Assessing the usefulness of a novel MRI-based breast density estimation algorithm in a cohort of women at high genetic risk of breast cancer: the UK MARIBS studyReportar como inadecuado

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Breast Cancer Research

, 11:R80

First Online: 11 November 2009Received: 03 April 2009Revised: 01 September 2009Accepted: 11 November 2009


IntroductionMammographic breast density is one of the strongest known risk factors for breast cancer. We present a novel technique for estimating breast density based on 3D T1-weighted Magnetic Resonance Imaging MRI and evaluate its performance, including for breast cancer risk prediction, relative to two standard mammographic density-estimation methods.

MethodsThe analyses were based on MRI n = 655 and mammography n = 607 images obtained in the course of the UK multicentre magnetic resonance imaging breast screening MARIBS study of asymptomatic women aged 31 to 49 years who were at high genetic risk of breast cancer. The MRI percent and absolute dense volumes were estimated using our novel algorithm MRIBview while mammographic percent and absolute dense area were estimated using the Cumulus thresholding algorithm and also using a 21-point Visual Assessment scale for one medio-lateral oblique image per woman. We assessed the relationships of the MRI and mammographic measures to one another, to standard anthropometric and hormonal factors, to BRCA1-2 genetic status, and to breast cancer risk 60 cases using linear and Poisson regression.

ResultsMRI percent dense volume is well correlated with mammographic percent dense area R = 0.76 but overall gives estimates 8.1 percentage points lower P < 0.0001. Both show strong associations with established anthropometric and hormonal factors. Mammographic percent dense area, and to a lesser extent MRI percent dense volume were lower in BRCA1 carriers P = 0.001, P = 0.010 respectively but there was no association with BRCA2 carrier status. The study was underpowered to detect expected associations between percent density and breast cancer, but women with absolute MRI dense volume in the upper half of the distribution had double the risk of those in the lower half P = 0.009.

ConclusionsThe MRIBview estimates of volumetric breast density are highly correlated with mammographic dense area but are not equivalent measures; the MRI absolute dense volume shows potential as a predictor of breast cancer risk that merits further investigation.

AbbreviationsBMIbody mass index


CIconfidence interval

IQRinter quartile range

IRRincidence rate ratio

MARIBSmagnetic resonance imaging breast screening

MLOmedial-lateral oblique

MLPAmultiple ligation dependant probe amplification

MRImagnetic resonance imaging

ONSoffice of national statistics

RRrelative risk

UCLUniversity College London

VAvisual assessment

WHRwaist-hip ratio

XRMX-ray mammography

Electronic supplementary materialThe online version of this article doi:10.1186-bcr2447 contains supplementary material, which is available to authorized users.

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Autor: Deborah J Thompson - Martin O Leach - Gek Kwan-Lim - Simon A Gayther - Susan J Ramus - Iqbal Warsi - Fiona Lennard - Mi


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