the results and wrote the first and revised manuscript. KML, JHC and XMC participated in the study design and supplied with contrast medium. XPL RGL and XZ carried out the images analysis and revised manuscripts. LLY, WSL participated in the design of the study, redesigned the data analysis. All authors read and approved the final manuscript.\u003c/p\u003e\n\u003ch3\u003eAcknowledgment\u003c/h3\u003e\n\u003cp\u003eWe thank the study team at Jiangmen Central Hospital for their continuous support.\u003c/p\u003e"},{"header":"Abbreviations","content":"LVI: lymphovascular invasion DM: digital mammography \nDBT: digital breast tomosynthesis CESM: contrast-enhanced digital mammography \nPACS: picture archiving and communication system\nRCC : right craniocaudal LCC: left craniocaudal\nRMLO: right mediolateral oblique LMLO : left mediolateral oblique"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eW. Wang, A. Belosay, X. Yang, J.A. Hartman, H. et al. 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Development and validation of a\u0026nbsp;nomogram\u0026nbsp;predicting the overall survival of stage IV\u0026nbsp;breast cancer\u0026nbsp;patients. \u003ca href=\"https://www.ncbi.nlm.nih.gov/pubmed/28980424\"\u003eCancer\u0026ensp;Med.\u003c/a\u003e2017 Nov;6(11):2586-2594.\u003c/li\u003e\n\u003c/ol\u003e"},{"header":"Tables","content":"\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eTable.1\u0026nbsp; Comparison of patient characteristics according to Vascular invasion\u003c/span\u003e\u003c/p\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none;\"\u003e\n\u003ctbody\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eCharacteristics\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eTotal\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eVI=0(Negative)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eVI=1(Positive)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eP\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eAge \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e49.99(10.17)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e48.93(9.34)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.566\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHistory of giving birth\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.488\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e4(5.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1(2.38)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e117\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e76(95.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e41(97.62)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHistory of abortion\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.560\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e86\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e55(68.75)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e31(73.81)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e36\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e25(31.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e11(26.19)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003ch3 style=\"background: white; margin: 0in 0in 4.5pt 0in;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003enipple discharge\u003c/span\u003e\u003c/h3\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e120\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80(100.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e40(95.24)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0(0.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e2(4.76)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eCA153*\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e121\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e79\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e77(97.47)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e40(95.24)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; 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height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.488\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e117\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e76(95.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e41(97.62)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e5\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e4(5.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1(2.38)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eER\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.062\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eNegative\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e39\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e21(26.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e18(42.86)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.0591\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eNegative\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e47\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e26(32.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e21(50.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e29(36.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e7(16.67)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHigh\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e59\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e31(38.75)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e28(66.67)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eP53\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.126\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eNegative\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e40\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e30(37.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e10(23.81)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003ePositive\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e82\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e50(62.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e32(76.19)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eAmount of fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.431\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eAlmost entirely fat/Scattered fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e49\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e33(41.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e16(38.10)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHeterogeneous fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e54\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e37(46.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e17(40.48)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eExtreme fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e19\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e10(12.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e9(21.43)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eSize(cm)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.094\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e79\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e56(70.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e23(54.76)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003eMultiple\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e27\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e17(21.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e10(23.81)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.8855\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMass\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMass/calcification\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e57\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eObscure\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e27\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e16(20.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003eSubcutaneous fat\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e67(83.75)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e34(80.95)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMuddy\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e21\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e13(16.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e8(19.05)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.000\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e86\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e65(81.25)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e21(50.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e36\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e15(18.75)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e24\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e12(15.00)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e12(28.57)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eAxillary lymph node enlargement\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e122\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e80\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e42\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.166\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eNo\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e77\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e54(67.