Abstract

BackgroundPreviously, a strong positive association between background parenchymal enhancement (BPE) at magnetic resonance imaging (MRI) and breast cancer was reported in high-risk populations. We sought to determine, whether this was also true for non-high-risk patients.Methods540 consecutive patients underwent breast MRI for assessment of breast findings (BI-RADS 0–5, non-high-risk screening (no familial history of breast cancer, no known genetic mutation, no prior chest irradiation, or previous breast cancer diagnosis)) and subsequent histological work-up. For this IRB-approved study, BPE and fibroglandular tissue FGT were retrospectively assessed by two experienced radiologists according to the BI-RADS lexicon. Pearson correlation coefficients were calculated to explore associations between BPE, FGT, age and final diagnosis of breast cancer. Subsequently, multivariate logistic regression analysis, considering covariate colinearities, was performed, using final diagnosis as the target variable and BPE, FGT and age as covariates.ResultsAge showed a moderate negative correlation with FGT (r = -0.43, p<0.001) and a weak negative correlation with BPE (r = -0.28, p<0.001). FGT and BPE correlated moderately (r = 0.35, p<0.001). Final diagnosis of breast cancer displayed very weak negative correlations with FGT (r = -0.09, p = 0.046) and BPE (r = -0.156, p<0.001) and weak positive correlation with age (r = 0.353, p<0.001). On multivariate logistic regression analysis, the only independent covariate for prediction of breast cancer was age (OR 1.032, p<0.001).ConclusionsBased on our data, neither BPE nor FGT independently correlate with breast cancer risk in non-high-risk patients at MRI. Our model retained only age as an independent risk factor for breast cancer in this setting.

Highlights

  • A strong positive association between background parenchymal enhancement (BPE) at magnetic resonance imaging (MRI) and breast cancer was reported in high-risk populations

  • 540 consecutive patients underwent breast MRI for assessment of breast findings (BIRADS 0–5, non-high-risk screening) and subsequent histological work-up. For this IRB-approved study, BPE and fibroglandular tissue FGT were retrospectively assessed by two experienced radiologists according to the Breast Imaging Reporting and Data System (BI-RADS) lexicon

  • Neither BPE nor FGT independently correlate with breast cancer risk in non-high-risk patients at MRI

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Summary

Introduction

Breast density has evolved to be a major factor in clinical risk assessment of breast tissue in mammography [1,2,3,4,5]. High background parenchymal enhancement (BPE) is considered to correspond to hormonally active glandular tissue while fibroglandular tissue (FGT) values reflect the relative presence of breast parenchymal compared to fatty tissue. The former is sensitive to hormonal changes and is higher in the second part of the menstrual cycle in younger women. BPE is on the other hand largely independent from mammography density values [13,14,15] Both BPE and FGT vary considerably between patients and are currently reported using the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) [16,17,18]. Whether this was true for non-high-risk patients

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