Using Volumetric Breast Density to Quantify the Potential Masking Risk of Mammographic Density

Destounis, Stamatia; Johnston, Lisa; Highnam, Ralph; Arieno, Andrea; Morgan, Renee; Chan, Ariane

doi:10.2214/ajr.16.16489

Cited by 74 publications

(52 citation statements)

References 17 publications

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“…A European study by Wanders et al found that Volpara is also associated with increased interval cancer rates for women, with interval cancer rates increasing from 0.7% to 4.4% across VDG categories 1 to 4, respectively [90]. Research we carried out at our center highlighted some of the limitations of using categories of MBD for the assessment of mammographic sensitivity [5]. Continuous VBD measurements allow for a finer discrimination of the mammographic sensitivity for women within a given BI-RADS or VDG category.…”

Section: The Current Clinical Landscape Of Mbdmentioning

confidence: 99%

“…Due to their similar X-ray attenuation properties, dense tissue and tumors both appear white on a mammogram and numerous studies have shown the potential masking risk of MBD for cancer detection and negative association of increasing MBD with mammographic sensitivity [5,6,7,8,9,10,11]. Although the molecular and biological mechanisms underpinning breast cancer development are still being elucidated, MBD has also been established as a strong, independent risk factor for de novo development of breast cancer and for cancer recurrence [12,13].…”

Section: Introductionmentioning

confidence: 99%

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Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Destounis¹,

Arieno²,

Morgan³

et al. 2017

Diagnostics

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Mammographic breast density (MBD) has been proven to be an important risk factor for breast cancer and an important determinant of mammographic screening performance. The measurement of density has changed dramatically since its inception. Initial qualitative measurement methods have been found to have limited consistency between readers, and in regards to breast cancer risk. Following the introduction of full-field digital mammography, more sophisticated measurement methodology is now possible. Automated computer-based density measurements can provide consistent, reproducible, and objective results. In this review paper, we describe various methods currently available to assess MBD, and provide a discussion on the clinical utility of such methods for breast cancer screening.

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Section: The Current Clinical Landscape Of Mbdmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Destounis¹,

Arieno²,

Morgan³

et al. 2017

Diagnostics

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“…For instance, we were not able to demonstrate a difference in pre‐ to postsurgery values for breast density using BI‐RADS; however, quantitative measurement of density with VolparaDensity™ revealed an increase in VBD related to the differential changes in FGV and adipose tissue. These findings highlight the previously described discrepancy between qualitative and quantitative measures of breast density, suggesting that BI‐RADS may ultimately prove less effective than VolparaDensity™ at estimating breast cancer risk …”

Section: Discussionmentioning

confidence: 90%

The impact of bariatric surgery on qualitative and quantitative breast density

et al. 2019

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Background Obesity and breast density are associated with breast cancer in postmenopausal women. Bariatric surgery effectively treats morbid obesity, with sustainable weight loss and reductions in cancer incidence. We evaluated changes in qualitative and quantitative density; hypothesizing breast density would increase following bariatric surgery. Methods Women undergoing bariatric surgery from 1990 to 2015 were identified, excluding patients without a mammogram performed both before and after surgery. Changes in body mass index (BMI), time between mammograms and surgery, and American College of Radiology Breast Imaging Reporting and Data System (BI‐RADS) scores were assessed. VolparaDensity™ automated software calculated volumetric breast density (VBD), fibroglandular volume (FGV), and total breast volume for the 82 women with digital data available. Differences between pre‐ and postsurgery values were assessed. Results One hundred eighty women were included. Median age at surgery was 50.0 years, with 8.8 months between presurgery mammogram and surgery and 62.3 months between surgery and postsurgery mammogram. Median BMI significantly decreased over the study period (46.0 vs 35.4 kg/m2; P < 0.001). No change in BI‐RADS scores was seen between the pre‐ and postsurgery mammograms. Eighty‐two women had VolparaDensity™ data available. While VBD increased in these patients, FGV and total breast volume both decreased following bariatric surgery. Conclusions Increased VBD, decreased FGV, and decreased total breast volume were seen following bariatric surgery‐induced weight loss. There was no difference in qualitative breast density, highlighting the discrepancy between BI‐RADS and VolparaDensity™ measurements. Further investigation will be required to determine how differential changes in components of breast density may affect breast cancer risk.

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“…Breast density is an independent risk factor for breast cancer and is associated with reduced mammographic accuracy because of masking and superimposition of dense tissue . The accuracy of mammography decreases with increasing mammographic breast density, and women with significant mammographic breast density are at higher risk of false‐negative findings, interval cancers, the diagnosis of a more advanced breast cancer, and breast cancer mortality .…”

Section: Breast Cancermentioning

confidence: 99%

“…8 Breast density is an independent risk factor for breast cancer 77 and is associated with reduced mammographic accuracy because of masking and superimposition of dense tissue. 78,79 The accuracy of mammography decreases with increasing mammographic breast density, and women with significant mammographic breast density are at higher risk of false-negative findings, interval cancers, the diagnosis of a more advanced breast cancer, and breast cancer mortality. 61,80 Although test sensitivity for women with dense breast tissue has improved with the evolution of mammography technology, sensitivity still is inversely associated with various measures of increased density and, among women with the highest breast density (Breast Imaging-Reporting and Data System type 4), mammography is largely ineffective for breast cancer screening.…”

Section: Benefits Limitations and Harmsmentioning

confidence: 99%

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

Wender

Brawley

Fedewa

et al. 2018

CA A Cancer J Clinicians

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From the mid‐20th century, accumulating evidence has supported the introduction of screening for cancers of the cervix, breast, colon and rectum, prostate (via shared decisions), and lung. The opportunity to detect and treat precursor lesions and invasive disease at a more favorable stage has contributed substantially to reduced incidence, morbidity, and mortality. However, as new discoveries portend advancements in technology and risk‐based screening, we fail to fulfill the greatest potential of the existing technology, in terms of both full access among the target population and the delivery of state‐of‐the art care at each crucial step in the cascade of events that characterize successful cancer screening. There also is insufficient commitment to invest in the development of new technologies, incentivize the development of new ideas, and rapidly evaluate promising new technology. In this report, the authors summarize the status of cancer screening and propose a blueprint for the nation to further advance the contribution of screening to cancer control.

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Using Volumetric Breast Density to Quantify the Potential Masking Risk of Mammographic Density

Cited by 74 publications

References 17 publications

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

Qualitative Versus Quantitative Mammographic Breast Density Assessment: Applications for the US and Abroad

The impact of bariatric surgery on qualitative and quantitative breast density

A blueprint for cancer screening and early detection: Advancing screening’s contribution to cancer control

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