MRI background enhancement: Its relationship with breast density and breast cancer risk

2007 ◽  
Vol 25 (18_suppl) ◽  
pp. 1539-1539
Author(s):  
A. Kwong ◽  
J. Rosenberg ◽  
M. A. Van den Bosch ◽  
B. L. Daniel ◽  
G. Lo ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Density ◽  
Breast Imaging ◽  
Premenopausal Women ◽  
Breast Mri ◽  
Weighted Kappa ◽  
Contrast Enhanced ◽  
Background Enhancement

1539 Background: Increased breast density increases breast cancer risk. MRI breast is increasingly used for imaging as unlike mammography, the sensitivity of MRI breast is not affected by breast density but rather, the amount of background enhancement. It has been suggested that increased background enhancement may be related to the amount of proliferative breast tissue present; hence this may also be related to increased breast cancer risk. To date there have been no study published assessing background enhancement and its relation to breast cancer risk. Method: A retrospective review 45 mammography films and breast MRI scans of 36 patients (9 bilateral) with normal breast imaging was performed and scored independently by 3 radiologists for breast density using BI-RADS criteria. MRI breast density was scored on the non-contrast enhanced T1-weighted series whereas background enhancement was quantified on the first contrast-enhanced T1-weighted fat-suppressed series. Background enhancement was scored as none-minimal, mild, moderate, marked. Weighted kappa was used to assess the inter-modality agreement. A partial approximation to the Gail risk score was calculated from the available risk factors (age, menarche, number of biopsies, births and relatives with breast cancer), using coefficients from a Caucasian population; the resulting values were converted to ranks and was correlated with background enhancement. Result: There was substantial within-reader agreement between mammographic and MRI density (kappa=0.68; p=0.001). There were no correlation between background enhancement and breast density. All 6 patients with background-enhancement were pre-menopausal. Although not statistically significant (p<0.37), it is suggestive that 4 of the 6 (67%) had a history of breast cancer while only 6 of the 13 premenopausal non-enhancers (46%) had cancer. Moreover, the mean of the rank risk for enhancing premenopausal women was 29.5 while the non-enhancing pre-menopausal women was 16.6 (p=0.048 by one-tailed t-test). Conclusion: We found good correlation between mammographic and MRI breast density. There was no correlation between breast density and MRI background enhancement. There is a suggestion that MRI background enhancement may be associated with a higher risk of breast cancer. No significant financial relationships to disclose.

scholarly journals Population-Based Assessment of the Association Between Magnetic Resonance Imaging Background Parenchymal Enhancement and Future Primary Breast Cancer Risk

2019 ◽  
Vol 37 (12) ◽  
pp. 954-963 ◽  
Author(s):  
Vignesh A. Arasu ◽  
Diana L. Miglioretti ◽  
Brian L. Sprague ◽  
Nila H. Alsheik ◽  
Diana S.M. Buist ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Density ◽  
Ductal Carcinoma ◽  
Breast Mri ◽  
Resonance Imaging ◽  
Background Parenchymal Enhancement ◽  
Parenchymal Enhancement

PURPOSE To evaluate comparative associations of breast magnetic resonance imaging (MRI) background parenchymal enhancement (BPE) and mammographic breast density with subsequent breast cancer risk. PATIENTS AND METHODS We examined women undergoing breast MRI in the Breast Cancer Surveillance Consortium from 2005 to 2015 (with one exam in 2000) using qualitative BPE assessments of minimal, mild, moderate, or marked. Breast density was assessed on mammography performed within 5 years of MRI. Among women diagnosed with breast cancer, the first BPE assessment was included if it was more than 3 months before their first diagnosis. Breast cancer risk associated with BPE was estimated using Cox proportional hazards regression. RESULTS Among 4,247 women, 176 developed breast cancer (invasive, n = 129; ductal carcinoma in situ,n = 47) over a median follow-up time of 2.8 years. More women with cancer had mild, moderate, or marked BPE than women without cancer (80% v 66%, respectively). Compared with minimal BPE, increasing BPE levels were associated with significantly increased cancer risk (mild: hazard ratio [HR], 1.80; 95% CI, 1.12 to 2.87; moderate: HR, 2.42; 95% CI, 1.51 to 3.86; and marked: HR, 3.41; 95% CI, 2.05 to 5.66). Compared with women with minimal BPE and almost entirely fatty or scattered fibroglandular breast density, women with mild, moderate, or marked BPE demonstrated elevated cancer risk if they had almost entirely fatty or scattered fibroglandular breast density (HR, 2.30; 95% CI, 1.19 to 4.46) or heterogeneous or extremely dense breasts (HR, 2.61; 95% CI, 1.44 to 4.72), with no significant interaction ( P = .82). Combined mild, moderate, and marked BPE demonstrated significantly increased risk of invasive cancer (HR, 2.73; 95% CI, 1.66 to 4.49) but not ductal carcinoma in situ (HR, 1.48; 95% CI, 0.72 to 3.05). CONCLUSION BPE is associated with future invasive breast cancer risk independent of breast density. BPE should be considered for risk prediction models for women undergoing breast MRI.

scholarly journals Effect of personalized breast cancer risk tool on chemoprevention and breast imaging: ENGAGED-2 trial

2021 ◽  
Author(s):  
Karen J Wernli ◽  
Sarah Knerr ◽  
Tengfei Li ◽  
Kathleen Leppig ◽  
Kelly Ehrlich ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Imaging ◽  
Controlled Trial ◽  
Breast Mri ◽  
Analysis Of Covariance ◽  
Web Based ◽  
Logistic Regression Models ◽  
Mean Differences

