RSNA: Breast density predictive of breast cancer in younger women

CHIICAGO—Automated volumetric breast density measurement is predictive of breast cancer in young women and the risk of breast cancer may be related to an altered pattern of breast density regression with age, according to research presented Dec. 3 at the annual meeting of the Radiological Society of North America (RSNA).

Dense breast tissue is a significant risk factor for breast cancer and reduces the accuracy of image interpretation, as radiologists tend to overestimate density, according to senior author Nicholas M. Perry, MBBS, FRCS, FRCR, of the London Breast Institute.

“The aims of our study were to assess the risk of breast cancer associated with dense breasts according to age, to compare the predictive accuracy between automated and radiologists’ breast density, and to identify differences in age density pattern between women with and without breast cancer,” said Perry in a press conference at RSNA.

Perry and colleagues created a study in which the breast density and cancer risk between younger and older women were compared. They also analyzed how the risk relates to changes in breast density over time. The study population included 282 breast cancer cases and 317 healthy control participants who underwent digital mammography. Breast density was measured separately using an automated volumetric system.

The study’s findings indicated that the automatic system was more accurate than the radiologists. Up to age 50, breast cancer patients had higher mammographic density than healthy patients. The control group had a significant decline in density with age that followed a linear pattern, while there was much more variability in density regression amongst the breast cancer patients.

“The cancer cases in no way followed that straight line,” remarked Perry. “It’s a very curvy, non-linear pattern. There is quite a difference between the breast cancer patients and the healthy controls.”

Thus, density risk is more relevant for younger age. Automated measurements could be more reliable than radiologists, as well as more suitable for density readings.

“It’s estimated that 40 percent of all life years lost to breast cancer are from unscreened women aged under 50 at diagnosis. Their tumors are often more aggressive and difficult to treat, with higher rates of reoccurrence,” said Perry.

This research could lead to alternative preventative strategies for younger women, such as an elective density estimation between 35 and 40 years old, concluded Perry.