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Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark

BACKGROUND: Screening mammography works better in fatty than in dense breast tissue. Computerized assessment of parenchymal texture is a non-subjective method to obtain a refined description of breast tissue, potentially valuable in addition to breast density scoring for the identification of women...

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Autores principales: von Euler-Chelpin, My, Lillholm, Martin, Vejborg, Ilse, Nielsen, Mads, Lynge, Elsebeth
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796411/
https://www.ncbi.nlm.nih.gov/pubmed/31623646
http://dx.doi.org/10.1186/s13058-019-1203-3
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author von Euler-Chelpin, My
Lillholm, Martin
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
author_facet von Euler-Chelpin, My
Lillholm, Martin
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
author_sort von Euler-Chelpin, My
collection PubMed
description BACKGROUND: Screening mammography works better in fatty than in dense breast tissue. Computerized assessment of parenchymal texture is a non-subjective method to obtain a refined description of breast tissue, potentially valuable in addition to breast density scoring for the identification of women in need of supplementary imaging. We studied the sensitivity of screening mammography by a combination of radiologist-assessed Breast Imaging Reporting and Data System (BI-RADS) density score and computer-assessed parenchymal texture marker, mammography texture resemblance (MTR), in a population-based screening program. METHODS: Breast density was coded according to the fourth edition of the BI-RADS density code, and MTR marker was divided into quartiles from 1 to 4. Screening data were followed up for the identification of screen-detected and interval cancers. We calculated sensitivity and specificity with 95% confidence intervals (CI) by BI-RADS density score, MTR marker, and combination hereof. RESULTS: Density and texture were strongly correlated, but the combination led to the identification of subgroups with different sensitivity. Sensitivity was high, about 80%, in women with BI-RADS density score 1 and MTR markers 1 or 2. Sensitivity was low, 67%, in women with BI-RADS density score 2 and MTR marker 4. For women with BI-RADS density scores 3 and 4, the already low sensitivity was further decreased for women with MTR marker 4. Specificity was 97–99% in all subgroups. CONCLUSION: Our study showed that women with low density constituted a heterogenous group. Classifying women for extra imaging based on density only might be a too crude approach. Screening sensitivity was systematically high in women with fatty and homogenous breast tissue.
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spelling pubmed-67964112019-10-21 Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark von Euler-Chelpin, My Lillholm, Martin Vejborg, Ilse Nielsen, Mads Lynge, Elsebeth Breast Cancer Res Research Article BACKGROUND: Screening mammography works better in fatty than in dense breast tissue. Computerized assessment of parenchymal texture is a non-subjective method to obtain a refined description of breast tissue, potentially valuable in addition to breast density scoring for the identification of women in need of supplementary imaging. We studied the sensitivity of screening mammography by a combination of radiologist-assessed Breast Imaging Reporting and Data System (BI-RADS) density score and computer-assessed parenchymal texture marker, mammography texture resemblance (MTR), in a population-based screening program. METHODS: Breast density was coded according to the fourth edition of the BI-RADS density code, and MTR marker was divided into quartiles from 1 to 4. Screening data were followed up for the identification of screen-detected and interval cancers. We calculated sensitivity and specificity with 95% confidence intervals (CI) by BI-RADS density score, MTR marker, and combination hereof. RESULTS: Density and texture were strongly correlated, but the combination led to the identification of subgroups with different sensitivity. Sensitivity was high, about 80%, in women with BI-RADS density score 1 and MTR markers 1 or 2. Sensitivity was low, 67%, in women with BI-RADS density score 2 and MTR marker 4. For women with BI-RADS density scores 3 and 4, the already low sensitivity was further decreased for women with MTR marker 4. Specificity was 97–99% in all subgroups. CONCLUSION: Our study showed that women with low density constituted a heterogenous group. Classifying women for extra imaging based on density only might be a too crude approach. Screening sensitivity was systematically high in women with fatty and homogenous breast tissue. BioMed Central 2019-10-17 2019 /pmc/articles/PMC6796411/ /pubmed/31623646 http://dx.doi.org/10.1186/s13058-019-1203-3 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
von Euler-Chelpin, My
Lillholm, Martin
Vejborg, Ilse
Nielsen, Mads
Lynge, Elsebeth
Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title_full Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title_fullStr Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title_full_unstemmed Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title_short Sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in Denmark
title_sort sensitivity of screening mammography by density and texture: a cohort study from a population-based screening program in denmark
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6796411/
https://www.ncbi.nlm.nih.gov/pubmed/31623646
http://dx.doi.org/10.1186/s13058-019-1203-3
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