2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq
Pectoral Muscles Removal in Mammogram Image
by Hybrid Bounding Box and Region Growing
Algorithm
Enas Mohammed Hussein Saeed
Department of Computer Science
College of Education
University of Mustansiriyah
Baghdad, Iraq
enas.saeed38@gmail.com
Abstract—Breast cancer is one of the most common causes
of death among women globally. Accurate and early detection is
necessary for decreasing mortality and increase treatment
success rates. Mammogram image is currently one of the best
ways to detect breast cancer in the early stages, but it contains
many artifacts such as noise, labels, and pectoral muscles, that
must be deleted or suppressed because it greatly affects the
results of the diagnosis in the coming stages. Removing the
pectorals muscle is the biggest problem because it possesses an
intensity tissue that closely resembles the tissue of fat, glands,
and tumors in the form of mammograms. In this paper, an
effective algorithm has been suggested by Hybridization
Bounding Box and Region growing algorithm (HBBRG)
algorithm to solve the problem of pectoral muscle removal
which greatly affects the results of tumor detection in the next
stages by combines the Bounding Box (BB) and Region growing
(RG). To perform this work, pre-processing for mammogram
images was applied in two stages. In the first stage, a medium
filter and binary image with a specific threshold were used to
remove noise and label respectively. In the second phase, the
pectoral muscles were removed by applying the (BB) and (RG)
algorithm separately, and then we proposed merging the two
methods to set up an HBBRG algorithm with the aim to get
better results for remove pectoral muscles. The proposed
algorithms were tested on all the Mammographic Image
Analysis Society (MIAS) database images, and the results
showed a significant advantage in the HBBRG algorithm
compared to other algorithms as it achieved results in over 98%
to completely remove the pectoral muscles of all types of images.
Keywords—Breast Cancer, Mammography, Preprocessing,
pectoral muscles, Bounding box, and Region Growing
I. INTRODUCTION
Breast cancer infects nearly 8 percent of the world's
women throughout their lifetime. It ranked second among the
causes of female deaths worldwide. [1].According to
statistical data conducted throughout the United States in
2015, breast cancer takes 29 percent of new cancer cases and
15 percent of cancer deaths [2]. Early and efficient detection
is the best way for limited deaths and successful treatment.
Now, mammography is one of the best and most common
methods for early diagnosis of breast cancer, it is a low dose
X-ray that allows visualization of the Inner structure of the
breast [3]. A mammogram is a clinical image that contains
many additions such as noise, labels, pectoral muscles, black
background, etc. that make it difficult to analyze and
understand for diagnosis cancer in the early stages see Fig. 1.
Therefore, the suppression of these artifacts and the
enhancement quality of an image is essential for the extraction
Region of interest (ROI) [4]. Noises are most likely to be
978-1-7281-5249-3/20$31.00 ©2020 IEEE
Authorized licensed use limited to: University of Massachusetts Amherst. Downloaded on July 27,2020 at 13:05:23 UTC from IEEE Xplore. Restrictions apply.
Hayder Adnan, Saleh
Department of Computer Science
College of Education
University of Mustansiriyah
Baghdad, Iraq
haider8883@gmail.com
caused by the digitization process image, it can be easily
removed by using image processing techniques depend on the
spatial domain or frequency domain of an image [5]. Labels
and small artifacts are removed by converting the image to a
binary format using an appropriate threshold and then
arranging these components by area to isolate the small
spaces, including the labels [4]. The biggest obstacle is the
removal of the pectoral muscle, whose presence significantly
affects the results of the analysis image in the next stages, such
as segmentation and feature extraction. It appears as a dense
area in the X-ray image and is sometimes similar to the rest of
the breast tissue, especially in the types of glandular and fatty,
so some algorithms used to suppression the pectoral muscles
based on the threshold and intensity and morphological
operation may not give good results in this case [6]. In this
paper, a hybrid method has been used to remove the pectoral
muscle based on the Bounding Box and Region growing
algorithms (HBBRG Algorithm) to obtain better results by
taking e benefits of each method and reducing the defects
existing.
Fig. 1. Shows types of noises observed in mammogram images and marked
with numbers as 1. Pictorial Muscle, 2.Tumor, 3.High Intensity, 4.Low
Intensity, 5. Breast Part and 6. Background [4].
II. RELATED WORK
Many image processing algorithms have been developed
by many researchers to suppress the pectoral muscles in the
form of a mammogram. The most important research in this
field will be covered as follows:
In 2014 L. Aroquiaraj and K. Thangavel., they proposed
Hybrid Component Connected Labeling, Fuzzy, and Straight-
line technique to remove the pectoral muscles from the
mammogram, to obtain only the breast image to be ready for
the next treatment. The system was tested in 322 images from
the MIAS database. Results indicated a 96% achieving for
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2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq
removing pectoral muscles. The results indicated that this
achieved good results, but it is considered complex
programmatically to be applicable[7]
In 2015 Sreedevi. S and Elizabeth. S., They used a
universality threshold for pectoral muscle removal and edge
detection techniques to define the breast area alone to remove
pixels outside the breast area. Experimental results indicated
that the system received 90%. The results showed that you
are the determinants of this method: cutting different parts of
the breast tissue beyond the pectoral muscle in some types of
images[8]
In 2016 Aziz .M and Bhagirathi .H ., They proposed a
method based on threshold techniques and modified region
growing to remove pectoral muscles, Also the proposed
method shown that the Contrast Limited Adaptive Histogram
Equalization (CLAHE) and Wiener filter for enhancing the
image quality. The system was tested on each MIAS database
image with 98% accurate results [4].
In 2017, Anitha. Immanuel.Sand J, Dinesh. P., in this
work, the noise was removed by the application of the medium
filter 3 × 3, and then the labels are Marks suppressed by an
application global thresholding along with morphological
techniques like erode, dilation, open, and close. A single-seed
region growing (SRG) has been utilized for pectoral muscle
removal [9].
In 2018 K.U. Sheba and S. Gladston Raj2., in this research
pre-processing, have been implemented in two-phase. In the
first phase, the Median filter has been used for noise filtering,
noise filtering, global thresholding for small artifact and label
removal and adaptive fuzzy logic based bi-histogram
equalization for enhanced image quality. In the second stage,
the pectoral muscles were suppressed by applying a Bounding
Box technique[10].
III. DATASET USED
Due to personal privacy concerns and the difficulty of
obtaining real pictures for testing and analysis, Therefore the
images available in the Mammogram image analysis
Society(MIAS) were used for this purpose [11]. The image
was presented by The United Kingdom national breast
screening program, and capturing from a film-screen
mammographic. The database consists of 322 digitized
mammograms 208 normal and 114 abnormal, which
subdividing to 63 Benign and 51 malignant. The image of the
size is 1024 x 1024 pixels and format "PGM" [12].
IV. MAGE SEGMENTATION (RG)
There are a lot of medical imaging methods Such as
mammography, Computed Tomography (CT) and magnetic
resonance imaging, which are widely used in hospitals and
clinics. In general, image processing techniques such as
feature extraction and segmentation are necessary to assist
physicians and specialists to achieve more accurate diagnostic
results. Region growing One of the techniques that have
proven successful in the analysis and partition of medical
images [13]. SRG is an algorithm that integrates adjacent
pixels into larger and larger areas based on the similarity of
pixel intensity by identifying the seed point as the primary
point and maximum difference of intensity (threshold). The
algorithm tests the adjacent pixels of the seed point, then it
was decided whether to add to the seed point or not depend on
the threshold that has been specified [14]. The algorithm is
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fast, powerful, easy to implement and can provide a high level
of knowledge, On the other hand, she is suffering the problem
of automatically setting the seed point [15]. The steps of the
algorithm are explained in the following points:
1. At the start, a list of regions {Ri, i = 1, n} is formatted (n
represents a number of pixels in the image). Firstly each
region is consists of one pixel, so-named “seed point.
Mean value and neighboring regions are sitting for each
region.
2. For each region, Ri its neighboring regions N(Ri ) are
testing and the most similar neighboring region Rk ę
N(Ri ) is select and both regions are merged If D(Ri, Rk
) d T where Rk: the best neighbor of Ri, dist(Ri, Rk): is
the Euclidian distance between the mean grey levels of
the regions and T: threshold value
3. Each time the area that is merged is deleted from the list
and mean value is updated
4. This process repeats even no joinable areas remain [16].
VI. THE PROPOSED METHOD
This paper focuses on removing the pectoral muscles to
obtain a better quality image that contains only the breast,
helps in achieving more accurate diagnostic results and is
ready for use in the next stages such as feature extraction and
segmentation. Fig. 2 illustrates the proposed system stages and
the proposed algorithm for removing the pectoral muscles.
Start
Image acquisition
L noise removal
Label removal
Pectoral muscles removal By Hybrid Bounding Box
and Region Growing (HBBRG) algorithm
3fffrgg
Extract ROI
End
Fig. 2. Block diagram of the proposed method
A. Noise Removal
Mammograms sometimes contain many errors such as
noise, scratches, weak borders, and poor contrast. This can
result from fast or bad lighting conditions of the camera
shutter when taking an image. In this work, we used a 3 x 3
median filters, it is a spatial domain filter work by replaces
the pixels in a given block with the average values of those
pixels. It is easy to implement and gives good results to
suppress noise and reduce local contrast see ALGORITHM I.
B. Label Removal
Some mammogram image Contains a special mark (label
) for the hospital or clinic in which it was taken, it represents
the High-Intensity artifacts. This also needs to be eliminated
2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq

