Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer

Kathleen R. Brandt; Christopher G. Scott; Diana L. Miglioretti; Matthew R. Jensen; Amir P. Mahmoudzadeh; Carrie Hruska; Lin Ma; Fang Fang Wu; Steven R. Cummings; Aaron D. Norman; Natalie J. Engmann; John A. Shepherd; Stacey J. Winham; Karla Kerlikowske; Celine M. Vachon

doi:10.1186/s13058-019-1198-9

Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer

Kathleen R. Brandt, Christopher G. Scott, Diana L. Miglioretti, Matthew R. Jensen, Amir P. Mahmoudzadeh, Carrie Hruska, Lin Ma, Fang Fang Wu, Steven R. Cummings, Aaron D. Norman, Natalie J. Engmann, John A. Shepherd, Stacey J. Winham, Karla Kerlikowske, Celine M. Vachon

Research output: Contribution to journal › Article › peer-review

2 Scopus citations

Abstract

Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls. Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara™. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time. Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and-2.10 cm³) than the normal breast (-0.39% and-2.74 cm³) for a difference of 0.13% (p value < 0.001) and 0.63 cm³ (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV. Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.

Original language	English (US)
Article number	118
Journal	Breast Cancer Research
Volume	21
Issue number	1
DOIs	https://doi.org/10.1186/s13058-019-1198-9
State	Published - Oct 28 2019

Keywords

Breast cancer
Breast density
Risk
Tissue asymmetry
Volumetric density

ASJC Scopus subject areas

Oncology
Cancer Research

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10.1186/s13058-019-1198-9

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Brandt, K. R., Scott, C. G., Miglioretti, D. L., Jensen, M. R., Mahmoudzadeh, A. P., Hruska, C., Ma, L., Wu, F. F., Cummings, S. R., Norman, A. D., Engmann, N. J., Shepherd, J. A., Winham, S. J., Kerlikowske, K., & Vachon, C. M. (2019). Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer. Breast Cancer Research, 21(1), Article 118. https://doi.org/10.1186/s13058-019-1198-9

Brandt, KR, Scott, CG, Miglioretti, DL, Jensen, MR, Mahmoudzadeh, AP, Hruska, C, Ma, L, Wu, FF, Cummings, SR, Norman, AD, Engmann, NJ, Shepherd, JA, Winham, SJ, Kerlikowske, K & Vachon, CM 2019, 'Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer', Breast Cancer Research, vol. 21, no. 1, 118. https://doi.org/10.1186/s13058-019-1198-9

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title = "Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer",

abstract = "Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls. Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara{\texttrademark}. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time. Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and-2.10 cm3) than the normal breast (-0.39% and-2.74 cm3) for a difference of 0.13% (p value < 0.001) and 0.63 cm3 (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV. Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.",

keywords = "Breast cancer, Breast density, Risk, Tissue asymmetry, Volumetric density",

author = "Brandt, {Kathleen R.} and Scott, {Christopher G.} and Miglioretti, {Diana L.} and Jensen, {Matthew R.} and Mahmoudzadeh, {Amir P.} and Carrie Hruska and Lin Ma and Wu, {Fang Fang} and Cummings, {Steven R.} and Norman, {Aaron D.} and Engmann, {Natalie J.} and Shepherd, {John A.} and Winham, {Stacey J.} and Karla Kerlikowske and Vachon, {Celine M.}",

note = "Publisher Copyright: {\textcopyright} 2019 The Author(s).",

year = "2019",

month = oct,

day = "28",

doi = "10.1186/s13058-019-1198-9",

language = "English (US)",

volume = "21",

journal = "Breast Cancer Research",

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T1 - Automated volumetric breast density measures

T2 - Differential change between breasts in women with and without breast cancer

AU - Brandt, Kathleen R.

AU - Scott, Christopher G.

AU - Miglioretti, Diana L.

AU - Jensen, Matthew R.

AU - Mahmoudzadeh, Amir P.

AU - Hruska, Carrie

AU - Ma, Lin

AU - Wu, Fang Fang

AU - Cummings, Steven R.

AU - Norman, Aaron D.

AU - Engmann, Natalie J.

AU - Shepherd, John A.

AU - Winham, Stacey J.

AU - Kerlikowske, Karla

AU - Vachon, Celine M.

PY - 2019/10/28

Y1 - 2019/10/28

N2 - Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls. Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara™. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time. Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and-2.10 cm3) than the normal breast (-0.39% and-2.74 cm3) for a difference of 0.13% (p value < 0.001) and 0.63 cm3 (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV. Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.

AB - Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls. Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara™. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time. Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and-2.10 cm3) than the normal breast (-0.39% and-2.74 cm3) for a difference of 0.13% (p value < 0.001) and 0.63 cm3 (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV. Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.

KW - Breast cancer

KW - Breast density

KW - Risk

KW - Tissue asymmetry

KW - Volumetric density

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Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer

Abstract

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