Correlation of Age and HRT Use with Breast Density as Assessed by Quantra^™

Abstract

Breast density is a significant predictor in the risk of developing breast cancer. Several methods are available for assessing breast density, but most are subject to intra-observer variability and are unable to assess the breast as a three-dimensional structure. Using Quantra(™) to quantify breast density, we have correlated this with risk factors to determine what impact these variables have on breast density. Women attending for full field digital mammography at the South West London Breast Screening Unit between December 2008 and March 2009 were invited to participate in the study by questionnaire. Consenting women returned the questionnaire allowing further data collection including demographics, menopausal status and hormone replacement therapy (HRT) use. Data were correlated against breast density measurements to determine the degree of association. Mammograms were assessed on a Hologic(™) workstation and breast density calculated using Quantra(™). Quantra(™) is an automated algorithm for volumetric assessment of breast tissue composition from digital mammograms. Six-hundred and eighty-three women were invited to participate. Those with implants or mastectomy were excluded. Three-hundred and twenty questionnaires were fully completed and able to be assessed. The mean age of participants was 59 years (range 49-81). Mean density was 19.7% (range 8.5-48.5%). There was a decrease in density with age (Pearson product-moment correlation coefficient -0.17). Correlation between density and HRT use showed a significant positive result (correlation coefficient 0.07). Quantra(™) has shown to be an accurate, reproducible tool for quantifying breast density, demonstrated by its correlation with lifestyle and demographic data. Given its ease of acquisition this may be the future of breast density quantification in the digital age.

Automated Percentage of Breast Density Measurements for Full-field Digital Mammography Applications

“…Standardized and calibrated approaches have given mixed results in producing a measure that provides equivalent or stronger breast cancer associations than given by PD (17, 20, 42-44, 47, 48). There are commercial products available that use standardized data for estimating breast density from raw FFDM images including studies that show their comparison with the clinical BI-RADS density measure (21, 22) and other risk factors (23). But, to date, there are no published data that demonstrates their association with breast cancer.…”

“…There are various methods under development to automate the estimation of breast density (4-21). Developing a fully automated and standardized breast density measurement has proven somewhat difficult, but at least two commercial standardized measures are available for raw FFDM images, Volpara and Quantra (19, 21-23). However, these have not been shown to be associated with breast cancer risk to date.…”

Measurement of breast density with digital breast tomosynthesis—a systematic review

“…[22][23][24] Others are automated thresholding approaches, such as Autodensity and MedDensity, 25,26 and three physical model-based techniques: standard mammographic form (SMF), Volpara and Quantra. [27][28][29] Irrespective of the method of measurement, breast density has been shown to be a potent risk factor for breast cancer.…”

Breast density: the trend in breast cancer screening

“…In addition to their feasibility proven by several studies [36][37][38], they have been reported to be effective for assessing breast cancer risk derived from breast density [39]. Brand et al [40] evaluated the performance of a fully automated volumetric method (Volpara), which is capable of calculating volumetric breast density out of raw mammogram imaging data, regardless of the mammography system used.…”