RSNA 2016

Abstract Archives of the RSNA, 2016


RC215-05

Associations of Volumetric Mammographic Density Measures with Breast Cancer Risk in 5,746 Women

Monday, Nov. 28 9:20AM - 9:30AM Room: Arie Crown Theater



Bennett Battle, MD, Little Rock, AR (Presenter) Nothing to Disclose
Sharp F. Malak, MD, MPH, Little Rock, AR (Abstract Co-Author) Nothing to Disclose
Ishwori Dhakal, MPH, Little Rock, AR (Abstract Co-Author) Nothing to Disclose
Jeannette Lee, PhD, Little Rock, AR (Abstract Co-Author) Nothing to Disclose
Noel Keith, Little Rock, AR (Abstract Co-Author) Nothing to Disclose
Barbara Fuhrman, PhD, Little Rock, AR (Abstract Co-Author) Nothing to Disclose
PURPOSE

Previously, methods for measurement of mammographic density (MD) have been either time-consuming, or subjective and only modestly reliable. Because MD offers information both about individual risk and about the efficacy of screening, a standardized and robust method for measurement of this prevalent risk factor has been a goal of many researchers.

METHOD AND MATERIALS

Using Volpara software (Matakina, New Zealand), we measured volumetric mammographic density on images from 42,527 screening mammograms done on 13,942 women seen at our institution between 2006-2012. Billing data and data collected by the cancer registrar was gathered to document person-level and procedure-level factors on 25,034 women seen for mammography assessment in the same period. A retrospective cohort was defined using women with both imaging and billing data who were initially seen for a screening mammogram, had no previous history of breast cancer, and were followed at our institution for at least 6 months following their first captured visit.

RESULTS

Among 5746 eligible women, 92 registry-confirmed breast cancers and a total of 121 registry-confirmed or treated breast cancer cases were ascertained. We observed monotonically increasing risks of registry-verified incident breast cancers by quartile of VMD% with HR= 1.0, 1.2 (0.7-2.2), 1.2 (0.7-2.2), and 2.2 (1.2-4.1), Ptrend=0.02; a similar trend was seen by quartile of DV, with HR across quartiles = 1.0, 1.5 (0.8-2.9), 1.8 (0.9-3.4), and 2.9 (1.5-5.4) (Ptrend=0.0009). Among women without a breast cancer diagnosis, changes in MD were significantly modified by birth cohort; while both VMD% and DV increased significantly in serial images taken over time in women born before 1940, VMD% declined significantly over time (P<0.0001) and DV decreased on average, but not statistically significantly (p=0.46), in women born between 1950-1959.

CONCLUSION

Automated measurement of Volumetric MD allows for assessment of this important breast cancer risk factor in a large number of women and on repeated mammographic assessments. In this cohort, assembled using the Enterprise Data Warehouse, mammographic density was associated with increased risk of subsequent breast cancer as expected, supporting the validity of the automated measures.

CLINICAL RELEVANCE/APPLICATION

Automated volumetric mammographic density measurement allows for the identification of women at increased risk of developing breast cancer.