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 journalArticle

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 languageEnglish (US)
Article number118
JournalBreast Cancer Research
Volume21
Issue number1
DOIs
StatePublished - Oct 28 2019
Externally publishedYes

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Breast
Breast Neoplasms
ROC Curve
Area Under Curve
Breast Density
Nonparametric Statistics
Neoplasms

Keywords

  • Breast cancer
  • Breast density
  • Risk
  • Tissue asymmetry
  • Volumetric density

ASJC Scopus subject areas

  • Oncology
  • Cancer Research

Cite this

Automated volumetric breast density measures : Differential change between breasts in women with and without breast cancer. / Brandt, Kathleen R.; Scott, Christopher G.; Miglioretti, Diana L.; Jensen, Matthew R.; Mahmoudzadeh, Amir P.; Hruska, Carrie; Ma, Lin; Wu, Fang Fang; Cummings, Steven R.; Norman, Aaron D.; Engmann, Natalie J.; Shepherd, John A.; Winham, Stacey J.; Kerlikowske, Karla; Vachon, Celine M.

In: Breast Cancer Research, Vol. 21, No. 1, 118, 28.10.2019.

Research output: Contribution to journalArticle

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
Brandt, Kathleen R. ; Scott, Christopher G. ; Miglioretti, Diana L. ; Jensen, Matthew R. ; Mahmoudzadeh, Amir P. ; Hruska, Carrie ; Ma, Lin ; Wu, Fang Fang ; Cummings, Steven R. ; Norman, Aaron D. ; Engmann, Natalie J. ; Shepherd, John A. ; Winham, Stacey J. ; Kerlikowske, Karla ; Vachon, Celine M. / Automated volumetric breast density measures : Differential change between breasts in women with and without breast cancer. In: Breast Cancer Research. 2019 ; Vol. 21, No. 1.
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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.",
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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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