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Radiology. 2011 Jul;260(1):50-60. doi: 10.1148/radiol.11102156. Epub 2011 Apr 14.

Background parenchymal enhancement at breast MR imaging and breast cancer risk.

Author information

1
Department of Radiology, Memorial Sloan-Kettering Cancer Center, Evelyn H. Lauder Breast Center, 300 E 66th St, Room 715, New York, NY 10065, USA.

Abstract

PURPOSE:

To examine the relationships between breast cancer and both amount of fibroglandular tissue (FGT) and level of background parenchymal enhancement (BPE) at magnetic resonance (MR) imaging.

MATERIALS AND METHODS:

A waiver of authorization was granted by the institutional review board for this retrospective HIPAA-compliant study. Among 1275 women who underwent breast MR imaging screening between December 2002 and February 2008, 39 breast carcinoma cases were identified. Two comparisons were performed: In one comparison, two normal controls--those of the women with negative (benign) findings at breast MR imaging--were matched to each breast cancer case on the basis of age and date of MR imaging. In the second comparison, one false-positive control--that of a woman with suspicious but nonmalignant findings at MR imaging--was similarly matched to each breast cancer case. Two readers independently rated the level of MR imaging-depicted BPE and the amount of MR imaging-depicted FGT by using a categorical scale: BPE was categorized as minimal, mild, moderate, or marked, and FGT was categorized as fatty, scattered, heterogeneously dense, or dense.

RESULTS:

Compared with the odds ratio (OR) for a normal control, the OR for breast cancer increased significantly with increasing BPE: The ORs for moderate or marked BPE versus minimal or mild BPE were 10.1 (95% confidence interval [CI]: 2.9, 35.3; P < .001) and 3.3 (95% CI: 1.3, 8.3; P = .006) for readers 1 and 2, respectively. Similar odds were seen when the false-positive controls were compared with the breast cancer cases: The ORs for moderate or marked BPE versus minimal or mild BPE were 5.1 (95% CI: 1.4, 19.1; P = .005) and 3.7 (95% CI: 1.2, 11.2; P = .013) for readers 1 and 2, respectively. The breast cancer odds also increased with increasing FGT, but the BPE findings remained significant after adjustment for FGT.

CONCLUSION:

Increased BPE is strongly predictive of breast cancer odds.

PMID:
21493794
DOI:
10.1148/radiol.11102156
[Indexed for MEDLINE]

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