TY - JOUR
T1 - Breast cancer risk associations with digital mammographic density by pixel brightness threshold and mammographic system
AU - Nguyen, Tuong L.
AU - Choi, Yoon Ho
AU - Aung, Ye K.
AU - Evans, Christopher F.
AU - Trinh, Nhut H.
AU - Li, Shuai
AU - Dite, Gillian S.
AU - Kim, Myeong Seong
AU - Brennan, Patrick C.
AU - Jenkins, Mark A.
AU - Sung, Joohon
AU - Song, Yun Mi
AU - Hopper, John L.
PY - 2018/2
Y1 - 2018/2
N2 - Purpose: To compare three mammographic density measures defined by different pixel intensity thresholds as predictors of breast cancer risk for two different digital mammographic systems. Materials and Methods: The Korean Breast Cancer Study included 398 women with invasive breast cancer and 737 control participants matched for age at mammography (61 year), examination date, mammographic system, and menopausal status. Mammographic density was measured by using the automated Laboratory for Individualized Breast Radiodensity Assessment (LIBRA) software and the semiautomated Cumulus software at the conventional threshold (Cumulus) and at increasingly higher thresholds (Altocumulus and Cirrocumulus, respectively). Measures were Box- Cox-transformed and adjusted for age, body mass index, and menopausal status. Conditional logistic regression was used to estimate risk associations. For calculation of measures of predictive value, the change in odds per standard deviation (OPERA) and the area under the receiver operating characteristic curve (AUC) were used. Results: For dense area, with use of the direct conversion system the OPERAs were 1.72 (95% confidence interval [CI]: 1.38, 2.15) for LIBRA, 1.58 (95% CI: 1.27, 1.97) for Cumulus, 2.04 (95% CI: 1.60, 2.59) for Altocumulus, and 3.48 (95% CI: 2.45, 4.47) for Cirrocumulus (P , .001). The corresponding AUCs were 0.70, 0.69, 0.76, and 0.89, respectively. With use of the indirect conversion system, the corresponding OPERAs were 1.50 (95% CI: 1.28, 1.76), 1.36 (95% CI: 1.16, 1.59), 1.40 (95% CI: 1.19, 1.64), and 1.47 (95% CI: 1.25, 1.73) (P , .001) and the AUCs were 0.64, 0.60, 0.61, and 0.63, respectively. Conclusion: It is possible that mammographic density defined by higher pixel thresholds could capture more risk-predicting information with use of a direct conversion mammographic system; the mammographically bright, rather than white, regions are etiologically important.
AB - Purpose: To compare three mammographic density measures defined by different pixel intensity thresholds as predictors of breast cancer risk for two different digital mammographic systems. Materials and Methods: The Korean Breast Cancer Study included 398 women with invasive breast cancer and 737 control participants matched for age at mammography (61 year), examination date, mammographic system, and menopausal status. Mammographic density was measured by using the automated Laboratory for Individualized Breast Radiodensity Assessment (LIBRA) software and the semiautomated Cumulus software at the conventional threshold (Cumulus) and at increasingly higher thresholds (Altocumulus and Cirrocumulus, respectively). Measures were Box- Cox-transformed and adjusted for age, body mass index, and menopausal status. Conditional logistic regression was used to estimate risk associations. For calculation of measures of predictive value, the change in odds per standard deviation (OPERA) and the area under the receiver operating characteristic curve (AUC) were used. Results: For dense area, with use of the direct conversion system the OPERAs were 1.72 (95% confidence interval [CI]: 1.38, 2.15) for LIBRA, 1.58 (95% CI: 1.27, 1.97) for Cumulus, 2.04 (95% CI: 1.60, 2.59) for Altocumulus, and 3.48 (95% CI: 2.45, 4.47) for Cirrocumulus (P , .001). The corresponding AUCs were 0.70, 0.69, 0.76, and 0.89, respectively. With use of the indirect conversion system, the corresponding OPERAs were 1.50 (95% CI: 1.28, 1.76), 1.36 (95% CI: 1.16, 1.59), 1.40 (95% CI: 1.19, 1.64), and 1.47 (95% CI: 1.25, 1.73) (P , .001) and the AUCs were 0.64, 0.60, 0.61, and 0.63, respectively. Conclusion: It is possible that mammographic density defined by higher pixel thresholds could capture more risk-predicting information with use of a direct conversion mammographic system; the mammographically bright, rather than white, regions are etiologically important.
UR - https://www.scopus.com/pages/publications/85041459922
U2 - 10.1148/radiol.2017170306
DO - 10.1148/radiol.2017170306
M3 - Article
C2 - 29040039
AN - SCOPUS:85041459922
SN - 0033-8419
VL - 286
SP - 433
EP - 442
JO - Radiology
JF - Radiology
IS - 2
ER -
