Segmentation of pectoral muscle from digital mammograms with depth-first search algorithm towards breast density classification.

Digital mammography acts as a unique screening technology to protect the lives of females against breast cancer for the past few decades. Mammographic breast density is a well-known biomarker and plays a substantial role in breast cancer prediction and treatments. Breast density is calculated based on the opacity of fibro-glandular tissue reflected on digital mammograms concerning the whole area of the breast. The opacity of pectoral muscle and fibro-glandular tissue is similar to each other; hence, the small presence of the pectoral muscle in the breast area can hamper the accuracy of breast density classification. Successful removal of pectoral muscle is challenging due to changes in shape, size, and texture of pectoral muscle in every MLO and LMO views of mammogram. In this article, the depth-first search (DFS) algorithm is proposed to remove artifacts and pectoral muscle from digital mammograms. In the proposed algorithm, image enhancement is performed to improve the pixel quality of the input image. The whole breast as a single connected component is identified from the background region to remove the artifacts and tags. The depth-first search method with and without the heuristic approach is used to delineate the pectoral muscle, and then final suppression is performed on it. This algorithm is tested on 2675 images of the DDSM dataset, which is further divided into four density classes as per BIRADs classification. Segmentation results are calculated individually on each BIRADs density class of the DDSM dataset. Results are validated subjectively by the expert's Radiologist's ground truth with segmentation accuracy and objectively by the Jaccard coefficient and a dice similarity coefficient. This algorithm is found robust on each density class and provides overall segmentation accuracy of 86.18%, a mean value of Jaccard index, and a Dice similarity coefficient of 0.9315 and 0.9548, respectively. The experimental results show that the proposed algorithms applied for pectoral muscle removal follow the ground truth marked by an expert radiologist. The proposed algorithm can be part of the pre-processing unit of breast density measurement and breast cancer detection system used during clinical practice. [ABSTRACT FROM AUTHOR]