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e23(54.76)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 1.15pt;\"\u003e\n\u003ctd style=\"width: 156.35pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"208\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eYes\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 50.75pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"68\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e45\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e26(32.50)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 118.1pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"157\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e19(45.24)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 62.85pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 1.15pt;\" width=\"84\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e* Missing value exists\u003c/span\u003e\u003c/p\u003e\n\u003cp\u003e\u0026nbsp;\u003c/p\u003e\n\u003cp style=\"text-indent: 10.5pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eVI\u003c/span\u003e\u003cspan style=\"font-family: SimSun;\"\u003e：\u003c/span\u003e\u003cspan style=\"font-family: 'Times New Roman',serif;\"\u003eVascular invasion\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003cbr\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 12pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eTable 2. Univariate and multivariate analysis\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" rowspan=\"2\" width=\"195\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eFactors\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 182.1pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" colspan=\"2\" width=\"243\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eUnivariate analysis\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 191.65pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" colspan=\"2\" width=\"256\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMultivariate analysis\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 105.55pt; border: none; border-bottom: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cem\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003eOR\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"font-size: 10.0pt; font-family: SimSun;\"\u003e（\u003c/span\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e95%\u003cem\u003eCI\u003c/em\u003e\u003c/span\u003e\u003cspan style=\"font-size: 10.0pt; font-family: SimSun;\"\u003e）\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; border: none; border-bottom: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cem\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border-top: none; border-left: solid white 1.0pt; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cem\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003eOR\u003c/span\u003e\u003c/em\u003e\u003cspan style=\"font-size: 10.0pt; font-family: SimSun;\"\u003e（\u003c/span\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e95%\u003cem\u003eCI\u003c/em\u003e\u003c/span\u003e\u003cspan style=\"font-size: 10.0pt; font-family: SimSun;\"\u003e）\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; border: none; border-bottom: solid windowtext 1.0pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cem\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003eP\u003c/span\u003e\u003c/em\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eInterstitial edema\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e4.471(1.260,15.864)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif;\"\u003e0.020\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e12.610(1.061,149.922)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; border: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e0.045\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eSubcutaneous fat\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.213(0.458,3.207)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.698\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e0.081(0.012,0.645)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e0.017\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 12.9pt;\"\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.9pt;\" width=\"195\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eThicken Skin\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.9pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e4.333(1.899,9.891)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.9pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif;\"\u003e0.000\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.9pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e9.041(2.553,32.022)\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 12.9pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cstrong\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e0.001\u003c/span\u003e\u003c/strong\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eER\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.475(0.216,1.044)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.064\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"color: #000000;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif;\"\u003e1.595(0.252,\u003c/span\u003e\u003cspan style=\"font-size: 10.0pt; font-family: 'Times New Roman',serif;\"\u003e10.084)\u003c/span\u003e\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.62\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003ePR\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.481(0.224,1.034)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.061\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.508(0.085,3.035)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.458\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHER-2\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.003(0.429,2.345)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; vertical-align: bottom;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.994\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.436(0.462,4.466)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.532\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 4.5pt;\"\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.5pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eKi-67\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.5pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.5pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.5pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt; height: 4.5pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eModerate\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.690(0.209,2.273)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.541\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.382(0.094,1.551)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.178\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHigh\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e2.581(0.948,7.022)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.063\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.298(0.350,4.809)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.696\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eP53\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp;\u0026nbsp; \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.920(0.827,4.457)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.129\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e2.115(0.739,6.050)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.163\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eAmount of fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"margin-left: 9.95pt; text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHeterogeneous fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.948(0.414,2.179)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.899\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.439(0.491,4.215)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.507\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left; text-indent: 10.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eExtreme fibroglandular tissue\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.856(0.630,5.469)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.262\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e3.773(0.707,20.154)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.12\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eSize(cm)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.928(0.890,4,176)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.057(0.500,2.233)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.885\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.712(0.256,1.979)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.514\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMass shape\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.472(0.163,1.365)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.166\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.624(0.128,3.047)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.56\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eMargin\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.224(0.043,1.389)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; 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font-family: 'Times New Roman', serif; color: #000000;\"\u003eBoundary\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; 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line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.168\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.909(0.295,2.805)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.868\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; 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padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eLocation \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eOuter lower\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.510(0.054,4.819)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.557\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eLower inner\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.021(0.314,3.320)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.973\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eUpper