to provide the correct interpretation of images. ALGORITHM
I illustrates the process and Fig. 3 illustrates the results, this
process has been used for the removal of the label and obtain
preprocessing images consist only of the breast and pectoral
muscles.
Algorithm I: Remove label
Input: Image from MIA’s data base
Output: Filtered image without label
Step 1: Apply 3*3 median filters.
Step2: convert the image to a binary forms with a
Appropriate threshold.
Step3: find the area for all components in the image were
Arranged from the largest to the smallest.
Step4: Create Mask 1, which represents the two largest
Areas in the image breast and background and
Exclude small areas including the label.
Step 5: multiply mask1 with filtered image to obtain the
Pre-processing image.
Step 6: end
the obstacles facing each algorithm separately. As an
additional step, image enhancement techniques and
morphological operation were used to fill the holes to remove
impurities and extreme edges for obtaining better results on
the mask, ALGORITHM VI illustrates the process and Fig. 6
illustrates the results.
Algorithm II: Bounding Box algorithm (BB)
Input: preprocessing- image
Output: image without pectoral muscle
Step1: Specify the breast orientation
Step2: Create a zero array (SZ) with size equal to the
Size of the preprocessing image
Step3: find Bounding Box of the breast contour in the
Mammogram represented Mask1 (Which contains
Only the boundaries of the breast).
Step4: Create a white mask (binary mask) called mask2
For the previous mask (mask1).
Step5: Find the upper triangle of the mask2 to create
BB mask by a specific diagonal related to the
Width of the image (k) and set it to ones value,
While the others is zeros.
Step6: Replace the BB mask with coordinates of the
Bounding box in the SZ array (mask3).
Step7: invert the values for all pixels of mask3 to form a
mask4, which has been used to remove muscle.
Step8: end

