Automated, clinical BI-RADS predict breast cancer with same accuracy

According to a study published May 1 in Annals of Internal Medicine, automated and clinical Breast Imaging Reporting and Data System (BI-RADS) density can similarly predict and detect breast cancer and equally inform women about their breast density.  

The case-control study, funded by the National Cancer Institute and led by Karla Kerlikowske, MD, a professor of epidemiology and biostatistics at the University of California, San Fransisco, was conducted at the San Francisco Mammography Registry and Mayo Clinic.  

"In 30 states, women who have had screening mammography are informed of their breast density on the basis of Breast Imaging Reporting and Data System (BI-RADS) density categories estimated subjectively by radiologists," Kerlikowske et al. wrote.  "Variation in these clinical categories across and within radiologists has led to discussion about whether automated BI-RADS density should be reported instead." 

Automated and clinical Breast Imaging Reporting and Data System (BI-RADS) density can similarly detect and predict breast cancer, according to a study published May 1 in Annals of Internal Medicine. The two methods also perform similarly equally in measuring breast density.

The case-control study—funded by the National Cancer Institute and led by Karla Kerlikowske, MD, a professor of epidemiology and biostatistics at the University of California, San Fransisco—was conducted at the San Francisco Mammography Registry and Mayo Clinic. 

"In 30 states, women who have had screening mammography are informed of their breast density on the basis of Breast Imaging Reporting and Data System (BI-RADS) density categories estimated subjectively by radiologists," Kerlikowske et al. wrote.  "Variation in these clinical categories across and within radiologists has led to discussion about whether automated BI-RADS density should be reported instead."

The study included 1,609 women with screen-detected cancer, 351 women with interval invasive cancer and 4,409 control participants. Kerlikowske and her colleagues then assessed automated and clinical BI-RADS density on digital mammography two different times between September 2006 to October 2014, as well as measuring interval and screen-detected breast cancer risk and mammography sensitivity.  

"Neither automated nor clinical BI-RADS density was assessed on tomosynthesis, an emerging breast screening method," the researchers wrote.  

Study results included the following:  

  • Of women whose breast density was categorized by automated BI-RADS more than six months to five years before diagnosis, those with extremely dense breasts had a 5.65-fold higher interval cancer risk and a 1.43-fold higher screen-detected risk than those with scattered fibroglandular densities.  
  • Associations of interval and screen-detected cancer with clinical BI-RADS density were like those with automated BI-RADS density, regardless of whether density was measured more than six months to less than two years or two to five years before diagnosis. 
  • Automated and clinical BI-RADS density measures had similar discriminatory accuracy, which was higher for interval than screen-detected cancer. 
  • Mammography sensitivity was similar for automated and clinical BI-RADS categories: fatty, 93 percent versus 92 percent; scattered fibroglandular densities, 90 percent versus 90 percent; heterogeneously dense, 82 percent versus 78 percent; and extremely dense, 63 percent versus 64 percent, respectively. 
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A recent graduate from Dominican University (IL) with a bachelor’s in journalism, Melissa joined TriMed’s Chicago team in 2017 covering all aspects of health imaging. She’s a fan of singing and playing guitar, elephants, a good cup of tea, and her golden retriever Cooper.

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