Breast density measured volumetrically in a clinical environment: cross-sectional study with photon counting technology

Breast Cancer Res Treat. 2020 Feb;179(3):755-762. doi: 10.1007/s10549-019-05502-7. Epub 2019 Nov 27.

Abstract

Objective: Mammographic breast density (BDen), the ratio of glandular volume (GVol) to breast volume (BVol), is the second most prevalent risk factor for breast cancer (BC). Newly developed photon counting technology allows precise and systematic measurements in clinical practice. Our objective is to see how these parameters change with age in women with and without cancer.

Materials and methods: This retrospective study analyzed results of BDen, GVol, and BVol in 64,182 mammograms performed with photon counting technology on 32,448 consecutive women from April 2014 to December 2015. Only their first study was included. We excluded women with incomplete data or with breast implants.

Results: Mean age of women without BC diagnosed during the study period was 52.1 ± 9.9. BC and was found in 263 women (0.81%). Mean age was 53.0 ± 10.4. BDen, GVol, and BVol were 14%, 24%, and 2% greater in women with BC (P < 0.001 for BDen and GVol and P = 0.02 for BVol). BDen and GVol diminished following similar patterns across age in both groups, with soft slopes before and after a steep drop from 50 to 60, probably due to menopause.

Conclusion: BDen diminishes with age in women with or without BC, but it is generally higher in women with BC. GVol could be a more robust indicator associated with BC risk than BDen. This technology can ease the way to studies of interventions to diminish BDen (or GVol) in the hope of diminishing BC incidence or predict if longitudinal changes are indicative of impending cancer.

Keywords: Breast cancer; Breast density; Mammography; Photon counting technology; Volumetric.

MeSH terms

  • Absorptiometry, Photon / methods
  • Absorptiometry, Photon / standards
  • Adult
  • Aged
  • Breast Density*
  • Breast Neoplasms / diagnosis*
  • Breast Neoplasms / epidemiology*
  • Breast Neoplasms / therapy
  • Cross-Sectional Studies
  • Data Analysis
  • Female
  • Humans
  • Mammary Glands, Human / diagnostic imaging*
  • Mammary Glands, Human / pathology*
  • Mammography* / methods
  • Middle Aged
  • Retrospective Studies
  • Tumor Burden