Skip to main content

Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software

European Radiology volume 22, pages 1265–1270 (2012)Cite this article

Abstract

Objective

To compare breast density on digital mammography and digital breast tomosynthesis using fully automated software.

Methods

Following institutional approval and written informed consent from all participating women, both digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM) were obtained. Breast percentage density was calculated with software on DBT and FFDM.

Results

Fifty consecutive patients (mean age, 51 years; range, 35–83 years) underwent both FFDM and DBT. Using a method based on the integral curve, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 16.2% (P < 0.0001). Using a method based on maximum entropy thresholding, breast density showed higher results on FFDM (68.1 ± 12.1 for FFDM and 51.9 ± 6.5 for DBT). FFDM overestimated breast density in 11.4% (P < 0.0001). There was a good correlation among BI-RADS categories on a four-grade scale and the density evaluated with DBT and FFDM (r = 0.54, P < 0.01 and r = 0.44, P < 0.01).

Conclusion

Breast density appeared to be significantly underestimated on digital breast tomosynthesis.

Key Points

  • Breast density is considered to be an independent risk factor for cancer

  • Density can be assessed on full-field digital mammography and digital breast tomosynthesis

  • Objective automated estimation of breast density eliminates subjectivity

  • Automated estimation is more accurate than BI-RADS quantitative evaluation

  • Breast density may be significantly underestimated on digital breast tomosynthesis

This is a preview of subscription content, access via your institution.

Access options

Buy single article

Instant access to the full article PDF.

43,34 €

Price includes VAT (Finland)
Tax calculation will be finalised during checkout.

Fig. 1

References

  1. Lehman CD, Blume JD, Weatherall P et al (2005) Screening women at high risk for breast cancer with mammography and magnetic resonance imaging. Cancer 103:1898–1905

    PubMed  Article  Google Scholar 

  2. Sardanelli F, Podo F, Santoro F et al; High Breast Cancer Risk Italian 1 (HIBCRIT-1) Study (2011) Multicenter surveillance of women at high genetic breast cancer risk using mammography, ultrasonography, and contrast-enhanced magnetic resonance imaging (the high breast cancer risk Italian 1 study): final results. Invest Radiol 46:94–105

    Article  Google Scholar 

  3. Sardanelli F, Podo F, D’Agnolo G, Trial High Breast Cancer Risk Italian et al (2007) Multicenter comparative multimodality surveillance of women at genetic-familial high risk for breast cancer (HIBCRIT study): interim results. Radiology 242:698–715

    PubMed  Article  Google Scholar 

  4. Harvey JA, Bovbjerg VE (2004) Quantitative assessment of mammographic breast density: relationship with breast cancer risk. Radiology 230:29–41

    PubMed  Article  Google Scholar 

  5. Highnam R, Jeffreys M, McCormack V et al (2007) Comparing measurements of breast density. Phys Med Biol 52:5881–5895

    PubMed  Article  CAS  Google Scholar 

  6. Diorio C, Pollak M, Byrne C et al (2005) Insulin-like growth factor-I, IGF-binding protein-3, and mammographic breast density. Cancer Epidemiol Biomarkers Prev 14:1065–1073

    PubMed  Article  CAS  Google Scholar 

  7. Gram IT, Funkhouser E, Tabar L (1997) The Tabar classification of mammographic parenchymal patterns. Eur J Radiol 24:131–136

    PubMed  Article  CAS  Google Scholar 

  8. Gram IT, Bremnes Y, Ursin G, Maskarinec G, Bjurstam N, Lund E (2005) Percentage density, Wolfe’s and Tabar’s mammographic patterns: agreement and association with risk factors for breast cancer. Breast Cancer Res 7:R854–R861

    PubMed  Article  Google Scholar 

  9. Boyd NF, Byng JW, Jong RA et al (1995) Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst 87:670–675

    PubMed  Article  CAS  Google Scholar 

  10. Bakic PR, Carton AK, Kontos D, Zhang C, Troxel AB, Maidment AD (2009) Breast percent density: estimation on digital mammograms and central tomosynthesis projections. Radiology 252:40–49

