Wolfe mammographic parenchymal patterns. A study of the masking hypothesis of Egan and Mosteller

Whitehead, John; Carlile, Thomas; Kopecky, Kenneth J.; Thompson, Donovan J.; Gilbert, Fred I.; Present, Arthur J.; Threatt, Barbara; Krook, P M; Hadaway, Evelyn

doi:10.1002/1097-0142(19850915)56:6<1280::aid-cncr2820560610>3.0.co;2-8

Cited by 58 publications

(24 citation statements)

References 7 publications

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“…A further 19 studies were excluded from the main analysis, as they were not independent of other included studies (studies; refs. [8][9][10][11][12][13][14] as well as 12 studies from Breast Cancer Detection and Demonstration Project centers (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26) that were likely to have been subsets of two studies that included cases from all or most centers (2, 27), although they were considered in subgroup analyses. Four articles were found manually (28-31), giving a total of 42 included articles for the main analysis.…”

Section: Resultsmentioning

confidence: 99%

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

McCormack

dos‐Santos‐Silva

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

1,856

1,458

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Mammographic features are associated with breast cancer risk, but estimates of the strength of the association vary markedly between studies, and it is uncertain whether the association is modified by other risk factors. We conducted a systematic review and meta-analysis of publications on mammographic patterns in relation to breast cancer risk. Random effects models were used to combine study-specific relative risks. Aggregate data for >14,000 cases and 226,000 noncases from 42 studies were included. Associations were consistent in studies conducted in the general population but were highly heterogeneous in symptomatic populations. They were much stronger for percentage density than for Wolfe grade or Breast Imaging Reporting and Data System classification and were 20% to 30% stronger in studies of incident than of prevalent cancer. No differences were observed by age/menopausal status at mammography or by ethnicity. For percentage density measured using prediagnostic mammograms, combined relative risks of incident breast cancer in the general population were 1.79 (95% confidence interval, 1.48-2.16), 2.11 (1.70-2.63), 2.92 (2.49-3.42), and 4.64 (3.64-5.91) for categories 5% to 24%, 25% to 49%, 50% to 74%, and z75% relative to <5%. This association remained strong after excluding cancers diagnosed in the first-year postmammography. This review explains some of the heterogeneity in associations of breast density with breast cancer risk and shows that, in well-conducted studies, this is one of the strongest risk factors for breast cancer. It also refutes the suggestion that the association is an artifact of masking bias or that it is only present in a restricted age range. (Cancer Epidemiol Biomarkers Prev 2006;15(6):1159-69)

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Section: Resultsmentioning

confidence: 99%

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

McCormack

dos‐Santos‐Silva

2006

Cancer Epidemiology, Biomarkers &Amp; Prevention

1,856

1,458

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“…25 According to the "masking hypothesis" 14 , at the prevalent screening examination a higher proportion of tumours would be detected in the N1 and P1 breasts than in the dense P2 and DY breasts. This is because tumours in dense P2 and DY breasts may be masked by radiographic densities.…”

Section: Discussionmentioning

confidence: 99%

Mammographic parenchymal patterns and mode of detection: implications for the breast screening programme