inner\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.361(0.434,4.267)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.597\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eCentral area\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.531(0.477,4.913)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.474\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eCalcification \u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.857(0.601,5.734)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.166\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eFamily history\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.927(0.117,31.602)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.646\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHistory of giving birth\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e2.158(0.233,19.947)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.498\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHistory of abortion\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.781(0.339,1.799)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.561\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eCA15-3\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e1.925(0.261,14.179)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.52\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 145.9pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"195\"\u003e\n\u003cp style=\"text-align: left;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003eHistory of related illness\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 105.55pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"141\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.463(0.050,4.284)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 76.55pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"102\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e0.498\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 127.55pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"170\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 64.1pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt;\" width=\"85\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003e\u003cspan style=\"font-size: 10pt; font-family: 'Times New Roman', serif; color: #000000;\"\u003e\u0026nbsp;\u003c/span\u003e\u003c/p\u003e\n\u003cbr\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eTable 3. Diagnostic performance\u003c/span\u003e\u003c/p\u003e\n\u003ctable style=\"border-collapse: collapse; border: none; margin-left: 6.75pt; margin-right: 6.75pt;\"\u003e\n\u003ctbody\u003e\n\u003ctr\u003e\n\u003ctd style=\"width: 114.6pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"153\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eMethods\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eSensitivity\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eSpecificity\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eAccuracy\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003ePPV\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.55pt; border-top: solid windowtext 1.5pt; border-left: none; border-bottom: solid windowtext 1.0pt; border-right: none; padding: 0in 5.4pt 0in 5.4pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center; line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eNPV\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.6pt;\"\u003e\n\u003ctd style=\"width: 114.6pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"153\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eInterstitial edema\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e19.0(8/42)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e95.0(76/80)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e68.9(84/122)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e66.7(8/12)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e69.1(76/110)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.6pt;\"\u003e\n\u003ctd style=\"width: 114.6pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"153\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eThicken Skin\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e50.0(21/42)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e81.3(65/80)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e70.5(86/122)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e58.3(21/36)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e75.6(65/86)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.6pt;\"\u003e\n\u003ctd style=\"width: 114.6pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"153\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003eSubcutaneous fat\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e19.0(8/42)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e83.8(67/80)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e61.2(75/122)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e38.1(8/21)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.55pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e66.3(67/101)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003ctr style=\"height: 17.6pt;\"\u003e\n\u003ctd style=\"width: 114.6pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"153\"\u003e\n\u003cp style=\"line-height: 11.0pt;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003econnection\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e14.3(6/42)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e98.8(79/80)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e69.7(85/122)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.45pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e85.7(6/7)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003ctd style=\"width: 80.55pt; border: none; border-bottom: solid windowtext 1.5pt; padding: 0in 5.4pt 0in 5.4pt; height: 17.6pt;\" width=\"107\"\u003e\n\u003cp style=\"text-align: center;\"\u003e\u003cspan style=\"font-family: 'Times New Roman', serif; color: #000000;\"\u003e68.7(79/115)\u003c/span\u003e\u003c/p\u003e\n\u003c/td\u003e\n\u003c/tr\u003e\n\u003c/tbody\u003e\n\u003c/table\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":true,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true},"keywords":"Lymphovascular invasion, Breast, Cancer, Digital mammography","lastPublishedDoi":"10.21203/rs.2.18849/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.2.18849/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e: To use digital mammography, a more popular imaging tool, for predicting lymphovascular invasion(LVI) in breast cancer patients preoperatively.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eMethods:\u003c/strong\u003e 122 cases of invasive ductal carcinoma diagnosed between May 2017 and September 2018 were collected, which were divided into positive group (n=42) and negative group (n=80) according to the presence or absence of LVI.\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eResults:\u003c/strong\u003e The differences of these variables(childbearing history, miscarriage history, other breast diseases history, nipple discharge, breast cancer marker CA153, age, ER, PR, HER-2, E-CAD, P53, Ki-67) between LVI positive group and the LVI negative group were not statistically significant, except that of Ki-67 (P=0.012). For the image features of digital mammography, the differences of interstitial edema (P=0.013) and skin thickening (P=0.000) between LVI positive group and negative groups were statistically significant. The differences of other imaging patterns, that is, fibroglandular tissue density, size , solitary/multiple, mass shape, mass margin , subcutaneous fat, axillary adenopathy and so on, between the two groups were not statistically significant. Multiple factor analysis shows that, there are three independent risk factors for predicting LVI occurrence: interstitial edema (OR = 12.610, 95% confidence interval CI: 1.061, 149.922, P=0.045), subcutaneous fat (OR=0.081, 95% confidence interval CI: 0.012, 0.645, P =0.017) and skin thickening (OR=9.041, 95% confidence interval CI: 2.553, 32.022, P=0.001).\u003c/p\u003e\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e: Interstitial edema, blurring of subcutaneous fat layer, and skin thickening were independent risk factors for predicting LVI occurrence. When applying these three imaging patterns together, the specificity of LVI prediction was as high as 98.8%.\u003c/p\u003e","manuscriptTitle":"Value of digital mammography in predicting lymphovascular invasion of breast cancer","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2019-12-16 23:11:38","doi":"10.21203/rs.2.18849/v1","editorialEvents":[{"type":"communityComments","content":0}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"researchsquare","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":true,"externalIdentity":"","sideBox":"","snPcode":"","submissionUrl":"/submission","title":"Research Square","twitterHandle":"researchsquare","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"","reportingPortfolio":"","inReviewEnabled":false,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"6b42e568-e5ad-45de-8ed7-44e0269f88ef","owner":[],"postedDate":"December 16th, 2019","published":true,"recentEditorialEvents":[],"rejectedJournal":[],"revision":"","amendment":"","status":"posted","subjectAreas":[{"id":42842,"name":"Nuclear Medicine \u0026 Medical Imaging"}],"tags":[],"updatedAt":"2020-05-29T03:04:31+00:00","versionOfRecord":[],"versionCreatedAt":"2019-12-16 23:11:38","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-9467","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"identity":"rs-9467","version":["v1"]},"buildId":"_2-kVJe1T_tPrBINL-cwx","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}