Variability in Breast Density Estimation and Its Impact on Breast Cancer Risk Assessment.

IF 2.2 4区 医学 Q3 ONCOLOGY Journal of Breast Cancer Pub Date : 2024-10-01 Epub Date: 2024-08-12 DOI:10.4048/jbc.2024.0101
Hye Ji, Myoung-Jin Jang, Jung Min Chang
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Abstract

Breast density is an independent risk factor for breast cancer, although variability exists in measurements. This study sought to evaluate the agreement between radiologists and automated breast density assessment software and assess the impact of breast density measures on breast cancer risk estimates using the Breast Cancer Surveillance Consortium (BCSC) model (v.2). A retrospective database search identified women who had undergone mammography between December 2021 and June 2022. The Breast Imaging Reporting and Data System (BI-RADS) breast composition index assigned by a radiologist (R) was recorded and analyzed using three commercially available software programs (S1, S2, and S3). The agreement rate and Cohen's kappa (κ) were used to evaluate inter-rater agreements concerning breast density measures. The 5-year risk of invasive breast cancer in women was calculated using the BCSC model (v.2) with breast density inputs from various density estimation methods. Absolute differences in risk between various density measurements were evaluated. Overall, 1,949 women (mean age, 53.2 years) were included. The inter-rater agreement between R, S1, and S2 was 75.0-75.6%, while that between S3 and the others was 60.2%-63.3%. Kappa was substantial between R, S1, and S2 (0.66-0.68), and moderate (0.49-0.50) between S3 and the others. S3 placed fewer women in mammographic density d (14.9%) than R, S1, and S2 (40.5%-44.0%). In BCSC risk assessment (v.2), S3 assessed fewer women with a high 5-year risk of invasive breast cancer than the other methods, resulting in an absolute difference of 0% between R, S1, and S2 in 75.0%-75.6% of cases, whereas the difference between S3 and the other methods occurs in 60.2%-63.3% of cases. Breast density assessment using various methods showed moderate-to-substantial agreement, potentially affecting risk assessments. Precise and consistent breast density measurements may lead to personalized and effective strategies for breast cancer prevention.

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乳房密度估算的变异性及其对乳腺癌风险评估的影响。
乳腺密度是乳腺癌的一个独立风险因素,但测量结果存在差异。本研究旨在评估放射医师与自动乳腺密度评估软件之间的一致性,并使用乳腺癌监测联盟(BCSC)模型(v.2)评估乳腺密度测量对乳腺癌风险估计的影响。通过回顾性数据库搜索,确定了在2021年12月至2022年6月期间接受过乳腺X光检查的女性。放射科医生(R)分配的乳腺成像报告和数据系统(BI-RADS)乳腺成分指数被记录下来,并使用三种市售软件程序(S1、S2和S3)进行分析。采用一致率和科恩卡帕(κ)来评估评分者之间在乳腺密度测量方面的一致性。使用 BCSC 模型(v.2)计算妇女患浸润性乳腺癌的 5 年风险,并输入各种密度估算方法得出的乳腺密度。评估了不同密度测量方法之间风险的绝对差异。共纳入了 1,949 名女性(平均年龄 53.2 岁)。R、S1和S2之间的评分者间一致性为75.0%-75.6%,而S3和其他评分者之间的一致性为60.2%-63.3%。R、S1和S2之间的Kappa相当高(0.66-0.68),而S3和其他人之间的Kappa则适中(0.49-0.50)。与 R、S1 和 S2(40.5%-44.0%)相比,S3 将更少的妇女列入乳腺密度 d(14.9%)。在 BCSC 风险评估(v.2)中,S3 评估的 5 年浸润性乳腺癌高风险女性少于其他方法,在 75.0%-75.6% 的病例中,R、S1 和 S2 的绝对差异为 0%,而在 60.2%-63.3% 的病例中,S3 与其他方法的差异出现。使用不同方法进行的乳腺密度评估显示出中等至相当程度的一致性,这可能会影响风险评估。精确而一致的乳腺密度测量可为乳腺癌的预防提供个性化的有效策略。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
Journal of Breast Cancer
Journal of Breast Cancer 医学-肿瘤学
CiteScore
3.80
自引率
4.20%
发文量
43
审稿时长
6-12 weeks
期刊介绍: The Journal of Breast Cancer (abbreviated as ''J Breast Cancer'') is the official journal of the Korean Breast Cancer Society, which is issued quarterly in the last day of March, June, September, and December each year since 1998. All the contents of the Journal is available online at the official journal website (http://ejbc.kr) under open access policy. The journal aims to provide a forum for the academic communication between medical doctors, basic science researchers, and health care professionals to be interested in breast cancer. To get this aim, we publish original investigations, review articles, brief communications including case reports, editorial opinions on the topics of importance to breast cancer, and welcome new research findings and epidemiological studies, especially when they contain a regional data to grab the international reader''s interest. Although the journal is mainly dealing with the issues of breast cancer, rare cases among benign breast diseases or evidence-based scientifically written articles providing useful information for clinical practice can be published as well.
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