title: Variability of breast density assessment in short-term reimaging with digital mammography.
abstract: OBJECTIVE
  To evaluate the variability of breast density assessments in short-term reimaging with digital mammography.
  
  
  METHODS
  In 186 women, short term (mean interval, 27.6 days) serial digital mammograms including CC and MLO views were obtained without any treatment. Mammographic density assessments were performed by three blinded radiologists for Breast Imaging Report and Data System (BI-RADS, grades 1-4) and visual percentage density (PD) estimation, and by one radiologist for computer-aided PD estimation. The variability of assessments was analyzed according to the age, breast density, and mammography types by multivariate logistic regression.
  
  
  RESULTS
  In BI-RADS assessments, 29% (161 of 558) of breast density categories were assessed differently after short-term reimaging and the mean absolute difference in PD for CC and MLO view was 7.6% and 8.1% for visual assessments, and 7.4% and 6.4% for computer-aided assessments, respectively. Among all computer-aided assessments, 29% (54 of 186) of CC view and 22% (41 of 186) of MLO view assessments had discrepancy over 10% in PD. Younger age (<50), greater breast density (grades 3 and 4), and different mammography types were significantly associated with the variability.
  
  
  CONCLUSIONS
  Considerable variability in breast density assessments occurred in short-term reimaging with digital mammography, particularly in women with younger age and greater breast density and when examined using different types of mammography.
authors.affiliation: Department of Radiology, Seoul National University Hospital, Seoul, Republic of Korea.
authors.forename: Won Hwa
authors.initials: WH
authors.lastname: Kim
authors.forename: Woo Kyung
authors.initials: WK
authors.lastname: Moon
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Kim
authors.forename: Ann
authors.initials: A
authors.lastname: Yi
authors.forename: Jung Min
authors.initials: JM
authors.lastname: Chang
authors.forename: Hye Ryoung
authors.initials: HR
authors.lastname: Koo
authors.forename: Su Hyun
authors.initials: SH
authors.lastname: Lee
authors.forename: Nariya
authors.initials: N
authors.lastname: Cho
mesh_terms: D015502:Absorptiometry, Photon / Q000379:methods*; D000328:Adult; D000368:Aged; D000375:Aging; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000503:physiopathology*; D055088:Early Detection of Cancer / Q000379:methods*; D005260:Female; D006801:Humans; D008327:Mammography / Q000379:methods*; D008875:Middle Aged; D015588:Observer Variation; D011856:Radiographic Image Enhancement / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
keywords: Breast; Breast density; Mammography/methods; Mammography/utilization; Reproducibility of results