Interobserver and intraobserver variability in determining breast density according to the fifth edition of the BI-RADS® Atlas

Pesce, Karina; Tajerian, Matias; Chico, M.J.; Swiecicki, M; Boietti, Bruno; Frangella, M.J.; Benítez, Sonia

doi:10.1016/j.rxeng.2020.04.004

Cited by 5 publications

(3 citation statements)

References 28 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…density classification is based on the masking effect of BTD, while the 2003 BI-RADS 4th ed. [ 23 ] was based on visually estimated percentage BTD; both are associated with high rates of inter- and intra-observer variability [ 24 , 25 ]. Future considerations for OBSP include whether women’s BC risk needs to be reassessed at some point, for example after menopause when many women’s BTD decreases.…”

Section: Discussionmentioning

confidence: 99%

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

Rusnak

Morrison²,

Smith³

et al. 2022

Current Oncology

View full text Add to dashboard Cite

Breast tissue density (BTD) is known to increase the risk of breast cancer but is not routinely used in the risk assessment of the population-based High-Risk Ontario Breast Screening Program (HROBSP). This prospective, IRB-approved study assessed the feasibility and impact of incorporating breast tissue density (BTD) into the risk assessment of women referred to HROBSP who were not genetic mutation carriers. All consecutive women aged 40–69 years who met criteria for HROBSP assessment and referred to Genetics from 1 December 2020 to 31 July 2021 had their lifetime risk calculated with and without BTD using Tyrer-Cuzick model version 8 (IBISv8) to gauge overall impact. McNemar’s test was performed to compare eligibility with and without density. 140 women were referred, and 1 was excluded (BRCA gene mutation carrier and automatically eligible). Eight of 139 (5.8%) never had a mammogram, while 17/131 (13%) did not have BTD reported on their mammogram and required radiologist review. Of 131 patients, 22 (16.8%) were clinically impacted by incorporation of BTD: 9/131 (6.9%) became eligible for HROBSP, while 13/131 (9.9%) became ineligible (p = 0.394). It was feasible for the Genetics clinic to incorporate BTD for better risk stratification of eligible women. This did not significantly impact the number of eligible women while optimizing the use of high-risk supplemental MRI screening.

show abstract

Section: Discussionmentioning

confidence: 99%

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

Rusnak

Morrison²,

Smith³

et al. 2022

Current Oncology

View full text Add to dashboard Cite

show abstract

“…The categories range from A to D and correspond to fatty, scattered, heterogeneous, and extremely dense breasts. The qualitative classification of breast density in mammography is an accepted method in breast radiology with good inter-observer and intra-observer agreement ( 2 ), despite the fact that commercial software can produce a more accurate quantitative measure by calculating the ratio of fibroglandular tissue to the total breast area.…”

Section: Introductionmentioning

confidence: 99%

High-resolution synthesis of high-density breast mammograms: Application to improved fairness in deep learning based mass detection

et al. 2023

View full text Add to dashboard Cite

Computer-aided detection systems based on deep learning have shown good performance in breast cancer detection. However, high-density breasts show poorer detection performance since dense tissues can mask or even simulate masses. Therefore, the sensitivity of mammography for breast cancer detection can be reduced by more than 20% in dense breasts. Additionally, extremely dense cases reported an increased risk of cancer compared to low-density breasts. This study aims to improve the mass detection performance in high-density breasts using synthetic high-density full-field digital mammograms (FFDM) as data augmentation during breast mass detection model training. To this end, a total of five cycle-consistent GAN (CycleGAN) models using three FFDM datasets were trained for low-to-high-density image translation in high-resolution mammograms. The training images were split by breast density BI-RADS categories, being BI-RADS A almost entirely fatty and BI-RADS D extremely dense breasts. Our results showed that the proposed data augmentation technique improved the sensitivity and precision of mass detection in models trained with small datasets and improved the domain generalization of the models trained with large databases. In addition, the clinical realism of the synthetic images was evaluated in a reader study involving two expert radiologists and one surgical oncologist.

show abstract

“…22 was based on visually estimated percentage breast density; both are associated with high rates of inter- and intra-observer variability. 23,24 There is less variability for women with extremely dense than with heterogeneously dense breast tissue. 24,25 Dense breasts are normal and common: 43.3% of women 40 to 74 years of age have heterogeneously or extremely dense breasts, and the incidence decreases with age, particularly around menopause.…”

Section: Introductionmentioning

confidence: 99%

Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

et al. 2021

View full text Add to dashboard Cite

Regular screening mammography reduces breast cancer mortality. However, in women with dense breasts, the performance of screening mammography is reduced, which is reflected in higher interval cancer rates (ICR). In Canada, population-based screening mammography programs generally screen women biennially; however, some provinces and territories offer annual mammography for women with dense breast tissue routinely and/or on recommendation of the radiologist. This study compared the ICRs in those breast screening programs with a policy of annual vs. those with biennial screening for women with dense breasts. Among 148,575 women with dense breasts screened between 2008 to 2010, there were 288 invasive interval breast cancers; screening programs with policies offering annual screening for women with dense breasts had fewer interval cancers 63/70,814 (ICR 0.89/1000, 95% CI: 0.67-1.11) compared with those with policies of usual biennial screening 225/77,761 (ICR 1.45 /1000 (annualized), 95% CI: 1.19-1.72) i.e. 63% higher (p = 0.0016). In screening programs where radiologists’ screening recommendations were able to be analyzed, a total of 76,103 women were screened, with 87 interval cancers; the ICR was lower for recommended annual (65/69,650, ICR 0.93/1000, 95% CI: 0.71, 1.16) versus recommended biennial screening (22/6,453, ICR 1.70/1000 (annualized), 95%CI: 0.70, 2.71)(p = 0.0605). Screening program policies of annual as compared with biennial screening in women with dense breasts had the greatest impact on reducing interval cancer rates. We review our results in the context of current dense breast notification in Canada.

show abstract

Interobserver and intraobserver variability in determining breast density according to the fifth edition of the BI-RADS® Atlas

Cited by 5 publications

References 28 publications

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

Feasibility Study and Clinical Impact of Incorporating Breast Tissue Density in High-Risk Breast Cancer Screening Assessment

High-resolution synthesis of high-density breast mammograms: Application to improved fairness in deep learning based mass detection

Breast Density and Risk of Interval Cancers: The Effect of Annual Versus Biennial Screening Mammography Policies in Canada

Contact Info

Product

Resources

About