    PubMed  Article  Google Scholar 

  11. Tagliafico A, Tagliafico G, Tosto S et al (2009) Mammographic density estimation: comparison among BI-RADS categories, a semi-automated software and a fully automated one. Breast 18:35–40

    PubMed  Article  Google Scholar 

  12. Niklason LT, Christian BT, Niklason LE et al (1997) Digital tomosynthesis in breast imaging. Radiology 205:399–406

    PubMed  CAS  Google Scholar 

  13. Gur D, Abrams GS, Chough DM et al (2009) Digital breast tomosynthesis: observer performance study. AJR Am J Roentgenol 193:586–591

    PubMed  Article  Google Scholar 

  14. Tagliafico A, Calabrese M, Tagliafico G et al (2011) Increased mammographic breast density in acromegaly: quantitative and qualitative assessment. Eur J Endocrinol 164:335–340

    PubMed  Article  CAS  Google Scholar 

  15. European Reference Organisation for Quality Assured Breast Screening and Diagnostic Services. http://www.euref.org. Accessed May 17, 2011

  16. Dance DR, Young KC, van Engen RE (2011) Estimation of mean glandular dose for breast tomosynthesis: factors for use with the UK, European and IAEA breast dosimetry protocols. Phys Med Biol 56:453–471

    PubMed  Article  CAS  Google Scholar 

  17. Cavagnetto F, Bampi R, Calabrese M, Orlando B, Villa A, Taccini G (2011) Comparison of dose in digital breast tomosynthesis (DBT) and full-field digital mammography (FFDM). doi: 10.1594/ecr2011/C-1997

  18. Boyd NF, Guo H, Martin LJ et al (2007) Mammographic density and the risk and detection of breast cancer. N Engl J Med 356:227–232

    PubMed  Article  CAS  Google Scholar 

  19. Tagliafico A, Astengo D, Cavagnetto F et al (2011) One-to-one comparison between digital spot compression view and digital breast tomosynthesis. Eur Radiol. doi:10.1007/s00330-011-2305-1

  20. Gennaro G, Toledano A, di Maggio C et al (2010) Digital breast tomosynthesis versus digital mammography: a clinical performance study. Eur Radiol 20:1545–1553

    PubMed  Article  Google Scholar 

Download references

Author information

Affiliations

  1. Institute of Anatomy, Department of Experimental Medicine, University of Genoa, Largo Rosanna Benzi 8, 16132, Genoa, Italy

    Alberto Tagliafico

  2. Dipartimento di Chimica e Chimica Industriale (DCCI), University of Genoa, via Dodecaneso 31, 16146, Genoa, Italy

    Giulio Tagliafico

  3. Radiology Department, University of Genoa, Largo Rosanna Benzi 8, 16138, Genoa, Genova, Italy

    Davide Astengo

  4. Department of Medical Physics, Ist Istituto Nazionale per la Ricerca sul Cancro, IRCCS Azienda Ospedaliera Universitaria San Martino, Largo Rosanna Benzi 10, 16138, Genoa, Genova, Italy

    Francesca Cavagnetto & Raffaella Rosasco

  5. Department of Diagnostic Senology, Ist Istituto Nazionale per la Ricerca sul Cancro, IRCCS Azienda Ospedaliera Universitaria San Martino, Largo Rosanna Benzi 10, 16132, Genoa, Italy

    Giuseppe Rescinito, Francesco Monetti & Massimo Calabrese

Authors
  1. Alberto Tagliafico
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Giulio Tagliafico
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Davide Astengo
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Francesca Cavagnetto
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Raffaella Rosasco
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Giuseppe Rescinito
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Francesco Monetti
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Massimo Calabrese
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Alberto Tagliafico.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Tagliafico, A., Tagliafico, G., Astengo, D. et al. Mammographic density estimation: one-to-one comparison of digital mammography and digital breast tomosynthesis using fully automated software. Eur Radiol 22, 1265–1270 (2012). https://doi.org/10.1007/s00330-012-2380-y

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00330-012-2380-y

Keywords

  • Breast
  • Density
  • Digital
  • Mammography
  • Tomosynthesis