Mammographic Breast Density: Comparison Across Women with Conclusive and Inconclusive Mammography Reports

Ekpo, Ernest U.; Egbe, NO; Egom, Akwa E.; McEntee, Mark F.

doi:10.1016/j.jmir.2015.10.008

Cited by 6 publications

(6 citation statements)

References 36 publications

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“…Higher breast tissue density has been associated with lower screening sensitivity [17]. A study in Nigeria [13] reported that high breast density was higher in subjects with inconclusive reports than those with low breast density.…”

Section: Discussionmentioning

confidence: 99%

“…At the LFMMC, one radiologist has read the screening mammograms since its inception; thus, this aspect would not apply to our study. In Nigeria, a study of diagnostic mammography revealed an association between high breast density and inconclusive outcomes [ 13 ]. Yet, these findings contrast with a Taiwanese study that failed to find that breast density was associated with BI-RADS categorization [ 9 ].…”

Section: Introductionmentioning

confidence: 99%

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Bridging Gaps: Analyzing Breast Imaging-Reporting and Data System (BI-RADS) 0 Rates and Associated Risk Factors in Disproportionally Affected Communities

Roshan,

O'Connell,

Nazarally

et al. 2024

Cureus

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IntroductionDisparities in access to breast cancer screening led to the creation of the Linda Fenner 3D Mobile Mammography Center (LFMMC), successfully increasing screening for uninsured women in Miami-Dade. However, a higher-than-expected rate of inconclusive mammograms (Breast Imaging-Reporting and Data System (BI-RADS) 0) was found, which could lead to unnecessary procedures, stress, costs, and radiation. MethodsIn this retrospective cross-sectional study, we analyzed data from 3,044 uninsured women aged over 40 (younger if positive family history of breast cancer) from Miami-Dade without breast symptoms or breast cancer history. Women's demographic characteristics, primary language spoken, body mass index (BMI), use of hormone replacement therapy and birth control, history of benign biopsy, breast surgery, family breast cancer, and menopausal status were assessed as potential risk factors for an inconclusive (BI-RADS 0) screening mammogram result. Multivariable logistic regression analyses were used to evaluate associations. ResultsThe average age of women was 51 years (SD = 9); 59% were White, and 30% were African American. The overall frequency of BI-RADS 0 was 35%. Higher odds of BI-RADS 0 were found for women who were younger, single, premenopausal, and with benign biopsy history. Conversely, obesity and breast implant history decreased the odds of BI-RADS 0. ConclusionWe found a high frequency of BI-RADS 0 in the LFMMC sample. Potential reasons include a higher risk for breast cancer or a younger sample of women screened. Future research should explore radiologists' reasoning for assigning BI-RADS 0 results and testing alternative screening strategies for younger women.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bridging Gaps: Analyzing Breast Imaging-Reporting and Data System (BI-RADS) 0 Rates and Associated Risk Factors in Disproportionally Affected Communities

Roshan,

O'Connell,

Nazarally

et al. 2024

Cureus

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“…A standardized reporting system for MD was introduced according to the ACR BI-RADS (American College of Radiology Breast Imaging-Reporting and Data System) catalogue last updated in 2013, classifying MD in 4 categories from "A" to "D," with category A denoting almost completely fatty tissue, B denoting scattered fibroglandular tissue, C indicating heterogeneously dense tissue and D representing extremely dense tissue. [6] Overall, 40% of women have MD of ACR BI-RADS C or D, in women below 50 years dense MD is found in more than half of the patients. [7] Apart from its meaning for the estimation of breast cancer risk, MD is important for the assessment of the diagnostic performance of mammography screening.…”

Section: Introductionmentioning

confidence: 93%

“…In MD also changes in breast density due to different hormonal levels as menopausal transition and aging are reflected. A standardized reporting system for MD was introduced according to the ACR BI-RADS (American College of Radiology Breast Imaging-Reporting and Data System) catalogue last updated in 2013, classifying MD in 4 categories from “A” to “D,” with category A denoting almost completely fatty tissue, B denoting scattered fibroglandular tissue, C indicating heterogeneously dense tissue and D representing extremely dense tissue [6] . Overall, 40% of women have MD of ACR BI-RADS C or D, in women below 50 years dense MD is found in more than half of the patients [7] …”

