Mammographic texture features associated with contralateral breast cancer in the WECARE Study

Gordon P Watt,Charles F Lynch,Kathleen E Malone,Malcolm C Pike,Christine Lin,Xiaolin Liang,Anne S Reiner,Julia A Knight,John L Hopper,Leslie Bernstein,Tuong L Nguyen,Meghan Woods,Esther M John,Jonine L Bernstein,Jennifer D Brooks

doi:10.1038/s41523-021-00354-1

Abstract

To evaluate whether mammographic texture features were associated with second primary contralateral breast cancer (CBC) risk, we created a “texture risk score” using pre-treatment mammograms in a case–control study of 212 women with CBC and 223 controls with unilateral breast cancer. The texture risk score was associated with CBC (odds per adjusted standard deviation = 1.25, 95% CI 1.01–1.56) after adjustment for mammographic percent density and confounders. These results support the potential of texture features for CBC risk assessment of breast cancer survivors.

Highlights

Breast cancer survivors have a high risk of developing a second primary contralateral breast cancer (CBC), between 2 and 6 times greater than the risk of first primary breast cancer in the general population[1]
The association of CBC with the texture risk score was greater for women with body mass index (BMI) ≥ 25 kg/m2 (1.86, 95% CI 1.23–2.94) compared with women with BMI < 25 kg/ m2 (1.07, 95% CI 0.82–1.40; P-heterogeneity = 0.03) (Table 2)
This study evaluated the association of quantitative mammographic features with CBC risk for breast cancer survivors, whose absolute risk of CBC is high[1]

Summary

MPD only

WECARE Women’s Environment, Cancer, and Radiation Epidemiology Study, BMI body mass index, OPERA odds per age- and BMI-adjusted standard deviation, CI confidence interval, AIC Akaike’s information criterion. a Estimated via logistic regression of case–control status on predictors (texture risk score and/or MPD) expressed as odds per age- and BMI-. AEstimated via logistic regression of case-control status on predictors (texture risk score and mammographic percent density) expressed per as age- and BMI- adjusted standard deviation (OPERA), with additional adjustment (excluding strata variable) for (A) known risk factors for CBC: age at time of diagnosis of first breast cancer (continuous), estrogen receptor status of first breast cancer (Negative/Positive), stage at diagnosis of first breast cancer (I/ II), chemotherapy (Yes/No), hormonal therapy (Yes/No), radiation therapy (Yes/No) for the first breast cancer, menopausal status at time of mammogram (Premenopausal/Postmenopausal), and family history of breast cancer (Yes/No); and (B) matching variables to account for matched recruitment: cancer registry of recruitment, race/ethnicity (non-Hispanic White vs other), and year of diagnosis of first breast cancer (continuous). Mammographic texture features—which are objective and can be generated automatically—are a promising approach to improve risk stratification and tailor surveillance for CBC beginning at the time of the first primary cancer diagnosis

METHODS

Findings

CODE AVAILABILITY