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- Title
Quantitative breast density analysis to predict interval and node-positive cancers in pursuit of improved screening protocols: a case-control study.
- Authors
Burnside, Elizabeth S.; Warren, Lucy M.; Myles, Jonathan; Wilkinson, Louise S.; Wallis, Matthew G.; Patel, Mishal; Smith, Robert A.; Young, Kenneth C.; Massat, Nathalie J.; Duffy, Stephen W.
- Abstract
<bold>Background: </bold>This study investigates whether quantitative breast density (BD) serves as an imaging biomarker for more intensive breast cancer screening by predicting interval, and node-positive cancers.<bold>Methods: </bold>This case-control study of 1204 women aged 47-73 includes 599 cancer cases (302 screen-detected, 297 interval; 239 node-positive, 360 node-negative) and 605 controls. Automated BD software calculated fibroglandular volume (FGV), volumetric breast density (VBD) and density grade (DG). A radiologist assessed BD using a visual analogue scale (VAS) from 0 to 100. Logistic regression and area under the receiver operating characteristic curves (AUC) determined whether BD could predict mode of detection (screen-detected or interval); node-negative cancers; node-positive cancers, and all cancers vs. controls.<bold>Results: </bold>FGV, VBD, VAS, and DG all discriminated interval cancers (all p < 0.01) from controls. Only FGV-quartile discriminated screen-detected cancers (p < 0.01). Based on AUC, FGV discriminated all cancer types better than VBD or VAS. FGV showed a significantly greater discrimination of interval cancers, AUC = 0.65, than of screen-detected cancers, AUC = 0.61 (p < 0.01) as did VBD (0.63 and 0.53, respectively, p < 0.001).<bold>Conclusion: </bold>FGV, VBD, VAS and DG discriminate interval cancers from controls, reflecting some masking risk. Only FGV discriminates screen-detected cancers perhaps adding a unique component of breast cancer risk.
- Subjects
RESEARCH; CLINICAL trials; RESEARCH methodology; MAMMOGRAMS; EARLY detection of cancer; VISUAL analog scale; CASE-control method; MEDICAL cooperation; EVALUATION research; COMPARATIVE studies; RESEARCH funding; BREAST tumors
- Publication
British Journal of Cancer, 2021, Vol 125, Issue 6, p884
- ISSN
0007-0920
- Publication type
journal article
- DOI
10.1038/s41416-021-01466-y