Vision 20/20: Mammographic breast density and its clinical applications

Ng, Kwan-Hoong; Lau, Susie

doi:10.1118/1.4935141

Cited by 43 publications

(45 citation statements)

References 286 publications

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“…Given that a mammographic image is a 2-dimensional (area-based) representation of a 3-dimensional (volumetric) physiological phenomenon, numerous density assessment methods have been proposed and developed over the past 4 decades that measure various aspects of fibroglandular tissue [14,15,16,17]. These methods can be broadly classified by: (1) their mode of assessment (visual, semi-automated, fully-automated); (2) whether they measure area-based or volumetric parameters; and (3) whether they are qualitative or quantitative in nature (Figure 1).…”

Section: Mammographic Density Assessment Methodsmentioning

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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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: Mammographic Density Assessment Methodsmentioning

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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“…From this dense tissue segmentation, absolute breast tissue area and absolute dense tissue area (both in square centimeters) are derived, and PD is obtained from the ratio of dense tissue area to breast tissue area. For the purposes of this study, we focused our analysis specifically on the evaluation of PD because it is the most widely validated quantitative estimate of breast density in terms of its association with breast cancer risk (15,31). …”

Section: Methodsmentioning

confidence: 99%

Agreement between Breast Percentage Density Estimations from Standard-Dose versus Synthetic Digital Mammograms: Results from a Large Screening Cohort Using Automated Measures

et al. 2017

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Purpose To evaluate agreement between automated estimates of breast density made from standard-dose versus synthetic digital mammograms in a large cohort of women undergoing screening. Materials and Methods This study received institutional review board approval with waiver of consent. A total of 3668 negative (Breast Imaging Reporting and Data System category 1 or 2) digital breast tomosynthesis (DBT) screening examinations consecutively performed over a 4-month period at one institution for which both standard-dose and synthetic mammograms were available for analysis were retrospectively analyzed. All mammograms were acquired with a Selenia Dimensions system (Hologic, Bedford, Mass), and synthetic mammograms were generated by using the U.S. Food and Drug Administration–approved “C-View” software module. The “For Presentation” standard-dose mammograms and synthetic images were analyzed by using a fully automated algorithm. Agreement between density estimates was assessed by using Pearson correlation, linear regression, and Bland-Altman analysis. Differences were evaluated by using the paired Student t test. Results Breast percentage density (PD) estimates from synthetic and standard-dose mammograms were highly correlated (r = 0.92, P < .001), and the 95% Bland-Altman limits of agreement between PD estimates were −6.4% to 9.9%. Synthetic mammograms had PD estimates by an average of 1.7% higher than standard-dose mammograms (P < .001), with a larger disagreement by 1.56% in women with highly dense breast tissue (P < .0001). Conclusion Fully automated estimates of breast density made from synthetic mammograms are generally comparable to those made from standard-dose mammograms. This may be important, as standard two-dimensional mammographic images are increasingly being replaced by synthetic mammograms in DBT screening in an attempt to reduce radiation dose.

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“…To the best of our knowledge, most studies on mammographic compression so far were carried out on Caucasian women [1, 3, 9, 14, 20, 24], and only one study was reported on Asian women for screen-film mammography [8]. In addition, as opposed to screen-film mammography, digital mammography has the advantage of the digital images being intensively processed to better show breast lesions and cancers compared to film images [26–30], hence compression force applied in digital mammography can potentially be reduced to lower the risk of over-compression and pain in women during mammography. We want to contribute to the discussion and data on mammographic compression with this study on Asian women.…”

Section: Introductionmentioning

confidence: 99%

Mammographic compression in Asian women

Lau

Aziz

2017

PLoS ONE

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ObjectivesTo investigate: (1) the variability of mammographic compression parameters amongst Asian women; and (2) the effects of reducing compression force on image quality and mean glandular dose (MGD) in Asian women based on phantom study.MethodsWe retrospectively collected 15818 raw digital mammograms from 3772 Asian women aged 35–80 years who underwent screening or diagnostic mammography between Jan 2012 and Dec 2014 at our center. The mammograms were processed using a volumetric breast density (VBD) measurement software (Volpara) to assess compression force, compression pressure, compressed breast thickness (CBT), breast volume, VBD and MGD against breast contact area. The effects of reducing compression force on image quality and MGD were also evaluated based on measurement obtained from 105 Asian women, as well as using the RMI156 Mammographic Accreditation Phantom and polymethyl methacrylate (PMMA) slabs.ResultsCompression force, compression pressure, CBT, breast volume, VBD and MGD correlated significantly with breast contact area (p<0.0001). Compression parameters including compression force, compression pressure, CBT and breast contact area were widely variable between [relative standard deviation (RSD)≥21.0%] and within (p<0.0001) Asian women. The median compression force should be about 8.1 daN compared to the current 12.0 daN. Decreasing compression force from 12.0 daN to 9.0 daN increased CBT by 3.3±1.4 mm, MGD by 6.2–11.0%, and caused no significant effects on image quality (p>0.05).ConclusionsForce-standardized protocol led to widely variable compression parameters in Asian women. Based on phantom study, it is feasible to reduce compression force up to 32.5% with minimal effects on image quality and MGD.

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Vision 20/20: Mammographic breast density and its clinical applications

Cited by 43 publications

References 286 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

Agreement between Breast Percentage Density Estimations from Standard-Dose versus Synthetic Digital Mammograms: Results from a Large Screening Cohort Using Automated Measures

Mammographic compression in Asian women

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