Abstract Background Limited evidence exists about how to communicate breast density-informed breast cancer risk to women at elevated risk to motivate cancer prevention. Methods We conducted a randomized controlled trial evaluating a web-based intervention incorporating personalized breast cancer risk, information on chemoprevention, and values clarification on chemoprevention uptake vs. active control. Eligible women, aged 40–69 years with normal mammograms and elevated 5-year breast cancer risk, were recruited from Kaiser Permanente Washington from February 2017 to May 2018. Chemoprevention uptake was measured as any prescription for raloxifene or tamoxifen within 12-months from baseline in electronic health record pharmacy data. Secondary outcomes included breast MRI and mammography use and self-reported distress and communication with providers. We calculated unadjusted odds ratios (ORs) using logistic regression models and mean differences using analysis of covariance models with 95% confidence intervals (CIs) with generalized estimating equations. Results : We randomized 995 women (n = 492 intervention arm; 503 control arm). The intervention (vs. control) had no effect on chemoprevention uptake (OR = 1.04, 95% CI = 0.07-to 16.62). The intervention increased breast MRI use (OR = 5.65, 95% CI = 1.61 to19.74), while maintaining annual mammography (OR = 0.98, 95% CI = 0.75 to1.28). Women in the intervention (vs. control) arm had 5.67-times higher odds of having discussed chemoprevention or breast MRI with provider by 6-weeks (OR = 5.67, 95% CI = 2.47 to13.03), and 2.36-times higher odds by 12-months (OR = 2.36, 95% CI = 1.65 to3.37). No measurable differences in distress were detected. Conclusions and relevance A web-based, patient-level intervention activated women at elevated 5-year breast cancer risk to engage in clinical discussions about chemoprevention, but uptake remained low.

Contrast-Enhanced Spectral Mammography in Women With Intermediate Breast Cancer Risk and Dense Breasts

2018 ◽  
Vol 211 (5) ◽  
pp. W267-W274 ◽  
Author(s):  
Vera Sorin ◽  
Yael Yagil ◽  
Ady Yosepovich ◽  
Anat Shalmon ◽  
Michael Gotlieb ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Dense Breasts ◽  
Contrast Enhanced

scholarly journals Evaluation of 3.0-T MRI Brain Signal after Exposure to Gadoterate Meglumine in Women with High Breast Cancer Risk and Screening Breast MRI

Radiology ◽  
2019 ◽  
Vol 293 (3) ◽  
pp. 523-530 ◽  
Author(s):  
Barbara Bennani-Baiti ◽  
Barbara Krug ◽  
Daniel Giese ◽  
Martin Hellmich ◽  
Sophie Bartsch ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Breast Mri ◽  
Mri Brain ◽  
Gadoterate Meglumine ◽  
3.0 T ◽  
High Breast Cancer Risk ◽  
3.0 T Mri

scholarly journals Radiologic Technologist and Radiologist Knowledge Gaps about Breast Density Revealed by an Online Continuing Education Course

2020 ◽  
Vol 2 (4) ◽  
pp. 315-329 ◽  
Author(s):  
Robin L Seitzman ◽  
JoAnn Pushkin ◽  
Wendie A Berg
Keyword(s):  
Breast Cancer ◽  
Breast Cancer Risk ◽  
Cancer Risk ◽  
Continuing Education ◽  
Breast Density ◽  
Cancer Risk Assessment ◽  
Knowledge Gaps ◽  
Radiologic Technologists ◽  
Breast Cancer Risk Assessment ◽  
Post Test

Abstract Objective We sought to identify provider knowledge gaps and their predictors, as revealed by a breast density continuing education course marketed to the radiology community. Methods The course, continually available online during the study period of November 2, 2016 and December 31, 2018, includes demographics collection; a monograph on breast density, breast cancer risk, and screening; and a post-test. Four post-test questions were modified during the study period, resulting in different sample sizes pre- and postmodification. Multiple logistic regression was used to identify predictors of knowledge gaps (defined as &gt; 25% of responses incorrect). Results Of 1649 analyzable registrants, 1363 (82.7%) were radiologic technologists, 226 (13.7%) were physicians, and 60 (3.6%) were other nonphysicians; over 90% of physicians and over 90% of technologists/nonphysicians specialized in radiology. Sixteen of 49 physicians (32.7%) and 80/233 (34.3%) technologists/nonphysicians mistakenly thought the Gail model should be used to determine “high-risk” status for recommending MRI or genetic testing. Ninety-nine of 226 (43.8%) physicians and 682/1423 (47.9%) technologists/nonphysicians misunderstood the inverse relationship between increasing age and lifetime breast cancer risk. Fifty-two of 166 (31.3%) physicians and 549/1151 (47.7%) technologists/nonphysicians were unaware that MRI should be recommended for women with a family history of BRCA1/BRCA2 mutations. Tomosynthesis effectiveness was overestimated, with 18/60 (30.0%) physicians and 95/272 (34.9%) technologists/nonphysicians believing sensitivity nearly equaled MRI. Knowledge gaps were more common in technologists/nonphysicians. Conclusions Important knowledge gaps about breast density, breast cancer risk assessment, and screening exist among radiologic technologists and radiologists. Continued education efforts may improve appropriate breast cancer screening recommendations.

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