Section: Introductionmentioning

confidence: 99%

Breast density in dedicated breast computed tomography

Wieler¹,

Berger²,

Frauenfelder³

et al. 2021

Medicine

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The aim of this study was to develop a new breast density classification system for dedicated breast computed tomography (BCT) based on lesion detectability analogous to the ACR BI-RADS breast density scale for mammography, and to evaluate its interrater reliability. In this retrospective study, 1454 BCT examinations without contrast media were screened for suitability. Excluding datasets without additional ultrasound and exams without any detected lesions resulted in 114 BCT examinations. Based on lesion detectability, an atlas-based BCT density (BCTD) classification system of breast parenchyma was defined using 4 categories. Interrater reliability was examined in 40 BCT datasets between 3 experienced radiologists. Among the included lesions were 63 cysts (55%), 18 fibroadenomas (16%), 7 lesions of fatty necrosis (6%), and 6 breast cancers (5%) with a median diameter of 11 mm. X-ray absorption was identical between lesions and breast tissue; therefore, the lack of fatty septae was identified as the most important criteria for the presence of lesions in glandular tissue. Applying a lesion diameter of 10 mm as desired cut-off for the recommendation of an additional ultrasound, an atlas of 4 BCTD categories was defined resulting in a distribution of 17.5% for density A, 39.5% (B), 31.6% (C), and 11.4% (D) with an intraclass correlation coefficient (ICC) among 3 readers of 0.85 to 0.87. We propose a dedicated atlas-based BCTD classification system, which is calibrated to lesion detectability. The new classification system exhibits a high interrater reliability and may be used for the decision whether additional ultrasound is recommended.

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“…However, there are still difficulties reading DM images of women with dense breasts [ 4 ]. Mammographically dense tissue has been demonstrated to increase radiologists’ suspicion during the interpretation of screening mammograms, leading to higher recall rates for women with mammographically dense breasts [ 5 ].…”

Section: Introductionmentioning

confidence: 99%

Reducing Unnecessary Biopsies Using Digital Breast Tomosynthesis and Ultrasound in Dense and Nondense Breasts

et al. 2022

Self Cite

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Aim: To compare digital breast tomosynthesis (DBT) and ultrasound in women recalled for assessment after a positive screening mammogram and assess the potential for each of these tools to reduce unnecessary biopsies. Methods: This data linkage study included 538 women recalled for assessment from January 2017 to December 2019. The association between the recalled mammographic abnormalities and breast density was analysed using the chi-square independence test. Relative risks and the number of recalled cases requiring DBT and ultrasound assessment to prevent one unnecessary biopsy were compared using the McNemar test. Results: Breast density significantly influenced recall decisions (p < 0.001). Ultrasound showed greater potential to decrease unnecessary biopsies than DBT: in entirely fatty (21% vs. 5%; p = 0.04); scattered fibroglandular (23% vs. 10%; p = 0.003); heterogeneously dense (34% vs. 7%; p < 0.001) and extremely dense (39% vs. 9%; p < 0.001) breasts. The number of benign cases needing assessment to prevent one unnecessary biopsy was significantly lower with ultrasound than DBT in heterogeneously dense (1.8 vs. 7; p < 0.001) and extremely dense (1.9 vs. 5.1; p = 0.03) breasts. Conclusion: Women with dense breasts are more likely to be recalled for assessment and have a false-positive biopsy. Women with dense breasts benefit more from ultrasound assessment than from DBT.

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Mammographic Breast Density: Comparison Across Women with Conclusive and Inconclusive Mammography Reports

Cited by 6 publications

References 36 publications

Bridging Gaps: Analyzing Breast Imaging-Reporting and Data System (BI-RADS) 0 Rates and Associated Risk Factors in Disproportionally Affected Communities

Bridging Gaps: Analyzing Breast Imaging-Reporting and Data System (BI-RADS) 0 Rates and Associated Risk Factors in Disproportionally Affected Communities

Breast density in dedicated breast computed tomography

Reducing Unnecessary Biopsies Using Digital Breast Tomosynthesis and Ultrasound in Dense and Nondense Breasts

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