Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study

doi:10.1038/s41523-021-00272-2

. 2021 May 31;7(1):68.

doi: 10.1038/s41523-021-00272-2.

Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study

Erica T Warner¹, Megan S Rice^{2

3}, Oana A Zeleznik³, Erin E Fowler⁴, Divya Murthy³, Celine M Vachon⁵, Kimberly A Bertrand⁶, Bernard A Rosner³, John Heine⁴, Rulla M Tamimi^{3

7

8}

Affiliations

¹ Clinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. ewarner@mgh.harvard.edu.
² Clinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
³ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
⁵ Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
⁶ Slone Epidemiology Center, Boston University, Boston, MA, USA.
⁷ Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
⁸ Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.

PMID: 34059687
PMCID: PMC8166859
DOI: 10.1038/s41523-021-00272-2

Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study

Erica T Warner et al. NPJ Breast Cancer. 2021.

. 2021 May 31;7(1):68.

doi: 10.1038/s41523-021-00272-2.

Authors

Erica T Warner¹, Megan S Rice^{2

3}, Oana A Zeleznik³, Erin E Fowler⁴, Divya Murthy³, Celine M Vachon⁵, Kimberly A Bertrand⁶, Bernard A Rosner³, John Heine⁴, Rulla M Tamimi^{3

7

8}

Affiliations

¹ Clinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA. ewarner@mgh.harvard.edu.
² Clinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
³ Channing Division of Network Medicine, Department of Medicine, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, USA.
⁴ Division of Population Sciences, H. Lee Moffitt Cancer Center & Research Institute, Tampa, FL, USA.
⁵ Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA.
⁶ Slone Epidemiology Center, Boston University, Boston, MA, USA.
⁷ Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA, USA.
⁸ Department of Population Health Sciences, Weill Cornell Medicine, New York, NY, USA.

PMID: 34059687
PMCID: PMC8166859
DOI: 10.1038/s41523-021-00272-2

Abstract

Percent mammographic density (PMD) is a strong breast cancer risk factor, however, other mammographic features, such as V, the standard deviation (SD) of pixel intensity, may be associated with risk. We assessed whether PMD, automated PMD (APD), and V, yielded independent associations with breast cancer risk. We included 1900 breast cancer cases and 3921 matched controls from the Nurses' Health Study (NHS) and the NHSII. Using digitized film mammograms, we estimated PMD using a computer-assisted thresholding technique. APD and V were determined using an automated computer algorithm. We used logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs). Median time from mammogram to diagnosis was 4.1 years (interquartile range: 1.6-6.8 years). PMD (OR _{per SD}:1.52, 95% CI: 1.42, 1.63), APD (OR _{per SD}:1.32, 95% CI: 1.24, 1.41), and V (OR _{per SD}:1.32, 95% CI: 1.24, 1.40) were positively associated with breast cancer risk. Associations for APD were attenuated but remained statistically significant after mutual adjustment for PMD or V. Women in the highest quartile of both APD and V (OR _{vs Q1/Q1}: 2.49, 95% CI: 2.02, 3.06), or PMD and V (OR _{vs Q1/Q1}: 3.57, 95% CI: 2.79, 4.58) had increased breast cancer risk. An automated method of PMD assessment is feasible and yields similar, but somewhat weaker, estimates to a manual measure. PMD, APD and V are each independently, positively associated with breast cancer risk. Women with dense breasts and greater texture variation are at the highest relative risk of breast cancer.

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Conflict of interest statement

The authors declare no competing interests.

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References

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[1] Byrne C, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J. Natl Cancer Inst. 1995;87:1622–1629. doi: 10.1093/jnci/87.21.1622. - DOI - PubMed

[2] Byrne C, et al. Mammographic features and breast cancer risk: effects with time, age, and menopause status. J. Natl Cancer Inst. 1995;87:1622–1629. doi: 10.1093/jnci/87.21.1622. - DOI - PubMed

[3] Boyd NF, et al. Mammographic density as a marker of susceptibility to breast cancer: a hypothesis. IARC Sci. Publ. 2001;154:163–169. - PubMed

[4] Boyd NF, et al. Mammographic density as a marker of susceptibility to breast cancer: a hypothesis. IARC Sci. Publ. 2001;154:163–169. - PubMed

[5] Boyd NF, et al. Mammographic densities as a marker of human breast cancer risk and their use in chemoprevention. Curr. Oncol. Rep. 2001;3:314–321. doi: 10.1007/s11912-001-0083-7. - DOI - PubMed

[6] Boyd NF, et al. Mammographic densities as a marker of human breast cancer risk and their use in chemoprevention. Curr. Oncol. Rep. 2001;3:314–321. doi: 10.1007/s11912-001-0083-7. - DOI - PubMed

[7] Prevrhal S, Shepherd JA, Smith-Bindman R, Cummings SR, Kerlikowske K. Accuracy of mammographic breast density analysis: results of formal operator training. Cancer Epidemiol. Biomark. Prev. 2002;11:1389–1393. - PubMed

[8] Prevrhal S, Shepherd JA, Smith-Bindman R, Cummings SR, Kerlikowske K. Accuracy of mammographic breast density analysis: results of formal operator training. Cancer Epidemiol. Biomark. Prev. 2002;11:1389–1393. - PubMed

[9] Nicholson BT, et al. Accuracy of assigned BI-RADS breast density category definitions. Acad. Radio. 2006;13:1143–1149. doi: 10.1016/j.acra.2006.06.005. - DOI - PubMed

[10] Nicholson BT, et al. Accuracy of assigned BI-RADS breast density category definitions. Acad. Radio. 2006;13:1143–1149. doi: 10.1016/j.acra.2006.06.005. - DOI - PubMed

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Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study

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Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study

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Abstract

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