(a) (b) (C)

Fig. 3. Show results proposed algorithm (a) filter Image (b) cut breast
only(c) image without noise and label.

C. Pectoral Muscles Removal

In this paper two algorithms to remove the pectoral muscle
in the mammograms image BB algorithm, and RG algorithm
were tried and tested and, then the two algorithms have been
combined to get better results and reduce the defects of each
algorithm. The bounding box is calculated for the
mammogram, which is a rectangle to cut only the boundaries Fig. 4. Show results BB algorithm (a) pre-processing image (b) cut breast
only (c) one's value for breast (d create upper triangular (e) integrates with
of the breast that we will need in both ways. Firstly bounding the zero matrices ( Sz) (f) inverse mask g(output image).
box algorithm has implemented based on the fact that the
pectoral muscles that are nearly triangular shape and appear
in the upper left corner or the upper right corner of the breast
contour depending on whether it is the left or right breast, the
pectoral muscles are removed by this algorithm,
ALGORITHM II illustrates the process and Fig. 4
illustrates the results. Secondly, the region's growing
algorithm used to remove the pectoral muscle part, the
algorithm needs to select the seed point, Which is
automatically identified to be within the limits of the pectoral
muscle. also, the function needs to locate the maximum
intensity distance between seed point and neighboring pixels,
ALGORITHM III illustrates the process and Fig. 5
illustrates the results. Finally, the two algorithms are
combined to create an HBBRG algorithm to obtain an
algorithm that provides better results and overcome some of

