Abstract P2-02-05: Sensitivity of screening mammography by density and texture: A cohort study from a population based screening programme in Denmark

Abstract

Abstract Background Screening mammography works better in fatty than in dense breast tissue. Computerized assessment of parenchymal texture is a non-subjective method to obtain a refined description of breast tissue, potentially valuable in addition to breast density scoring for identification of women in need of supplementary imaging. We studied sensitivity of screening mammography by a combination of radiologist assessed BI-RADS density score and computer assessed parenchymal texture marker, MTR, in a population-based screening program, Capital Region, Denmark. Methods Breast density was coded according to the 4th Edition of the BI-RADS density code, and MTR marker was divided into quartiles from 1 to 4. Screening data were followed-up for identification of screen-detected and interval cancers. We calculated sensitivity and specificity with 95% confidence intervals (CI) by BI-RADS density score, MTR marker, and combination hereof. Results In total, 55 350 women were screened from 1 November 2012 to 31 December 2013. Full data were available for 54 997 women, of whom 28% had BI-RADS density score 1, 40% score 2, 27% score 3, and 5% score 4. Density and texture were strongly correlated, but the combination led to identification of subgroups with different sensitivity. Sensitivity was high, about 80%, in women with BI-RADS density scores 1 and MTR markers 1 or 2.Sensitivity was low, 67%, in women with BI-RADS density score 2 and MTR marker 4. For women with BI-RADS density scores 3 and 4, the already low sensitivity was further decreased for women with MTR marker 4. Specificity was 97-99% in all subgroups. Conclusion Our study showed that women with low density constituted a heterogenous group. Classifying women for extra imaging based on density only might be a too crude approach. Screening sensitivity was systematically high in women with fatty and homogeneous breast tissue. Sensitivity and specificity by combination of density score (BI-RADS) and texture marker (MTR), Denmark 2012-13 MeasureSensitivity % (95% CI)Specificity % (95% CI)BI-RADS 178 (69-85)99 (98-99)MTR 181 (70-90)99 (98-99)MTR 271 (54-85)99 (99-99)MTR 382 (48-98)98 (98-99)MTR 4BI-RADS 275 (70-81)97 (97-97)MTR 173 (57-85)98 (97-98)MTR 277 (66-85)97 (97-97)MTR 380 (64-88)97 (97-98)MTR 467 (51-81)97 (97-98)BI-RADS 369 (62-76)97 (97-97)MTR 171 (52-86)97 (96-98)MTR 2MTR 377 (66-87)97 (97-98)MTR 461 (46-72)97 (97-98)BI-RADS 447 (30-65)98 (97-98)MTR 157 (29-82)98 (97-99)MTR 2MTR 3MTR 441 (21-64)97 (97-98) Citation Format: My von Euler-Chelpin. Sensitivity of screening mammography by density and texture: A cohort study from a population based screening programme in Denmark [abstract]. In: Proceedings of the 2019 San Antonio Breast Cancer Symposium; 2019 Dec 10-14; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2020;80(4 Suppl):Abstract nr P2-02-05.