Shandong Wu PhD, MSc, Presenter: Nothing to Disclose

Margarita Louise Zuley MD, Abstract Co-Author: Research Grant, Hologic, Inc

Wendie A. Berg MD, PhD, Abstract Co-Author: Research Grant, Gamma Medica, Inc Research Grant, General Electric Company Equipment support, Gamma Medica, Inc Equipment support, General Electric Company

Brenda F. Kurland PhD, Abstract Co-Author: Nothing to Disclose

Rachel Jankowitz MD, Abstract Co-Author: Nothing to Disclose

Jules Henry Sumkin DO, Abstract Co-Author: Scientific Advisory Board, Hologic, Inc

David Gur PhD, Abstract Co-Author: Nothing to Disclose

Visually estimated background parenchymal enhancement (BPE) by BI-RADS categories in breast dynamic contrast enhanced MRI (DCE-MRI) has been correlated with breast cancer risk in high-risk women. We tested this association using fully automated, objectively derived, quantitative BPE measurements.

A retrospective case-control study was performed using breast DCE-MRI scans from 102 patients (mean 47.2±7.3 YO) who underwent either open surgical biopsy or core biopsy from 2009-2011: 51 women had unilateral breast cancer and 51 were age- and date-of-MRI matched controls with a unilateral biopsy-proven benign. The MRI was analyzed using fully automated computer algorithms, generating two quantitative BPE measures computed from the third post-contrast series: the absolute BPE volume (|BPE|) and its relative amount over the whole breast volume (BPE%). Breast density BI-RADS was retrieved from the mammography report (< 6 months) prior to diagnosis. Volumetric absolute and relative amounts of fibroglandular tissue (|FGT| and FGT%) were also automatically quantified from the MRI. Multivariable conditional logistic regression was performed to assess BPE measures as predictors of breast cancer risk: (comparison 1) breasts contralateral to the cancers vs. benign breasts of the controls, and (comparison 2) breasts contralateral to the cancers vs. contralateral (negative) breasts of the controls.

After adjustment for breast density, |FGT|, and FGT%, odds ratio (OR) for comparison 1 was 1.84 (95% confidence interval [CI]: 1.08, 3.14; p=0.02) for |BPE| and 3.85 (95% CI: 1.34, 11.05; p= 0.01) for BPE%. OR for comparison 2 was 1.71 (95% CI: 1.08, 2.71; p=0.02) for |BPE| and 2.30 (95% CI: 1.15, 4.59; p= 0.02) for BPE%. OR for breast density alone was 0.75 (95% CI: 0.35, 1.59; p=0.5). For comparison 1, OR was 1.19 (95% CI: 0. 71, 1.97; p=0.5) for |FGT|, and 0.71 (95% CI: 0.19, 2.67; p=0.6) for FGT%; for comparison 2, OR was 1.14 (95% CI: 0. 72, 1.81; p=0.6) for |FGT|, and 0.70 (95% CI: 0.19, 2.52; p=0.6) for FGT%.

Increased BPE (both |BPE| and BPE%) in breast DCE-MRI are predictive of breast cancer risk, independent of measures of breast density and FGT.

Objectively quantified BPE in breast DCE-MRI has potential for use as a biomarker of breast cancer risk and may be included to improve breast cancer risk assessment and stratification.  

Wu, S, Zuley, M, Berg, W, Kurland, B, Jankowitz, R, Sumkin, J, Gur, D, Quantitative Background Parenchymal Enhancement in Breast DCE-MRI Is Associated with Breast Cancer Risk.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14013899.html