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Review
. 2023 Nov;34(11):939-948.
doi: 10.1007/s10552-023-01739-2. Epub 2023 Jun 20.

Repeated measures of mammographic density and texture to evaluate prediction and risk of breast cancer: a systematic review of the methods used in the literature

Akila Anandarajah  1 , Yongzhen Chen  2 , Carolyn Stoll  1 , Angela Hardi  3 , Shu Jiang  1 , Graham A Colditz  4
Affiliations
Review

Repeated measures of mammographic density and texture to evaluate prediction and risk of breast cancer: a systematic review of the methods used in the literature

Akila Anandarajah et al. Cancer Causes Control. 2023 Nov.

Abstract

Purpose: It may be important for women to have mammograms at different points in time to track changes in breast density, as fluctuations in breast density can affect breast cancer risk. This systematic review aimed to assess methods used to relate repeated mammographic images to breast cancer risk.

Methods: The databases including Medline (Ovid) 1946-, Embase.com 1947-, CINAHL Plus 1937-, Scopus 1823-, Cochrane Library (including CENTRAL), and Clinicaltrials.gov were searched through October 2021. Eligibility criteria included published articles in English describing the relationship of change in mammographic features with risk of breast cancer. Risk of bias was assessed using the Quality in Prognostic Studies tool.

Results: Twenty articles were included. The Breast Imaging Reporting and Data System and Cumulus were most commonly used for classifying mammographic density and automated assessment was used on more recent digital mammograms. Time between mammograms varied from 1 year to a median of 4.1, and only nine of the studies used more than two mammograms. Several studies showed that adding change of density or mammographic features improved model performance. Variation in risk of bias of studies was highest in prognostic factor measurement and study confounding.

Conclusion: This review provided an updated overview and revealed research gaps in assessment of the use of texture features, risk prediction, and AUC. We provide recommendations for future studies using repeated measure methods for mammogram images to improve risk classification and risk prediction for women to tailor screening and prevention strategies to level of risk.

Keywords: Breast density; Mammography; Parenchymal patterns; Risk prediction; Texture.

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Conflict of interest statement

The authors declare they have no competing interests.

Figures

Fig. 1
Fig. 1
PRISMA 2020 flow diagram
Fig. 2
Fig. 2
Number of mammograms per study
See this image and copyright information in PMC

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