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2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq

AlgorithmIII: Region growing algorithm (RG)

Input: preprocessing- image
Output: image without pectoral muscle
Step1: apply step1, step2, step3 from algorithem2
Step2: getting the bounding box size (r, c).
Step3: assign suitable seed point (x, y) automatically so
That they are within the pectoral muscle area
step4: Set an appropriate threshold representing the
Maximum intensity distance
Between the seed point and its neighboring points.
Step5: Apply the region growing function to create
RGmask
Step6: apply step6 and step7 in algorithm2 on the result
of previous step to find
Fig. 6. Show results HBBRG algorithm (a) pre-processing image (b) cut
Final Mask, which has been used to remove breast only (c) ones value for breast (d) mask BB (e) mask RG ( sz) (f) and
pectoral muscle. between BB,RG (g) Enhancement mask HBBRG algorithm (h) integrates
Step7: end. with the zero matrix(sz) (i) invers mask (j)output image.

V. RESULTS AND DISCUSSION

In this paper, the proposed algorithm was tested on all
images in the MIAS database which contain all kinds of
image dense, glandular, and fatty images. To achieve this
work, some image processing techniques have been utilized
for preprocessing mammogram images. The median filter
3*3 pixels is used to remove noises. The label and small
artifacts are removed by converting an image to binary with
threshold value 0.1 then all components are organized in
largest to smallest So the largest two parts are taken in the
picture breast, background and the rest of the small effects,
including the label, are excluded. The HBBRG algorithm was
used to remove the pectoral muscle. The first mask was
created using the upper triangle function based on a diagonal
line with a value of (7) greater than the middle to give greater
Fig. 5. Show results RG algorithm (a) pre-processing image (b) cut breast
only (c) one's value for breast (d) Output the algorithm (e) integrates with results for muscle removal. The second mask was created
the zero matrix SZ (f) inverse mask (g) output image. using the SRG algorithm. Automatically, more than one point
has been testing to be within the boundaries of the so the point
(x=25, y=end-2) was given the best results. Also, more than
Algorithm VI: Hybrid Bounding Box and Region one value was tested for the difference between the seed point
growing algorithm (HBBRG) and the neighboring pixels so that the value (20) gives the
Input: preprocessing- image best results. Finally, the first and second masks were merged
Output: image without pectoral muscle using the BITAND function to form the third mask. As an
Step1: recall BB mask and RG mask. additional step, the image enhancement techniques were
Step2: Resize the BB mask and the RG mask to specific performed on the mask to fill the holes and then the
Size. morphological processes were used to correct and remove the
Step3: apply logical and operation between BB mask edges and impurities. To compare the results of the proposed
and RG mask to get HBBRG mask algorithms with the BB algorithm (Sheba, ET al.2018 [10]),
Step 4: Optimize mask 6 by applying instructions to fill and RG algorithm (Aziz, et al .2016 [4] & Anitha, ET al.2017
Holes. [9]), these algorithms are implemented separately. The results
Step 5: apply morphological operation (close operation) showed that the HBBRG algorithm achieved great success in
With disk structure element to improve the edges removing pectoral muscles and overcoming the problems of
of mask. the previous two algorithms, with results of more than 98%
Step6: apply step6 and step7 in algorithm2 on the result accuracy for the removal of muscles for all types of images.
Of previous step to find final mask, which has The results were calculated by finding the Real area that
Been used to remove pectoral muscle. should be removed for the pectoral muscle for ten images
Step7:
. end from the MIAS database with the help of Dr.Enam Aziz
Khalil, Breast Tumors Specialist and Mammogram Officer in
the Teaching Tumors Hospital / Medical City. Fig. 7 shows a
comparison between the real results with the results of the
proposed algorithm, BB and RG algorithm for ten images of
the MIAS dataset.

