Mammographic Breast Density: Comparison Across Women with Conclusive and Inconclusive Mammography Reports

Ernest U Ekpo; Nneoyi Onen Egbe; Akwa E Egom; Mark F McEntee

doi:10.1016/j.jmir.2015.10.008

Mammographic Breast Density: Comparison Across Women with Conclusive and Inconclusive Mammography Reports

J Med Imaging Radiat Sci. 2016 Mar;47(1):55-59. doi: 10.1016/j.jmir.2015.10.008. Epub 2015 Nov 28.

Authors

Ernest U Ekpo¹, Nneoyi Onen Egbe², Akwa E Egom², Mark F McEntee³

Affiliations

¹ Department of Radiography and Radiology, Faculty of Health Sciences, University of Calabar, Calabar, Nigeria; Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia. Electronic address: eekp9437@uni.sydney.edu.au.
² Department of Radiography and Radiology, Faculty of Health Sciences, University of Calabar, Calabar, Nigeria.
³ Discipline of Medical Radiation Sciences, Faculty of Health Sciences, University of Sydney, Lidcombe, NSW, Australia.

PMID: 31047165
DOI: 10.1016/j.jmir.2015.10.008

Abstract

Aims: To compare breast density (BD) across women with conclusive and inconclusive reports to establish whether BD impacts decisions to recall patients in Nigeria.

Methods: A total of 653 mammograms with associated radiologists' reports were retrieved from mammography archives across Nigeria. Ultrasound and biopsy results of cases reported as inconclusive and referred for additional examination were examined. Data were divided into two groups based on radiologists' reports (conclusive, 1 and inconclusive, 2). Each group was subgrouped into A-B and C-D, representing cases with low- and high-mammographic BD, respectively. A Mann-Whitney U test was used to compare breast densities (A-B vs. C-D) in subjects with conclusive and inconclusive mammographic reports.

Result: About 75.4% (n = 492) of mammograms had a conclusive report and comprised negative (n = 216), benign (n = 208), and equivocal to highly suggestive of malignancy (n = 68). A total of 161 cases had inconclusive reports, of which, 103 demonstrated high mammographic BD (C-D). Low BD (A-B) was significantly higher in subjects with conclusive mammography reports (mean = 0.88 ± 0.36) compared with high BD (z-score = 4.5; P = .0001). High BD (C-D) was significantly higher in subjects with inconclusive reports (mean = 0.64 ± 0.48) compared with low BD (z-score = 5.2; P = .005).

Conclusion: Findings demonstrate that high mammographic BD impact on radiologists' inconclusive decisions in Nigeria, suggesting a need to explore avenues to improve reader efficiency.

Keywords: Breast density; Nigeria; biopsy; breast lesions; mammography recall; ultrasound.