Abstract
BackgroundDense breast tissue may not only ‘mask’ small, non-calcified cancers but also represents an independent risk factor for the development of breast cancer. Computer-automated breast density quantification (CABD) software tools have been developed for the calculation of volumetric breast density.ObjectivesThis study sought: (1) to compare observer-based breast density scores, using the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS), with the breast density scores calculated using CABD quantification software tools, (2) to determine inter-reader variability in breast density scoring between qualified radiologists, between radiologists in training (registrars) and between these two groups and (3) to determine intra-reader reliability in breast density scoring.MethodsA cross-sectional study was performed using the data of 100 patients (200 breasts). Three qualified radiologists and three registrars were asked to review the mammograms in question and to assign a breast density score according to the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS) reporting system. Two readings took place at a minimum of 30 days apart. The percentage agreement between the automated and observer-based scores was calculated and intra-reader and inter-reader reliability values were determined.ResultsThe study found that there was poor agreement between the breast densities calculated by CABD and the more subjective observer-based BI-RADS density scores. These results further reflect a statistically significant degree of inter-reader and intra-reader variability in the evaluation of breast density.ConclusionWe conclude that the use of automated breast density quantification (i.e. CABD) is a valuable tool for the reduction of variability in breast density ratings.
Highlights
Mammographic breast density has been the subject of scholarly scrutiny and legal debate for more than 40 years.[1]
Published data suggest that dense breast tissue may ‘mask’ small, non-calcified cancers and represents an independent risk factor for the development of breast cancer
The patients, selected for participation in this study included all asymptomatic female patients who presented for screening mammograms at the Dr George Mukhari Academic Hospital (DGMAH); those symptomatic patients aged 18 years or older who were referred to the DGMAH with the clinical suspicion of breast cancer; and patients who had undergone the standard craniocaudal and mediolateral oblique views
Summary
Mammographic breast density has been the subject of scholarly scrutiny and legal debate for more than 40 years.[1]. Published data suggest that dense breast tissue may ‘mask’ small, non-calcified cancers and represents an independent risk factor for the development of breast cancer. Breast density is assessed by using observer-based scores and qualitative area-based measurements. These methods, are limited in terms of subjectivity, reliability and reproducibility.[4] More recently, computer-automated breast density quantification (CABD) software tools have been introduced for the calculation of volumetric breast density in an attempt to overcome these limitations. Dense breast tissue may ‘mask’ small, non-calcified cancers and represents an independent risk factor for the development of breast cancer. Computerautomated breast density quantification (CABD) software tools have been developed for the calculation of volumetric breast density
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