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J Natl Cancer Inst. 2019 Jan 8. doi: 10.1093/jnci/djy210. [Epub ahead of print]

Trends in Clinical Breast Density Assessment From the Breast Cancer Surveillance Consortium.

Author information

1
Departments of Surgery and Radiology, University of Vermont Cancer Center, University of Vermont, Burlington, VT.
2
Departments of Medicine and Epidemiology and Biostatistics and General Internal Medicine Section, Department of Veterans Affairs, University of California, San Francisco, CA.
3
Kaiser Permanente Washington Health Research Institute, Kaiser Permanente Washington, Seattle, WA, DLM.
4
Department of Epidemiology and Biostatistics, School of Public Health, University of Illinois at Chicago, Chicago, IL.
5
Department of Radiology, University of Washington School of Medicine, and the Hutchinson Institute for Cancer Outcomes Research, Seattle, WA.
6
The Dartmouth Institute for Health Policy and Clinical Practice and Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH.
7
Division of Biostatistics, Department of Public Health Sciences, University of California Davis School of Medicine, Davis, CA.

Abstract

Changes to mammography practice, including revised Breast Imaging Reporting and Data System (BI-RADS) density classification guidelines and implementation of digital breast tomosynthesis (DBT), may impact clinical breast density assessment. We investigated temporal trends in clinical breast density assessment among 2 990 291 digital mammography (DM) screens and 221 063 DBT screens interpreted by 722 radiologists from 144 facilities in the Breast Cancer Surveillance Consortium. After age-standardization, 46.3% (95% CI = 44.1% to 48.6%) of DM screens were assessed as dense (heterogeneously/extremely dense) during the BI-RADS 4th edition era (2005-2013), compared to 46.5% (95% CI = 43.8% to 49.1%) during the 5th edition era (2014-2016) (P = .93 from two-sided generalized score test). Among DBT screens in the BI-RADS 5th edition era, 45.8% (95% CI = 42.0% to 49.7%) were assessed as dense (P = .77 from two-sided generalized score test) compared to 46.5% (95% CI = 43.8% to 49.1%) dense on DM in BI-RADS 5th edition era. Results were similar when examining all four density categories and age subgroups. Clinicians, researchers, and policymakers may reasonably expect stable density distributions across screened populations despite changes to the BI-RADS guidelines and implementation of DBT.

PMID:
30624682
DOI:
10.1093/jnci/djy210

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