title: Volume of mammographic density and risk of breast cancer.
abstract: BACKGROUND
  Assessing the volume of mammographic density might more accurately reflect the amount of breast volume at risk of malignant transformation and provide a stronger indication of risk of breast cancer than methods based on qualitative scores or dense breast area.
  
  
  METHODS
  We prospectively collected mammograms for women undergoing screening mammography. We determined the diagnosis of subsequent invasive or ductal carcinoma in situ for 275 cases, selected 825 controls matched for age, ethnicity, and mammography system, and assessed three measures of breast density: percent dense area, fibroglandular volume, and percent fibroglandular volume.
  
  
  RESULTS
  After adjustment for familial breast cancer history, body mass index, history of breast biopsy, and age at first live birth, the ORs for breast cancer risk in the highest versus lowest measurement quintiles were 2.5 (95% CI: 1.5-4.3) for percent dense area, 2.9 (95% CI: 1.7-4.9) for fibroglandular volume, and 4.1 (95% CI: 2.3-7.2) for percent fibroglandular volume. Net reclassification indexes for density measures plus risk factors versus risk factors alone were 9.6% (P = 0.07) for percent dense area, 21.1% (P = 0.0001) for fibroglandular volume, and 14.8% (P = 0.004) for percent fibroglandular volume. Fibroglandular volume improved the categorical risk classification of 1 in 5 women for both women with and without breast cancer.
  
  
  CONCLUSIONS
  Volumetric measures of breast density are more accurate predictors of breast cancer risk than risk factors alone and than percent dense area.
  
  
  CONCLUSIONS
  Risk models including dense fibroglandular volume may more accurately predict breast cancer risk than current risk models.
authors: Department of Radiology, University of California, San Francisco, CA 94143, USA. john.shepherd@ucsf.edu
authors: John A
authors: JA
authors: Shepherd
authors: Karla
authors: K
authors: Kerlikowske
authors: Lin
authors: L
authors: Ma
authors: Frederick
authors: F
authors: Duewer
authors: Bo
authors: B
authors: Fan
authors: Jeff
authors: J
authors: Wang
authors: Serghei
authors: S
authors: Malkov
authors: Eric
authors: E
authors: Vittinghoff
authors: Steven R
authors: SR
authors: Cummings
references: Cancer Epidemiol Biomarkers Prev. 2005 May;14(5):1052-9
references: 15894652
references: Breast Cancer Res Treat. 2007 Jul;104(1):47-56
references: 17009106
references: Stat Med. 2008 Jan 30;27(2):157-72; discussion 207-12
references: 17569110
references: Med Phys. 2009 Dec;36(12):5525-36
references: 20095265
references: Breast Cancer Res. 2007;9(6):217
references: 18190724
references: Tidsskr Nor Laegeforen. 2003 Dec 4;123(23):3373-6
references: 14713971
references: Technol Cancer Res Treat. 2005 Apr;4(2):173-82
references: 15773786
references: IEEE Trans Med Imaging. 2006 Mar;25(3):273-82
references: 16524084
references: Cancer Epidemiol Biomarkers Prev. 2007 Jan;16(1):43-9
references: 17220330
references: J Natl Cancer Inst. 2006 Sep 6;98(17):1204-14
references: 16954473
references: J Magn Reson Imaging. 1995 Nov-Dec;5(6):695-701
references: 8748488
references: Phys Med Biol. 1994 Oct;39(10):1629-38
references: 15551535
references: Magn Reson Imaging. 2005 May;23(4):591-9
references: 15919606
references: Cancer Epidemiol Biomarkers Prev. 2002 Nov;11(11):1389-93
references: 12433716
references: Lancet Oncol. 2009 Jun;10(6):569-80
references: 19409844
references: Surg Clin North Am. 1999 Oct;79(5):1189-206
references: 10572558
references: J Natl Cancer Inst. 2010 Aug 18;102(16):1224-37
references: 20616353
references: Br J Cancer. 2005 Jun 20;92(12):2102-6
references: 15956963
references: J Natl Cancer Inst. 1995 May 3;87(9):670-5
references: 7752271
references: Radiology. 2009 Jul;252(1):40-9
references: 19420321
references: Ann Intern Med. 2008 Mar 4;148(5):337-47
references: 18316752
references: Stat Med. 1996 Feb 28;15(4):361-87
references: 8668867
references: Med Phys. 2002 Aug;29(8):1867-80
references: 12201434
references: Cancer. 1976 May;37(5):2486-92
references: 1260729
references: Cancer Epidemiol Biomarkers Prev. 2006 Jun;15(6):1159-69
references: 16775176
references: Breast Cancer Res Treat. 2010 Nov;124(2):551-4
references: 20544272
references: Cancer Epidemiol Biomarkers Prev. 2010 Feb;19(2):418-28
references: 20142240
references: Eur J Radiol. 2004 Dec;52(3):276-82
references: 15544906
references: Med Phys. 2003 Mar;30(3):352-64
references: 12674236