Mammographic signs of potential relevance to breast cancer risk: the agreement of radiologistsʼ classification

Jong, Roland; Fishell, Eve; Little, Laurie; Lockwood, G.R.; Boyd, N F

doi:10.1097/00008469-199608000-00008

Cited by 21 publications

(16 citation statements)

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“…Other methods used to visually estimate percent density, using six categories of percent density, have previously shown moderate to high inter-(ICCs ranging from 0.68 to 0.89) and intrarater reliabilities (ICCs ranging from 0.73 to 0.96), [38][39][40][41] and high inter-(ICC = 0.94) and intrarater reliabilities (ICC = 0.96) using 21 categories. 42 Consistent with the intrarater reliability estimates we observed for sound speed measures, mammographic breast density assessment using quantitative computer-assisted interactive thresholding methods has also yielded high intrarater reliability (correlation coefficients ranging from 0.82 to 0.94).…”

Section: Discussionmentioning

confidence: 99%

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density

et al. 2015

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Purpose: High breast density, as measured by mammography, is associated with increased breast cancer risk, but standard methods of assessment have limitations including 2D representation of breast tissue, distortion due to breast compression, and use of ionizing radiation. Ultrasound tomography (UST) is a novel imaging method that averts these limitations and uses sound speed measures rather than x-ray imaging to estimate breast density. The authors evaluated the reproducibility of measures of speed of sound and changes in this parameter using UST. Methods: One experienced and five newly trained raters measured sound speed in serial UST scans for 22 women (two scans per person) to assess inter-rater reliability. Intrarater reliability was assessed for four raters. A random effects model was used to calculate the percent variation in sound speed and change in sound speed attributable to subject, scan, rater, and repeat reads. The authors estimated the intraclass correlation coefficients (ICCs) for these measures based on data from the authors' experienced rater. Results: Median (range) time between baseline and follow-up UST scans was five (1-13) months. Contributions of factors to sound speed variance were differences between subjects (86.0%), baseline versus follow-up scans (7.5%), inter-rater evaluations (1.1%), and intrarater reproducibility (∼0%). When evaluating change in sound speed between scans, 2.7% and ∼0% of variation were attributed to inter-and intrarater variation, respectively. For the experienced rater's repeat reads, agreement for sound speed was excellent (ICC = 93.4%) and for change in sound speed substantial (ICC = 70.4%), indicating very good reproducibility of these measures. Conclusions: UST provided highly reproducible sound speed measurements, which reflect breast density, suggesting that UST has utility in sensitively assessing change in density. C 2015 American Association of Physicists in Medicine. [http://dx

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Section: Discussionmentioning

confidence: 99%

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density

et al. 2015

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“…The study was construed before the widespread use of digital mammograms and did not mandate uniform mammographic technique. As such, a small number of films (25) were either copies of plain films or printed digital films, and 11 cases were mixed, in that subjects did not have mammograms of uniform technique at each time point. This may have led to inaccurate density measurements, or to inaccurate intrasubject comparisons of density, as computer-assisted percent density readings may vary according to mammographic technique.…”

Section: Discussionmentioning

confidence: 99%

“…To confirm eligibility (screening assessment), baseline mammographic density was assessed by a trained physician and scored into one of six categories of density (0%, \10%, 10 to \25%, 25 to \50%, 50 to \75%, and C75%) that have been used in previous work [1,25]. Once enrolled in the study, mammographic percent density, including that of baseline mammogram, was assessed by a computerassisted method with Cumulus 5 software.…”

Section: Assessment Of Mammographic Densitymentioning

confidence: 99%

A randomized, placebo-controlled trial (NCIC CTG MAP1) examining the effects of letrozole on mammographic breast density and other end organs in postmenopausal women

