RESULTS

Histology

Breast tissue biopsy from the right breast revealed well-differentiated to moderately differentiated IDC consistent with the previously mentioned clinical diagnosis (Fig. 1A). Tissue samples from the hip (Fig. 1B) and femur (Fig. 1C) revealed metastases of the breast carcinoma in the skeletal sites.


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Radiological quantification: cross-section at L3 vertebra

Tumor tissue segmentation revealed an overall increase in TU from August 15, 2013, to July 29, 2015 (Fig. 3A), while AM and PM segmentations revealed an overall decrease from August 15, 2013, to July 29, 2015 (Fig. 3B and C, respectively). Fat segmentation and segregation into VF and SF also revealed an overall decrease in both SF and VF from August 15, 2013, to July 29, 2015 (Fig. 3D). Plotted over time, measurements of cross-sectional tissue areas revealed opposing trends in the areas of PM, AM, VF, and SF versus the area of TU (Fig. 4A and B), further investigated with correlation analysis. Correlation matrices of r are shown in Table 2A–F, and correlation matrices of ρ are shown in Table 3A–F. The matrices were built to show correlation coefficients of 1.00 when a tissue type is correlated with itself. Correlations among the raw cross-sectional areas of the five tissue types generally showed weak positive correlations among SF, VF, AM, and PM, but showed moderate-to-strong negative correlations when any of SF, VF, AM, or PM was correlated with TU.

(To view a larger version of Figure 4, click here.)

SF versus TU

SF correlated strongly negatively against TU with r = −0.65 (Table 2A), r = −0.64 (Table 2B), r = −0.70 (Table 2E), ρ = −0.54 (Table 3B), and ρ = −0.63 (Table 3E). Negative correlations for SF and TU, with SF at the lagging timepoint compared to TU, indicates that decreases in SF proceeded after a time lag following increases in TU in our case study patient (Table 4). This corresponds with the visual representation of SF over time peaking at timepoints after the troughs in TU over time, and vice versa (Fig. 4B).

VF versus TU

VF correlated strongly negatively against TU with r = −0.71 (Table 2A), r = −0.56 (Table 2B), r = −0.52 (Table 2C), r = −0.66 (Table 2F), ρ = −0.56 (Table 3C), and ρ = −0.62 (Table 3F). Negative correlations for VF and TU, with VF at the timepoint preceding TU, indicates that decreases in VF preceded increases in TU that followed after a time lag, and vice versa (Table 4). This corresponds with the graph of VF over time peaking at timepoints just prior to the troughs in TU (Fig. 4B).

AM versus TU

AM correlated strongly negatively against TU with r = −0.71 (Table 2D) and ρ = −0.71 (Table 3D). AM also correlated moderately positively against TU with r = 0.49 (Table 2E) and ρ = −0.27 (Table 3E). Correlations between AM and TU were strongly negative when the incremental change in AM was compared to the incremental change in TU between the same two timepoints, but were moderately positive when the incremental change in AM at a lagging timepoint was correlated with TU incremental change at a preceding timepoint (Table 4). This may indicate a closely inverse relationship at some timepoints between the growth in AM and the growth in TU for our case study patient, which corresponds with the graph representations of AM and TU over time (Fig. 4B).