Sala¹,

Warren

McCann³

et al. 1998

J Med Screen

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Objectives-To assess the eVects of mammographic parenchymal patterns on the risk of breast cancer detected at first screen, second screen, and in the interval between these two screens. Settings-A nested case-control study within a screening cohort in East Anglia was designed. The study group comprised 502 patients with cancer at the prevalence screening round, 198 patients with interval cancer, and 175 with cancer at the first incidence screen. These patients were matched with 2601 controls. Methods-The mammographic parenchymal patterns of breast tissue were assessed according to Wolfe's classification. Statistical analysis was by conditional logistic regression. Results-Overall, 67% of patients and 59% of controls were considered to have high risk pattern (P2+DY) mammogram. The risk associated with P2 or DY mammographic patterns compared with N1 was higher for interval cancers (odds ratios (ORs) 2.2 and 2.4 respectively) than for screen detected cancers (ORs 1.7 and 1.1 respectively). For interval cancers in the first 18 months after the last negative mammogram, the risk was particularly high (ORs 3.8 for P2 and 4.1 for DY compared with N1). The high risk associated with P2 and DY patterns was concentrated on invasive ductal grade III cancers (ORs 2.7 and 3.8) rather than grade I or II cancers (ORs 1.6 and 1.2). Conclusions-The study strongly suggests that screening eVectiveness is reduced for high risk parenchymal patterns which are associated with high grade cancers. Changes should aim at improving screening sensitivity for dense parenchymal patterns, and the diagnosis of high grade tumours. (J Med Screen 1998;5:207-212)

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“…A strong association between breast cancer risk and the appearance of the BP measured at mammography, and more recently, at MR imaging, has been demonstrated (6)(7)(8)(9)(10)(11)(12) …”

Section: Patient Selectionmentioning

confidence: 99%

“…Informed mammographic density, a reflection of both stromal and epithelial tissues (vs fat), is associated with a nearly five-fold increased risk of developing breast cancer (6,7). The combined effect of BP density and physiologic BP enhancement may increase the difficulty of detecting breast cancer on MR images, particularly for premenopausal women for whom both breast density and BP enhancement are higher (6,(8)(9)(10)12).…”

Section: Patient Selectionmentioning

confidence: 99%

Evaluation of the Kinetic Properties of Background Parenchymal Enhancement throughout the Phases of the Menstrual Cycle

Amarosa¹,

McKellop²,

Leite³

et al. 2013

Radiology

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Purpose:To develop and apply a semiautomatic method of segmenting fibroglandular tissue to quantify magnetic resonance (MR) imaging contrast material-enhancement kinetics of breast background parenchyma (BP) and lesions throughout the phases of the menstrual cycle in women with benign and malignant lesions. Materials and Methods:The institutional review board approved this retrospective HIPAA-compliant study, and informed consent was waived. From December 2008 to August 2011, 58 premenopausal women who had undergone contrast materialenhanced MR imaging and MR imaging-guided biopsy were identified. The longest time from the start of the last known period was 34 days. One lesion per patient (37 benign and 21 malignant) was analyzed. The patient groups were stratified according to the week of the menstrual cycle when MR imaging was performed. A method based on principal component analysis (PCA) was applied for quantitative analysis of signal enhancement in the BP and lesions by using the percentage of slope and percentage of enhancement. Linear regression and the Mann-Whitney U test were used to assess the association between the kinetic parameters and the week of the menstrual cycle. Results:In the women with benign lesions, percentages of slope and enhancement for both BP and lesions during week 2 were significantly (P , .05) lower than those in week 4. Percentage of enhancement in the lesion in week 2 was lower than that in week 3 (P , .05). The MR images of women with malignant lesions showed no significant difference between the weeks for any of the parameters. There was a strong positive correlation between lesion and BP percentage of slope (r = 0.72) and between lesion and BP percentage of enhancement (r = 0.67) in the benign group. There was also a significant (P = .03) difference in lesion percentage of slope between the benign and malignant groups at week 2. Conclusion:The PCA-based method can quantify contrast enhancement kinetics of BP semiautomatically, and kinetics of BP and lesions vary according to the week of the menstrual cycle in benign but not in malignant lesions.q RSNA, 2013

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Wolfe mammographic parenchymal patterns. A study of the masking hypothesis of Egan and Mosteller

Cited by 58 publications

References 7 publications

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

Breast Density and Parenchymal Patterns as Markers of Breast Cancer Risk: A Meta-analysis

Mammographic parenchymal patterns and mode of detection: implications for the breast screening programme

Evaluation of the Kinetic Properties of Background Parenchymal Enhancement throughout the Phases of the Menstrual Cycle

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