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Contrast-Enhanced Digital Mammography (CEDM) pp 9–16Cite as

Mammographic Breast Density and Its Effects on Imaging

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Abstract

Mammographic breast density (MBD) is a term used to define the proportion of radiologically dense tissue in the breast.

MBD has been shown to be a strong predictor of mammography screening failure to detect breast cancer because it has a “masking effect” on underlying cancers and is an independent risk factor for breast cancer. Relative to the lowest classification of breast density (fatty tissue, <5%), women with the highest classification (extreme density, >75%) may have a four- to sixfold increased risk of breast cancer.

Over the years, many breast density measurement methods have been introduced, and the development of automated quantitative density assessment software is an active area of research.

MBD assessment has clinical utility for identifying women at increased risk of developing breast cancer and determining which women would benefit from supplemental screening. Supplemental screening of women with dense breasts using different imaging technologies detects additional breast cancers, most of which are invasive, but increases false-positives, with the exception of digital breast tomosynthesis (DBT).

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References

  1. Boyd NF, Martin LJ, Rommens JM, et al. Mammographic density: a heritable risk factor for breast cancer. Methods Mol Biol. 2009;472:343–60.

    Article  Google Scholar 

  2. Ng K-H, Lau S. Vision 20/20: mammographic breast density and its clinical applications. Med Phys. 2015;42:7059–77.

    Article  Google Scholar 

  3. Ekpo EU, Hogg P, Highnam R, McEntee MF. Breast composition: measurement and clinical use. Radiography. 2015;21:324–33.

    Article  Google Scholar 

  4. Wolfe JN. Risk for breast cancer development determined by mammographic parenchymal pattern. Cancer. 1976;37:2486–92.

    Article  CAS  Google Scholar 

  5. Wolfe JN. Breast patterns as an index of risk for developing breast cancer. Am J Roentgenol. 1976;126:1130–7.

    Article  CAS  Google Scholar 

  6. Gram IT, Funkhouser E, Tabar L. The Tabar classification of mammographic parenchymal patterns. Eur J Radiol. 1997;24:131–6.

    Article  CAS  Google Scholar 

  7. Egan RL, Mosteller RC. Breast cancer mammography patterns. Cancer. 1977;40:2087–90.

    Article  CAS  Google Scholar 

  8. Whitehead J, Carlile T, Kopecky KJ, Thompson DJ, Gilbert FI, Present AJ, Threatt BA, Krook P, Hadaway E. The relationship between Wolfe’s classification of mammograms, accepted breast cancer risk factors, and the incidence of breast cancer. Am J Epidemiol. 1985;122:994–1006.

    Article  CAS  Google Scholar 

  9. Boyd NF, Jensen HM, Cooke G, Han HL. Relationship between mammographic and histological risk factors for breast cancer. J Natl Cancer Inst. 1992;84:1170–9.

    Article  CAS  Google Scholar 

  10. ACR. Breast imaging reporting and data system® (BI-RADS®). 3rd ed. Reston: American College of Radiology; 1998.

    Google Scholar 

  11. ACR. Breast imaging reporting and data system® (BI-RADS®). 4th ed. Reston: American College of Radiology; 2003.

    Google Scholar 

  12. ACR. Breast imaging reporting and data system® (BI-RADS®) Atlas. 5th ed. Reston: American College of Radiology; 2014.

    Google Scholar 

  13. Tagliafico G, Tosto S, Chiesa F, Martinoli C, Derchi LE, Calabrese M. Mammographic density estimation: comparison among BI-RADS categories, a semi-automated software and a fully automated one. Breast. 2009;18(1):35–40.

    Article  Google Scholar 

  14. Byng JF, Boyd NF, Fischell E, Iong RA, Yaffe MJ. The quantitative analysis of mammographic densities. Phys Med Biol. 1994;39:1629–38.

    Article  CAS  Google Scholar 

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

    Article  Google Scholar 

  16. Boyd NF, Lockwood GA, Byng JW, Tritchler DL, Yaffe MJ. Mammographic densities and breast cancer risk. Cancer Epidemiol Biomark Prev. 1998;7:1133–44.

    CAS  Google Scholar 

  17. Eng A, Gallant Z, Shepherd J, McCormack V, Li J, Dowsett M, Vinnicombe S, Steve A, dos-Santos-Silva I. Digital mammographic density and breast cancer risk: a case–control study of six alternative density assessment methods. Breast Cancer Res. 2014;16:439.

