Aims and objectives
The American College of Radiology’s Breast Imaging Reporting and Data System (BI-RADS) is the predominant method for assessing mammographic density in the clinic.
When this study was conducted,
we were using the 4th Edition of BI-RADS.
This method involves radiologists visually assigning the breasts into one of four categories :
The breast is almost entirely fat (<25% glandular)
There are scattered areas of fibroglandular densities (approximately 25-50% glandular)
The breast is heterogeneously dense,
which could obscure detection of small masses (approximately 51-75% glandular)
Methods and materials
The methods used for this study are outlined in Figure 1.
Eight experienced breast imaging radiologists,
from a single facility,
visually assigned 100 digital screening mammographic studies into one of four BI-RADS breast composition categories.
12 studies comprised women with breast implants and were excluded from the study,
leaving 88 studies in the final analyses.
For each pair of readers (i.e.
the inter-reader agreement was assessed using Cohen’s kappa coefficient (k).
The corresponding raw (for processing) images were processed using fully-automated quantitative software...
The overall visual BI-RADS distributions for each reader and the VDG distributions are shown in Table 1,
without (top panel) and with (bottom panel) the aid of Volpara.
Without the aid of Volpara,
there was considerable variability in the proportion of women assigned into each BI-RADS category.
without the software aid,
the percentage of women assigned as BI-RADS 1,
BI-RADS 3 and BI-RADS 4 ranged from 3.4 – 27.3%,
47.7 – 71.6%,
17.0 – 35.2%,
and 0 -6.8%,
Consistency in the determination of breast density is important for clinical decision-making regarding breast cancer risk assessment and adjunctive imaging in women with dense breasts.
Automated breast density software significantly improved inter-reader agreement of experienced radiologists’ assessment of mammographic breast density,
when using the ACR BI-RADS 4-category classification system.
The effectiveness of any particular software aid in improving the standardization of breast density assessment in the clinic,
on clinicians accepting and familiarizing themselves with objective measurements of breast density.
SIMONE KAHN GRIFF,
RAVINDER SINGH MAHAL,
MATTHEW SAADY M.D.,
MARIA VICTORIA VELASQUEZ,
Boca Raton Regional Hospital,
 American College of Radiology.Breast Imaging Reporting and Data System®(BI-RADS®)4.
Va: American College of Radiology; 2003
 Boyd NF,
Mammographic density and the risk and detection of breast cancer.
 Fujita H,
Muramatsu C (Eds): IWDM 2014,
 Ciatto S,