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2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq

The Rmoved Area (in pixel)

Optimal 200000
results 150000
BB results 100000
50000
RG results 0

Mdb320
Mdb293
Mdb281

Mdb183
Mdb170
Mdb134
mdb168

Mdb75
Mdb21
Mdb9
HBBRG
results
Mammogram Image

Fig. 8. Performance Analysis for Area values from Table I

TABLE II. THE DIFFERENCE BETWEEN THE REAL AREA WITH BB, RG
AND PROPOSED ALGORITHM, (IN PIXEL)

HBBRG
MIAS Image BB results[10] RG results[4,9]
results
Mdb9 26167 6230 5657
Mdb21 19404 8383 6961
Mdb75 21470 4590 8024
Mdb134 138918 7259 6030
Mdb170 24616 27695 14464
Mdb183 20654 98 1465
mdb168 20920 6343 5574
Mdb281 22104 71596 5577
Mdb293 11488 2174 4790
Mdb320 14841 21904 20314

Table II. Shows the Difference area between the real area of
the pectoral muscle that must be removed and the pectoral
muscles area removed by the proposed methods BB, and RG
algorithm. The results show that the HBBRG algorithm
achieved the lowest difference values for most images see
Fig. 9.
Fig. 7. Shows the comparison of the experimental results of the proposed
methods with the ideal results.
160000

The Difference of the Removed

BB 140000
TABLE I. RESULTS OF THE REMOVED PECTORAL MUSCLE AREA (IN results 120000
PIXEL) 100000

Area in pixels
80000
MIAS Image BB results[10] RG results[4,9] HBBRG results 60000
Mdb9 27227 6356 5899 RG 40000
Mdb21 22312 8445 7373 results 20000
Mdb75 24528 5250 8094 0
Mdb320
Mdb293
Mdb281

Mdb183
Mdb170
Mdb134

Mdb21
mdb168

Mdb75

Mdb9

Mdb134 139270 7343 6126

Mdb170 27862 48819 14464
HBBRG
Mdb183 42894 5778 2949
results
mdb168 20920 6343 5638
Mdb281 22528 81554 6117 Mammogram Image
Mdb293 23212 4562 4852
Mdb320 26193 21904 20314 Fig. 9. Performance analysis for the area difference from Table II

Table I.Show the Real area of the pectoral muscle and the
area removed by the proposed algorithms, BB and RG so that
the results of the HBBRG algorithm were closer to the Real
in most images as shown in Fig. 8.

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2020 International Conference on Computer Science and Software Engineering (CSASE), Duhok, Kurdistan Region – Iraq

TABLE III. HAMMING DISTANCE FOR THE RESULTS OF REMOVAL OF THE

PECTORAL MUSCLE (IN PIXEL)
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VI. CONCLUSIONS
The presence of pectoral muscles in mammograms affects
the overall accuracy of the next stages of screening and
classification of breast cancer. A new algorithm for pectoral
muscle removal has been applied to breast image based on a
hybridization of two algorithms that are bounding box and
region growing algorithm. The proposed algorithms are
tested on all images in the MIAS database which contain all
kinds of image are dense, glandular, and fatty. By comparing
HBBRG algorithm results with BB and RG algorithms the
following is concluded, Firstly, the results of the BB
algorithm showed that this algorithm does not produce good
results with all types of images because it cuts a triangle with
a fixed size while the size of the muscles varies greatly from
one image to another [10]. Secondly, the results show that the
RG algorithm generally yields good results, but it produces
fewer results with fatty and dens images, where the density
of the pectoral muscles is roughly similar to the rest of the
breast tissue [4, 9]. Finally, the proposed HBBRG algorithm
has yielded positive results in overcoming defects in previous
methods used to remove thoracic muscles in the
mammogram.
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