title: Fractal dimension and lacunarity of tumor microscopic images as prognostic indicators of clinical outcome in early breast cancer.
abstract: OBJECTIVE
  Research in the field of breast cancer outcome prognosis has been focused on molecular biomarkers, while neglecting the discovery of novel tumor histology structural clues. We thus aimed to improve breast cancer prognosis by fractal analysis of tumor histomorphology.
  
  
  METHODS
  This retrospective study included 92 breast cancer patients without systemic treatment.
  
  
  RESULTS
  Fractal dimension and lacunarity of the breast tumor microscopic histology possess prognostic value comparable to the major clinicopathological prognostic parameters.
  
  
  CONCLUSIONS
  Fractal analysis was performed for the first time on routinely produced archived pan-tissue stained primary breast tumor sections, indicating its potential for clinical use as a simple and cost-effective prognostic indicator of distant metastasis risk to complement the molecular approaches for cancer risk prognosis.
authors.affiliation: Department of Experimental Oncology, Institute of Oncology & Radiology of Serbia, Pasterova 14, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Pribic
authors.affiliation: Institute 'Mihajlo Pupin', Volgina 15, Belgrade, Serbia.
authors.forename: Jelena
authors.initials: J
authors.lastname: Vasiljevic
authors.affiliation: Department of Experimental Oncology, Institute of Oncology & Radiology of Serbia, Pasterova 14, Belgrade, Serbia.
authors.forename: Ksenija
authors.initials: K
authors.lastname: Kanjer
authors.affiliation: Department of Experimental Oncology, Institute of Oncology & Radiology of Serbia, Pasterova 14, Belgrade, Serbia.
authors.forename: Zora Neskovic
authors.initials: ZN
authors.lastname: Konstantinovic
authors.affiliation: Department of Biophysics, School of Medicine, University of Belgrade Visegradska 26/2, Belgrade, Serbia.
authors.forename: Nebojsa T
authors.initials: NT
authors.lastname: Milosevic
authors.affiliation: Department of Experimental Oncology, Institute of Oncology & Radiology of Serbia, Pasterova 14, Belgrade, Serbia.
authors.forename: Dragica Nikolic
authors.initials: DN
authors.lastname: Vukosavljevic
authors.affiliation: Department of Experimental Oncology, Institute of Oncology & Radiology of Serbia, Pasterova 14, Belgrade, Serbia.
authors.forename: Marko
authors.initials: M
authors.lastname: Radulovic
mesh_terms: D001943:Breast Neoplasms / Q000473:pathology*; D005260:Female; D017709:Fractals; D006801:Humans; D007091:Image Processing, Computer-Assisted; D053208:Kaplan-Meier Estimate; D011379:Prognosis; D016896:Treatment Outcome
keywords: breast cancer; chemotherapy; fractal dimension; histology; image analysis; lacunarity; prognosis