A Comparative Study of Volumetric and Area-Based Breast Density Estimation in Digital Mammography: Results from a Screening Population

Abstract

We compare a volumetric versus an area-based breast density estimation method in digital mammography. Bilateral images from 71 asymptomatic women were analyzed. Volumetric density was measured using Quantra TM (Hologic Inc.). Area-based density was estimated using Cumulus (Ver. 4.0, Univ. Toronto). Correlation and regression analysis was performed to determine the association between i) density from left versus right breasts and ii) volumetric versus the area-based measures. Volumetric breast density measures are strongly correlated but statistically significantly different than the area-based measures (r=0.79, p<0.001). Regression demonstrates a significant non-linear association (R 2=0.70,p<0.001). The density correlation between right and left breasts is also strong for both methods, (r≥0.95, p<0.001). The strong association with the area-based density measures suggests that volumetric breast density could potentially also aid in breast cancer risk estimation. The observed non-linear association between volumetric and area-based estimates may have implications for risk stratification in clinical practice.