    Article  Google Scholar 

  18. Kopans DB. Basic physics and doubts about relationship between mammographically determined tissue density and breast cancer risk. Radiology. 2008;246(2):348–53.

    Article  Google Scholar 

  19. Pisano ED, Hendrick RE, Yaffe MJ, Baum JK, Acharyya S, Cormack JB, Hanna LA, Conant EF, Fajardo LL, Bassett LW, et al. Diagnostic accuracy of digital versus film mammography: exploratory analysis of selected population subgroups in DMIST. Radiology. 2008;246:376–83.

    Article  Google Scholar 

  20. Prummel MV, Muradali D, Shumak R, Majpruz V, Brown P, Jiang H, Done SJ, Yaffe MJ, Chiarelli AM. Digital compared with screen-film mammography: measures of diagnostic accuracy among women screened in the Ontario breast screening program. Radiology. 2016;278:356–73.

    Article  Google Scholar 

  21. Arora N, King T, Jacks L, et al. Impact of breast density on the presenting features of malignancy. Ann Surg Oncol. 2010;17:211–8.

    Article  Google Scholar 

  22. Nickson C, Kavanagh AM. Tumor size at detection according to different measures of mammographic breast density. J Med Screen. 2009;16:140–6.

    Article  Google Scholar 

  23. Bae MS, Moon WK, Chang JM, et al. Breast cancer detected with screening US: reasons for nondetection at mammography. Radiology. 2014;270(2):369–77.

    Article  Google Scholar 

  24. McCormack VA, dos Santos Silva I. Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomark Prev. 2006;15:1159–69.

    Article  Google Scholar 

  25. Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, Jong RA, Hislop G, Chiarelli A, Minkin S, et al. Mammographic density and the risk and detection of breast cancer. N Engl J Med. 2007;356:227–36.

    Article  CAS  Google Scholar 

  26. Bertrand KA, Tamimi RM, Scott CG, Jensen MR, Pankratz VS, Visscher D, Norman A, Couch F, Shepherd J, Fan B, et al. Mammographic density and risk of breast cancer by age and tumor characteristics. Breast Cancer Res. 2013;15:R104.

    Article  Google Scholar 

  27. Park CC, Remberg J, Chew K, Moore D, Kerliwkowske K. High mammographic breast density is independent predictor of local but not distant recurrence after lumpectomy and radiotherapy for invasive breast cancer. Int J Radiat Oncol Biol Phys. 2009;73:75–9.

    Article  Google Scholar 

  28. Eriksson L, Czene K, Rosenberg L, Humphreys K, Hall P. Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res. 2013;15(4):R56.

    Article  Google Scholar 

  29. Gierach GL, Ichikawa L, Kerlikowske K, Brinton LA, Farhat GN, Vacek PM, Weaver DL, Schairer C, Taplin SH, Sherman ME. Relationship between mammographic density and breast cancer death in the breast cancer surveillance consortium. J Natl Cancer Inst. 2012;104:1218–27.

    Article  Google Scholar 

  30. Zhang S, Ivy JS, Diehl KM, Yankaskas BC. The association of breast density with breast cancer mortality in African American and white women screened in community practice. Breast Cancer Res Treat. 2013;13781:273–83.

    Article  Google Scholar 

  31. Dumas I, Diorio C. Polymorphism in genes involved in the estrogen pathway and mammographic density. BMC Cancer. 2010;10:636.

    Article  CAS  Google Scholar 

  32. Peng S, Lü B, Ruan W, Zhu Y, Sheng H, Lai M. Genetic polymorphism and breast cancer risk: evidence from meta-analyses, pooled analyses, and genome-wide association studies. Breast Cancer Res Treat. 2011;127(2):309–24.

    Article  Google Scholar 

  33. Lindström S, Vachon CM, Li J, et al. Common variants in ZNF365 are associated with both mammographic density and breast cancer risk. Nat Genet. 2011;43(3):185–7. Pearce MS, Tennant PW, Mann KD, et al. Lifecourse predictors of mammographic density: the Newcastle Thousand Families Cohort Study. Breast Cancer Res Treat 2012;131(1):187–95.

    Article  Google Scholar 

  34. Parce MS, Tennant PW, Mann KD, Pollard TM, McLean L, Kaye B, Parker L. Lifecourse predictors of mammographic density: the Newcastle thousand families cohort study. Breast Cancer Res Treat. 2012;131(1):187–95.

