Mammography-based determination of breast density and its implications for breast cancer risk in Saudi Arabia

Abstract

BACKGROUND: Breast cancer is the most commonly diagnosed malignancy in women worldwide. Mammography is the best screening method for the early detection of breast cancer in asymptomatic women; however, its results are associated with high false positive/negative rates. One factor that decreases the sensitivity of mammography-based diagnosis of breast cancer is breast density. This study aimed to identify the association between mammographically determined breast density and breast cancer.METHODS: This single-center retrospective study included 2158 female participants in the Eastern Province of Saudi Arabia who underwent mammography between 2016 and 2018. We evaluated baseline information on breast density and its relationship with breast cancer risk and other factors (age, age at first childbirth, menopause status, and family breast cancer history). Mammogram reports were categorized using the Breast Imaging Reporting and Data System lexicon. RESULTS: The majority (39%) of participants showed scattered fibroglandular density and Breast Imaging Reporting and Data System category 2 (62.5%), while the occurrence of extremely dense breasts was low (4.7%). Breast density was found to be associated with age and menopause status (p < 0.0005). Participants with Breast Imaging Reporting and Data System assessment categories 4 (suspicious for malignancy) and 5 (highly suggestive of malignancy) were associated with elevated breast cancer risk (confirmed by biopsy).CONCLUSION: Breast density was not found to be associated with breast cancer risk in this study. However, the proportion of participants with extremely dense breasts was very low (4.7%). Therefore, further studies are warranted with larger sample sizes including extremely dense breasts.