Cigler

Yaffe

et al. 2009

Breast Cancer Res Treat

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Mammographically detected breast density has been correlated with breast cancer risk. Breast density appears to be influenced by hormonal factors including increasing age, postmenopausal status, number of pregnancies, lower body weight, hormone replacement therapy, and tamoxifen therapy. The aromatase inhibitor letrozole profoundly reduces breast and circulating estrogen levels in postmenopausal women. We hypothesize that letrozole may reduce breast density and report here on its effects on mammographic breast density, bone mineral density (BMD), bone biomarkers, plasma hormone, and serum lipid levels. MAP1 was a multicenter, randomized, double-blind, placebo-controlled, feasibility trial in which postmenopausal women with or without prior invasive breast cancer were randomized in a 2:1 ratio of letrozole (2.5 mg daily) or placebo for 12 months and followed for a total of 24 months. Eligible women had an estimated >25% breast density on baseline mammogram. The primary endpoint was change in percent breast density (PD) between the baseline and 12-month mammograms as estimated by a computer-assisted thresholding program. Baseline and 12-month mammographic density was also assessed in a blinded manner by visual inspection. Secondary endpoints included changes in serum hormones, plasma lipid levels, bone biomarkers, and BMD. Data are available for 67 women (44 on letrozole and 23 on placebo). No significant changes in PD were noted between the treatment arms at either 12 or 24 months. No distinguishable difference in density measurements by visual inspection were noted between baseline and 12-month mammograms. A significant decrease in percentage change in T-score of the femoral neck at 12 months was noted in the letrozole arm without other significant changes in BMD parameters. Lipid values did not differ between treatment groups except for a borderline significant decrease in total cholesterol at 3 months among women treated with letrozole. Letrozole therapy was associated with a significant reduction in mean serum estradiol, estrone, and estrone sulfate levels at 12 months, but not at 24 months. A significant increase in serum IGF-1 levels was also noted in the letrozole group compared to the placebo group at both 12 and 24 months. To conclude, compared with placebo, 12 months of letrozole therapy does not appear to have a significant effect on mammographic PD. Twelve months of letrozole was associated with a decrease of uncertain clinical significance in the T-score of the femoral neck at 12 months which was reversible at 24 months with recovery of estrogen levels. Letrozole therapy was found to increase IGF-1 levels at 12 and 24 months.

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“…In order to confirm eligibility (screening assessment), baseline mammographic density was assessed by a trained physician and scored into one of six categories of density according to the Boyd scale [grade 1 (0%), grade 2 (\10%), grade 3 (10 to \25%), grade 4 (25 to \50%), grade 5 (50 to\75%), and grade 6 (C75%)] that have been used in previous work [3,33]. Once enrolled in the study, mammographic percent density, including that of the baseline mammogram, was assessed by a computer-assisted method.…”

Section: Assessment Of Mammographic Densitymentioning

confidence: 99%

A randomized, placebo-controlled trial (NCIC CTG MAP.2) examining the effects of exemestane on mammographic breast density, bone density, markers of bone metabolism and serum lipid levels in postmenopausal women

Cigler

Richardson²,

Yaffe

et al. 2011

Breast Cancer Res Treat

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We hypothesized that exemestane (EXE) would reduce mammographic breast density and have unique effects on biomarkers of bone and lipid metabolism. Healthy postmenopausal women were randomized to EXE (25 mg daily) or placebo (PLAC) for 12 months and followed for a total of 24 months. The primary endpoint was change in percent breast density (PD) between the baseline and 12-month mammograms and secondary endpoints were changes in serum lipid levels, bone biomarkers, and bone mineral density (BMD). Ninety-eight women were randomized (49 to EXE; 49 to PLAC) and 65 had PD data at baseline and 12 months. Among women treated with EXE, PD was not significantly changed from baseline at 6, 12, or 24 months and was not different from PLAC. EXE was associated with significant percentage increase from baseline in N-telopeptide at 12 months compared with PLAC. No differences in percent change from baseline in BMD (lumbar spine and femoral neck) were observed between EXE and PLAC at either 12 or 24 months. Patients on EXE had a significantly larger percent decrease in total cholesterol than in the PLAC arm at 6 months and in HDL cholesterol at 3, 6, and 12 months. No significant differences in percent change in LDL or triglycerides were noted at any time point between the two treatment arms. EXE administered for 1 year to healthy postmenopausal women did not result in significant changes in mammographic density. A reversible increase in the bone resorption marker N-telopeptide without significant change in bone specific alkaline phosphatase or BMD during the 12 months treatment period and 1 year later was noted. Changes in lipid parameters on this trial were modest and reversible.

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Mammographic signs of potential relevance to breast cancer risk: the agreement of radiologistsʼ classification

Cited by 21 publications

References 0 publications

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density

Determinants of the reliability of ultrasound tomography sound speed estimates as a surrogate for volumetric breast density

A randomized, placebo-controlled trial (NCIC CTG MAP1) examining the effects of letrozole on mammographic breast density and other end organs in postmenopausal women

A randomized, placebo-controlled trial (NCIC CTG MAP.2) examining the effects of exemestane on mammographic breast density, bone density, markers of bone metabolism and serum lipid levels in postmenopausal women

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