Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?

Abstract

Purpose:To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk. Materials and Methods:In this institutional review board-approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression. Results:Twenty-three women at high risk (mean age, 47 years 6 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively). Conclusion:Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study.q RSNA, 2015

Background parenchymal enhancement: is it just an innocent effect of estrogen on the breast?

“…Enhancement was highest during weeks 1 and 4 and lowest during week 2. Our results are consistent with those of previous studies (9,10,(16)(17)(18). This is not surprising, because we know that BPE depends on hormonal changes.…”

“…In their study, they claimed that the differences from the results of King et al (9) and Dontchos et al (10) were due to a high-risk study population in the former groups. Bennani-Baiti claims that in the non-high-risk group, BPE is not associated with malignancy; however, our study group also excluded patients with high risks such as previous history of breast cancer, breast surgery, and/or radiotherapy on the chest area.…”

“…BPE is thought to be correlated with breast cancer (9,10). This is not surprising, because we know that estrogen is associated with breast cancer (22)(23)(24).…”

Quantitative Assessment of Breast Parenchymal Uptake on 18F-FDG PET/CT: Correlation with Age, Background Parenchymal Enhancement, and Amount of Fibroglandular Tissue on MRI

“…In addition, MRI provides insight about the amount of fibroglandular tissue (FGT), as well as background parenchymal enhancement (BPE). Thus, FGT and BPE are considered more sensitive predictive and prognostic imaging biomarkers than density assessment with mammography (12)(13)(14)(15)(16)(17)(18).…”

Is Background Parenchymal Enhancement in Breast Magnetic Resonance Imaging Associated with Breast Cancer?

“…BPE may be correlated with BC risk (4,7,8), and, thus, BPE can be used for BC risk stratification and for monitoring chemoprevention (3,4). However, this association remains controversial (2).…”