Breast MRI background parenchymal enhancement (BPE) correlates with the risk of breast cancer

Telegrafo, Michele; Rella, Leonarda; Ianora, Amato Antonio Stabile; Angelelli, Giuseppe; Moschetta, Marco

doi:10.1016/j.mri.2015.10.014

Cited by 55 publications

(62 citation statements)

References 22 publications

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“…Two case-control studies 6, 7 reported an association between qualitative BPE and breast cancer risk in high-risk screening cohorts. While a recent study 8 showed an association of BPE with breast cancer presence, another study 23 on non-high-risk patients found an opposite result. The difference in the nature of the study populations may account for the discrepant findings of these previous studies.…”

Section: Discussionmentioning

confidence: 89%

“…Qualitatively assessed breast MRI BPE using the BI-RADS categories has been studied on its relationship with breast cancer presence or risk 6–8, 23 . Two case-control studies 6, 7 reported an association between qualitative BPE and breast cancer risk in high-risk screening cohorts.…”

Section: Discussionmentioning

confidence: 99%

“…Contrast enhancement of normal breast tissue (other than breast tumors) in DCE-MRI is known as background parenchymal enhancement (BPE), which has been reported to be associated with breast cancer risk 6–8 , when visually assessed by the four qualitative Breast Imaging-Reporting and Data System (BI-RADS) categories (i.e., minimal , mild , moderate , or marked ) 9 . Although clinically useful, BI-RADS-based BPE assessment is subjective, with high intra- and inter-reader variability 10, 11 , and there is particular difficulty distinguishing the categories of mild and moderate .…”

Section: Introductionmentioning

confidence: 99%

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DCE-MRI Background Parenchymal Enhancement Quantified from an Early versus Delayed Post-contrast Sequence: Association with Breast Cancer Presence

Zuley

Berg

et al. 2017

Sci Rep

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We investigated automated quantitative measures of background parenchymal enhancement (BPE) derived from an early versus delayed post-contrast sequence in breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) for association with breast cancer presence in a case-control study. DCE-MRIs were retrospectively analyzed for 51 cancer cases and 51 controls with biopsy-proven benign lesions, matched by age and year-of-MRI. BPE was quantified using fully-automated validated computer algorithms, separately from three sequential DCE-MRI post-contrast-subtracted sequences (SUB1, SUB2, and SUB3). The association of BPE computed from the three SUBs and other known factors with breast cancer were assessed in terms of odds ratio (OR) and area under the receiver operating characteristic curve (AUC). The OR of breast cancer for the percentage BPE measure (BPE%) quantified from SUB1 was 3.5 (95% Confidence Interval: 1.3, 9.8; p = 0.015) for 20% increments. Slightly lower and statistically significant ORs were also obtained for BPE quantified from SUB2 and SUB3. There was no significant difference (p > 0.2) in AUC for BPE quantified from the three post-contrast sequences and their combination. Our study showed that quantitative measures of BPE are associated with breast cancer presence and the association was similar across three breast DCE-MRI post-contrast sequences.

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Section: Discussionmentioning

confidence: 89%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

DCE-MRI Background Parenchymal Enhancement Quantified from an Early versus Delayed Post-contrast Sequence: Association with Breast Cancer Presence

Zuley

Berg

et al. 2017

Sci Rep

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“…Telegrafo et al (14) evaluated postmenopausal and premenopausal patients in 2015. They found a significant difference in the distribution of the BPE types in benign lesions compared with malignant ones; we had a similar finding such that 29.6% of the patients in the minimal BPE group had BI-RADS scores of 4 and 5 compared with 38.5% of the patients in the marked BPE group.…”

Section: Discussionmentioning

confidence: 99%

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

Arslan

Çelìk²,

Çubuk³

et al. 2017

Diagn Interv Radiol

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“…Some authors have suggested that an increased BPE has the possibility to obscure breast lesions and decrease MRI sensitivity for detection of BC or may even be misinterpreted as a suspicious finding itself, thus leading to an increased false-positive biopsy rate and short-interval follow-up rate [4] [10] [11] [12], but some others believe BPE does not significantly affect the diagnostic accuracy of breast MRIs [13]. Imaging material and hormonal status also affect BPE and can limit breast MRI interpretation [14] [15]. We aimed to investigate the correlations between BPE and the interpretation of MRI examinations with respect to BI-RADS scores, short-interval follow-up rates, and biopsy rates.…”

Section: Introductionmentioning

confidence: 99%

Is Breast Background Parenchymal Enhancement on MRI Related to BI-RADS Score and Follow-Up Rate?

Alikhassi¹,

Akbari²,

Yazdi³

et al. 2018

ABCR

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Objective: We investigated the correlations between background parenchymal enhancement (BPE) and MRI interpretations with respect to short-interval follow-ups and biopsy rates. Methods: All accessible MRI examinations from 128 women during a limited time period in 2016 were evaluated. A blinded radiologist visually categorized BPE as minimal, mild, moderate, or marked. A BI-RADS category was also assigned. We used descriptive statistics to report the findings and chi-square and Fisher's exact tests to compare categories. Results: Prevalence of minimal, mild, moderate, and marked BPE was 14.1%, 43.0%, 32.0%, and 10.9%, respectively. The short-interval follow-up rates were 22.2%, 27.3%, 26.8%, and 7.1% in women with minimal, mild, moderate, and marked BPE, respectively. BPE was not associated with the short-interval follow-up rate (p-value = 0.477). Biopsy rates were 22.2%, 27.3%, 22.0%, and 57.1% in women with minimal, mild, moderate, and marked BPE, respectively. Although there was no significant relationship between biopsy rates and BPE levels (p-value = 0.095) in the total population, these two factors were significantly associated in premenopausal women (p-value = 0.023) and in women of 30 -39 years (p-value = 0.001). Conclusion: Higher BPE does not correlate with short-interval follow-up rates, but appears to be related to biopsy rate, thus causing false-positives and unnecessary biopsy recommendations, particularly in younger, premenopausal women.

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Breast MRI background parenchymal enhancement (BPE) correlates with the risk of breast cancer

Cited by 55 publications

References 22 publications

DCE-MRI Background Parenchymal Enhancement Quantified from an Early versus Delayed Post-contrast Sequence: Association with Breast Cancer Presence

DCE-MRI Background Parenchymal Enhancement Quantified from an Early versus Delayed Post-contrast Sequence: Association with Breast Cancer Presence

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

Is Breast Background Parenchymal Enhancement on MRI Related to BI-RADS Score and Follow-Up Rate?

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