Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study
Abstract Percent mammographic density (PMD) is a strong breast cancer risk factor, however, other mammographic features, such as V, the standard deviation (SD) of pixel intensity, may be associated with risk. We assessed whether PMD, automated PMD (APD), and V, yielded independent associations with...
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doaj-38e65c2a56f14278945713b23d59b86a2021-06-06T11:04:04ZengNature Publishing Groupnpj Breast Cancer2374-46772021-05-01711810.1038/s41523-021-00272-2Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control studyErica T. Warner0Megan S. Rice1Oana A. Zeleznik2Erin E. Fowler3Divya Murthy4Celine M. Vachon5Kimberly A. Bertrand6Bernard A. Rosner7John Heine8Rulla M. Tamimi9Clinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical SchoolClinical and Translational Epidemiology Unit, Department of Medicine, Mongan Institute, Massachusetts General Hospital and Harvard Medical SchoolChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDivision of Population Sciences, H. Lee Moffitt Cancer Center & Research InstituteChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDepartment of Health Sciences Research, Mayo ClinicSlone Epidemiology Center, Boston UniversityChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolDivision of Population Sciences, H. Lee Moffitt Cancer Center & Research InstituteChanning Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital and Harvard Medical SchoolAbstract Percent mammographic density (PMD) is a strong breast cancer risk factor, however, other mammographic features, such as V, the standard deviation (SD) of pixel intensity, may be associated with risk. We assessed whether PMD, automated PMD (APD), and V, yielded independent associations with breast cancer risk. We included 1900 breast cancer cases and 3921 matched controls from the Nurses’ Health Study (NHS) and the NHSII. Using digitized film mammograms, we estimated PMD using a computer-assisted thresholding technique. APD and V were determined using an automated computer algorithm. We used logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs). Median time from mammogram to diagnosis was 4.1 years (interquartile range: 1.6–6.8 years). PMD (OR per SD:1.52, 95% CI: 1.42, 1.63), APD (OR per SD:1.32, 95% CI: 1.24, 1.41), and V (OR per SD:1.32, 95% CI: 1.24, 1.40) were positively associated with breast cancer risk. Associations for APD were attenuated but remained statistically significant after mutual adjustment for PMD or V. Women in the highest quartile of both APD and V (OR vs Q1/Q1: 2.49, 95% CI: 2.02, 3.06), or PMD and V (OR vs Q1/Q1: 3.57, 95% CI: 2.79, 4.58) had increased breast cancer risk. An automated method of PMD assessment is feasible and yields similar, but somewhat weaker, estimates to a manual measure. PMD, APD and V are each independently, positively associated with breast cancer risk. Women with dense breasts and greater texture variation are at the highest relative risk of breast cancer.https://doi.org/10.1038/s41523-021-00272-2 |
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DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Erica T. Warner Megan S. Rice Oana A. Zeleznik Erin E. Fowler Divya Murthy Celine M. Vachon Kimberly A. Bertrand Bernard A. Rosner John Heine Rulla M. Tamimi |
spellingShingle |
Erica T. Warner Megan S. Rice Oana A. Zeleznik Erin E. Fowler Divya Murthy Celine M. Vachon Kimberly A. Bertrand Bernard A. Rosner John Heine Rulla M. Tamimi Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study npj Breast Cancer |
author_facet |
Erica T. Warner Megan S. Rice Oana A. Zeleznik Erin E. Fowler Divya Murthy Celine M. Vachon Kimberly A. Bertrand Bernard A. Rosner John Heine Rulla M. Tamimi |
author_sort |
Erica T. Warner |
title |
Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
title_short |
Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
title_full |
Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
title_fullStr |
Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
title_full_unstemmed |
Automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
title_sort |
automated percent mammographic density, mammographic texture variation, and risk of breast cancer: a nested case-control study |
publisher |
Nature Publishing Group |
series |
npj Breast Cancer |
issn |
2374-4677 |
publishDate |
2021-05-01 |
description |
Abstract Percent mammographic density (PMD) is a strong breast cancer risk factor, however, other mammographic features, such as V, the standard deviation (SD) of pixel intensity, may be associated with risk. We assessed whether PMD, automated PMD (APD), and V, yielded independent associations with breast cancer risk. We included 1900 breast cancer cases and 3921 matched controls from the Nurses’ Health Study (NHS) and the NHSII. Using digitized film mammograms, we estimated PMD using a computer-assisted thresholding technique. APD and V were determined using an automated computer algorithm. We used logistic regression to generate odds ratios (ORs) and 95% confidence intervals (CIs). Median time from mammogram to diagnosis was 4.1 years (interquartile range: 1.6–6.8 years). PMD (OR per SD:1.52, 95% CI: 1.42, 1.63), APD (OR per SD:1.32, 95% CI: 1.24, 1.41), and V (OR per SD:1.32, 95% CI: 1.24, 1.40) were positively associated with breast cancer risk. Associations for APD were attenuated but remained statistically significant after mutual adjustment for PMD or V. Women in the highest quartile of both APD and V (OR vs Q1/Q1: 2.49, 95% CI: 2.02, 3.06), or PMD and V (OR vs Q1/Q1: 3.57, 95% CI: 2.79, 4.58) had increased breast cancer risk. An automated method of PMD assessment is feasible and yields similar, but somewhat weaker, estimates to a manual measure. PMD, APD and V are each independently, positively associated with breast cancer risk. Women with dense breasts and greater texture variation are at the highest relative risk of breast cancer. |
url |
https://doi.org/10.1038/s41523-021-00272-2 |
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