Aims and objectives
Breast density or paranchymal pattern of the breast are major risk factors for breast cancer with a four to six-fold increased risk of breast cancer for high-density women [1],
[2].
This increased risk so-exists with a reduction in mammographic sensitivity—the so-called masking effect—besides density being an independent marker of risk.
In recent years personalized screening strategies based on a woman´s risk profile (density profile) have been in focus.
However,
a great number of methodologies for measuring density or parenchymal pattern on mammograms exist.
These methodologies...
Methods and materials
This retrospective nested case-control study included 122 cases and 262 age-matched controls based on all 14,736 women with negative screening mammograms from a population-based screening service in Copenhagen in 2007 (follow-up period 2007-2011).
Use of screening data and tumour-related information was approved by the Danish Data Inspection Agency (2013-41-1604).
Film-based craniocaudal (CC) and mediolateral oblique (MLO) images (right and left) from the screening in 2007 were digitized.
The randomized mammograms were classified independently by two MDs (a senior breast radiologist and a resident in radiology)...
Results
The women were aged between 50 and 69 years (mean age of cases 57.8 (SEM 0.49) and controls 58.1 (SEM 0.34)).
Invasive cancer was diagnosed in 110 women and ductal carcinoma in situ (DCIS) in 12 women.
Substantial to almost perfect inter-observer reproducibility was seen for all three methods both on a multiple and a dichotomous scale (Table 1).
Risk estimates are shown in table 2.
A comparable stepwise increase in risk with increasing density measured by BI-RADS and PMD was seen for both readers....
Conclusion
This is to our knowledge the first study to report inter-observer agreement on the Tabár classification.
Whereas the BI-RADS density classification and the PMD measurements are based on simple quantitative assessment of density,
the Tabár classification is far more intuitive.
However,
we found inter-observer reproducibility on the Tabár classification to be highly comparable with the two other methods.
The Inter-observer concordances we demonstrated are also comparable with previous inter-observer studies reporting kappa values ranging from the extremes of 0.02-0.87 [11]–[15] regarding the BIRADS classification,
and...
References
[1] N.
F.
Boyd,
H.
Guo,
L.
J.
Martin,
L.
Sun,
J.
Stone,
E.
Fishell,
R.
A.
Jong,
G.
Hislop,
A.
Chiarelli,
S.
Minkin,
and M.
J.
Yaffe,
“Mammographic density and the risk and detection of breast cancer,” N.
Engl.
J.
Med.,
vol.
356,
no.
3,
pp.
227–236,
Jan.
2007.
[2] V.
A.
McCormack and I.
dos Santos Silva,
“Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis,” Cancer Epidemiol.
Biomark.
Prev.
Publ.
Am.
Assoc.
Cancer Res.
Cosponsored Am.
Soc.
Prev....