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Validity of computed mean compressed fibroglandular tissue thickness and breast composition for stratification of masking risk in Japanese women

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Abstract

Background

The volumetric measurement system for mammographic breast density is a high-precision objective method for evaluating the percentage of fibroglandular tissue volume (FG%). Nonetheless, FG% does not precisely correlate with subjective visual estimation (SVE) and shows poor evaluation performance regarding masking risk in patients with comparatively thin compressed breast thickness (CBT), commonly found in Japanese women. We considered that the mean compressed fibroglandular tissue thickness (mCGT), which incorporates the CBT element into the evaluation of breast density, may better predict masking risk.

Methods

Volumetric measurements and SVEs were performed on mammograms of 108 breast cancer patients from our center. mCGT was calculated as the product of CBT and FG%. SVE was classified using the Breast Imaging-Reporting and Data System classification, 5th edition. Subsequently, the performance of mCGT, SVE, and FG% in predicting masking risk was estimated using the AUC.

Results

The AUC values of mCGT and SVE were 0.84 (95% confidence interval, 0.71–0.92) and 0.78 (0.66–0.86), respectively (P = 0.16). The AUC of the FG% was 0.65 (0.52–0.77), which was significantly lower than that of mCGT (P < 0.001). The sensitivity and specificity of mCGT in predicting negative detection were 89% and 71%, respectively; of SVE 83% and 61% (versus 72% and 57% with FG%), suggesting that mCGT was superior to FG% in both sensitivity and specificity, and comparable with SVE.

Conclusions

Objective mCGT calculated from the volumetric measurement system will highly likely be useful in evaluating breast density and supporting visual assessment for masking risk stratification.

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Data availability

The datasets generated during and/or analyzed during the current study are available from the corresponding author on reasonable request.

Abbreviations

AI:

Artificial intelligence

BA:

Breast area

BV:

Breast volume

CBT:

Compressed breast thickness

CI:

Confidence interval

FG%:

Percentage of fibroglandular tissue volume to breast volume

FGV:

Fibroglandular tissue volume

IQR:

Interquartile range

κ :

Kappa coefficient

mCGT:

Mean compressed fibroglandular tissue thickness

MLO:

Mediolateral oblique

SVE:

Subjective visual estimation

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Acknowledgements

The authors thank A. Iwakoshi, Y. Murakami, H. Usami, Y. Ando, E. Matsuda, Y. Sasada, C. Suzuki, A. Morishita, N. Hara, Y. Araki, M. Ohashi, A. Ishida, A. Iwama, A. Okamoto, and K. Yokoyama from the NHO Nagoya Medical Center for breast cancer examination, as well as Editage (http://www.editage.com) for English language editing. We would like to particularly thank M. Noma from the Department of Breast Surgery, Hiroshima Prefectural Hospital, for her helpful suggestions.

Funding

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Author information

Authors and Affiliations

  1. Department of Radiology, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan

    Mikinao Oiwa & Tokiko Endo

  2. Department of Breast Surgery, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan

    Namiko Suda, Takako Morita, Yuko Takahashi, Yasuyuki Sato, Takako Hayashi & Aya Kato

  3. Department of Advanced Diagnosis, National Hospital Organization Division of Pathology, Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan

    Rieko Nishimura & Shu Ichihara

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  1. Mikinao Oiwa
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Contributions

MO, YS, and TE designed the study, collected and analyzed the data, and wrote the manuscript. MO and NS re-evaluated the mammograms. TM, YT, TH and AK carried out the clinical data collection and reviewed the medical charts. RN and SI made the diagnoses and carried out the pathological interpretations. All authors have read and approved the final manuscript.

Corresponding author

Correspondence to Mikinao Oiwa.

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Conflict of interest

The authors declare no conflicts of interest.

Ethical standards

This study received approval from the Ethical Review Board of Nagoya Medical Center (approval number: 2021-008). For this type of study formal consent is not required.

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Oiwa, M., Suda, N., Morita, T. et al. Validity of computed mean compressed fibroglandular tissue thickness and breast composition for stratification of masking risk in Japanese women. Breast Cancer 30, 541–551 (2023). https://doi.org/10.1007/s12282-023-01444-7

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