Comparison of mammographic density assessed as volumes and areas among women undergoing diagnostic image-guided breast biopsy. Gierach, G. L., Geller, B. M., Shepherd, J. A., Patel, D. A., Vacek, P. M., Weaver, D. L., Chicoine, R. E., Pfeiffer, R. M., Fan, B., Mahmoudzadeh, A. P., Wang, J., Johnson, J. M., Herschorn, S. D., Brinton, L. A., & Sherman, M. E. Cancer Epidemiology, Biomarkers & Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology, 23(11):2338–2348, November, 2014.
doi  abstract   bibtex   
BACKGROUND: Mammographic density (MD), the area of non-fatty-appearing tissue divided by total breast area, is a strong breast cancer risk factor. Most MD analyses have used visual categorizations or computer-assisted quantification, which ignore breast thickness. We explored MD volume and area, using a volumetric approach previously validated as predictive of breast cancer risk, in relation to risk factors among women undergoing breast biopsy. METHODS: Among 413 primarily white women, ages 40 to 65 years, undergoing diagnostic breast biopsies between 2007 and 2010 at an academic facility in Vermont, MD volume (cm(3)) was quantified in craniocaudal views of the breast contralateral to the biopsy target using a density phantom, whereas MD area (cm(2)) was measured on the same digital mammograms using thresholding software. Risk factor associations with continuous MD measurements were evaluated using linear regression. RESULTS: Percent MD volume and area were correlated (r = 0.81) and strongly and inversely associated with age, body mass index (BMI), and menopause. Both measures were inversely associated with smoking and positively associated with breast biopsy history. Absolute MD measures were correlated (r = 0.46) and inversely related to age and menopause. Whereas absolute dense area was inversely associated with BMI, absolute dense volume was positively associated. CONCLUSIONS: Volume and area MD measures exhibit some overlap in risk factor associations, but divergence as well, particularly for BMI. IMPACT: Findings suggest that volume and area density measures differ in subsets of women; notably, among obese women, absolute density was higher with volumetric methods, suggesting that breast cancer risk assessments may vary for these techniques.
@article{gierach_comparison_2014,
	title = {Comparison of mammographic density assessed as volumes and areas among women undergoing diagnostic image-guided breast biopsy},
	volume = {23},
	issn = {1538-7755},
	doi = {10.1158/1055-9965.EPI-14-0257},
	abstract = {BACKGROUND: Mammographic density (MD), the area of non-fatty-appearing tissue divided by total breast area, is a strong breast cancer risk factor. Most MD analyses have used visual categorizations or computer-assisted quantification, which ignore breast thickness. We explored MD volume and area, using a volumetric approach previously validated as predictive of breast cancer risk, in relation to risk factors among women undergoing breast biopsy.
METHODS: Among 413 primarily white women, ages 40 to 65 years, undergoing diagnostic breast biopsies between 2007 and 2010 at an academic facility in Vermont, MD volume (cm(3)) was quantified in craniocaudal views of the breast contralateral to the biopsy target using a density phantom, whereas MD area (cm(2)) was measured on the same digital mammograms using thresholding software. Risk factor associations with continuous MD measurements were evaluated using linear regression.
RESULTS: Percent MD volume and area were correlated (r = 0.81) and strongly and inversely associated with age, body mass index (BMI), and menopause. Both measures were inversely associated with smoking and positively associated with breast biopsy history. Absolute MD measures were correlated (r = 0.46) and inversely related to age and menopause. Whereas absolute dense area was inversely associated with BMI, absolute dense volume was positively associated.
CONCLUSIONS: Volume and area MD measures exhibit some overlap in risk factor associations, but divergence as well, particularly for BMI.
IMPACT: Findings suggest that volume and area density measures differ in subsets of women; notably, among obese women, absolute density was higher with volumetric methods, suggesting that breast cancer risk assessments may vary for these techniques.},
	language = {eng},
	number = {11},
	journal = {Cancer Epidemiology, Biomarkers \& Prevention: A Publication of the American Association for Cancer Research, Cosponsored by the American Society of Preventive Oncology},
	author = {Gierach, Gretchen L. and Geller, Berta M. and Shepherd, John A. and Patel, Deesha A. and Vacek, Pamela M. and Weaver, Donald L. and Chicoine, Rachael E. and Pfeiffer, Ruth M. and Fan, Bo and Mahmoudzadeh, Amir Pasha and Wang, Jeff and Johnson, Jason M. and Herschorn, Sally D. and Brinton, Louise A. and Sherman, Mark E.},
	month = nov,
	year = {2014},
	pmid = {25139935},
	pmcid = {PMC4337788},
	keywords = {Age Factors, Aged, Body Mass Index, Breast, Breast Density, Breast Neoplasms, Cross-Sectional Studies, Female, Humans, Image Interpretation, Computer-Assisted, Image-Guided Biopsy, Mammary Glands, Human, Menopause, Middle Aged, Organ Size, Prospective Studies, Radiography, Risk Factors, Smoking},
	pages = {2338--2348}
}
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