    Article  Google Scholar 

  35. Engmann NJ, Scott C, Jensen MR, Ma L, Brandt KR, Mahmoudzadeh A, Maikov S, Whaley DH, Hruska C, Wu FF, et al. Longitudinal changes in volumetric breast density with tamoxifen and aromatase inhibitors. Cancer Epidemiol Biomark Prev. 2017;26(6):930–7.

    Article  CAS  Google Scholar 

  36. Li J, Humphreys K, Eriksson L, Edgren G, Czene K, Hall P. Mammographic density reduction is a prognostic marker of response to adjuvant tamoxifen therapy in postmenopausal patients with breast cancer. J Clin Oncol. 2013;31:2249–56.

    Article  CAS  Google Scholar 

  37. Shawky MS, Martin H, Hugo HJ, Lloyd T, Britt KL, Redfern A, Thompson EW. Mammographic density: a potential monitoring biomarker for adjuvant and preventative breast cancer endocrine therapies. Oncotarget. 2017;8:5578–91.

    Article  Google Scholar 

  38. Are You Dense Inc. Are you dense? Exposing the best-kept secret. https://www.areyoudense.org. Accessed 28 Mar 2017.

  39. Melnikow J, et al. Supplemental screening for breast cancer in women with dense breasts: a systematic review for the US preventive services task force. Ann Intern Med. 2016;164:268–78.

    Article  Google Scholar 

  40. Tagliafico AS, Calabrese M, Mariscotti G, Durando M, Tosto S, Monetti F, Airaldi S, Bignotti B, Nori J, Bagni A, Signori A, Sormani MP, Houssami N. Adjunct screening with Tomosynthesis or Ultrasound in women with mammography—negative dense breast: interim report of a prospective comparative Trial. J Clin Oncol. 2016;34(16):1882–8.

    Article  CAS  Google Scholar 

  41. Bernardi D, Belli P, Benelli E, Brancato B, Bucchi L, Calabrese M, Carbonaro LA, Caumo F, Cavallo-Marincola B, Clauser P, Fedato C, Frigerio A, Galli V, Giordano L, Giorgi Rossi P, Golinelli P, Morrone D, Mariscotti G, Martincich L, Montemezzi S, Naldoni C, Paduos A, Panizza P, Pediconi F, Querci F, Rizzo A, Saguatti G, Tagliafico A, Trimboli RM, Zappa M, Zuiani C, Sardanelli F. Digital breast tomosynthesis (DBT): recommendations from the Italian College of Breast Radiologists (ICBR) by the Italian Society of Medical Radiology (SIRM) and the Italian Group for Mammography Screening (GISMa). Radiol Med. 2017;122(10):723–30. https://doi.org/10.1007/s11547-017-0769-z.

    Article  PubMed  PubMed Central  Google Scholar 

  42. Aiello EJ, Buist DSM, White E, et al. Association between mammographic breast density and breast cancer tumor characteristics. Cancer Epidemiol Biomark Prev. 2005;14:662–8.

    Article  Google Scholar 

  43. Gail MH, Brinton LA, Byar DP, Corle DK, Green SB, Schairer C, Mulvihill JJ. Projecting individualized probabilities of developing breast cancer for white females who are being examined annually. J Natl Cancer Inst. 1989;81(24):1879–86.

    Article  CAS  Google Scholar 

  44. Gail MH. Twenty-five years of breast cancer risk models and their applications. J Natl Cancer Inst. 2015;107(5):djv042.

    Article  Google Scholar 

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Authors and Affiliations

  1. Breast Imaging Center, “Senologia e Salute Srl- Centro di Diagnosi e Prevenzione”, Bari, Italy

    Vincenzo Lattanzio & Angela Maria Guerrieri

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  1. Vincenzo Lattanzio
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  2. Angela Maria Guerrieri
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Editors and Affiliations

  1. Diagnostic Senology Unit, Department of Radiology, Azienda Ospedaliero Universitaria Careggi, Florence, Italy

    Jacopo Nori

  2. Department of Radiology, Kuala Lumpur Hospital, Kuala Lumpur, Malaysia

    Maninderpal Kaur

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Lattanzio, V., Guerrieri, A.M. (2018). Mammographic Breast Density and Its Effects on Imaging. In: Nori, J., Kaur, M. (eds) Contrast-Enhanced Digital Mammography (CEDM). Springer, Cham. https://doi.org/10.1007/978-3-319-94553-8_2

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  • DOI: https://doi.org/10.1007/978-3-319-94553-8_2

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