Quantitative breast density analysis to predict interval and node-positive cancers in pursuit of improved screening protocols: a case–control study

• Published in: British journal of cancer 2021-09, Vol.125 (6), p.884-892
• Main Authors: Burnside, Elizabeth S., Warren, Lucy M., Myles, Jonathan, Wilkinson, Louise S., Wallis, Matthew G., Patel, Mishal, Smith, Robert A., Young, Kenneth C., Massat, Nathalie J., Duffy, Stephen W.
• Format: Article
• Language: English
• Subjects: 631/67/1347; 692/499; Aged; Biomedical and Life Sciences; Biomedicine; Breast cancer; Breast Density; Breast Neoplasms - diagnostic imaging; Cancer Research; Cancer screening; Case-Control Studies; Drug Resistance; Early Detection of Cancer; Epidemiology; Female; Humans; Mammography - methods; Medical screening; Middle Aged; Molecular Medicine; Oncology; Randomized Controlled Trials as Topic; Visual Analog Scale; Visual discrimination
• ISSN: 0007-0920; 1532-1827; 1532-1827
• DOI: 10.1038/s41416-021-01466-y

Background This study investigates whether quantitative breast density (BD) serves as an imaging biomarker for more intensive breast cancer screening by predicting interval, and node-positive cancers. Methods This case–control study of 1204 women aged 47–73 includes 599 cancer cases (302 screen-detected, 297 interval; 239 node-positive, 360 node-negative) and 605 controls. Automated BD software calculated fibroglandular volume (FGV), volumetric breast density (VBD) and density grade (DG). A radiologist assessed BD using a visual analogue scale (VAS) from 0 to 100. Logistic regression and area under the receiver operating characteristic curves (AUC) determined whether BD could predict mode of detection (screen-detected or interval); node-negative cancers; node-positive cancers, and all cancers vs. controls. Results FGV, VBD, VAS, and DG all discriminated interval cancers (all p