title: Are Qualitative Assessments of Background Parenchymal Enhancement, Amount of Fibroglandular Tissue on MR Images, and Mammographic Density Associated with Breast Cancer Risk?
abstract: OBJECTIVE
  To investigate whether qualitative magnetic resonance (MR) imaging assessments of background parenchymal enhancement (BPE), amount of fibroglandular tissue (FGT), and mammographic density are associated with risk of developing breast cancer in women who are at high risk.
  
  
  METHODS
  In this institutional review board-approved HIPAA-compliant retrospective study, all screening breast MR images obtained from January 2006 to December 2011 in women aged 18 years or older and at high risk for but without a history of breast cancer were identified. Women in whom breast cancer was diagnosed after index MR imaging comprised the cancer cohort, and one-to-one matching (age and BRCA status) of each woman with breast cancer to a control subject was performed by using MR images obtained in women who did not develop breast cancer with follow-up time maximized. Amount of BPE, BPE pattern (peripheral vs central), amount of FGT at MR imaging, and mammographic density were assessed on index images. Imaging features were compared between cancer and control cohorts by using conditional logistic regression.
  
  
  RESULTS
  Twenty-three women at high risk (mean age, 47 years ± 10 [standard deviation]; six women had BRCA mutations) with no history of breast cancer underwent screening breast MR imaging; in these women, a diagnosis of breast cancer (invasive, n = 12; in situ, n = 11) was made during the follow-up interval. Women with mild, moderate, or marked BPE were nine times more likely to receive a diagnosis of breast cancer during the follow-up interval than were those with minimal BPE (P = .007; odds ratio = 9.0; 95% confidence interval: 1.1, 71.0). BPE pattern, MR imaging amount of FGT, and mammographic density were not significantly different between the cohorts (P = .5, P = .5, and P = .4, respectively).
  
  
  CONCLUSIONS
  Greater BPE was associated with a higher probability of developing breast cancer in women at high risk for cancer and warrants further study.
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Brian N
authors.initials: BN
authors.lastname: Dontchos
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Habib
authors.initials: H
authors.lastname: Rahbar
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Savannah C
authors.initials: SC
authors.lastname: Partridge
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Larissa A
authors.initials: LA
authors.lastname: Korde
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Diana L
authors.initials: DL
authors.lastname: Lam
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: John R
authors.initials: JR
authors.lastname: Scheel
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Sue
authors.initials: S
authors.lastname: Peacock
authors.affiliation: From the Department of Radiology, Breast Imaging Section (B.N.D., H.R., S.C.P., D.L.L., J.R.S., S.P., C.D.L.), and Department of Medicine, Division of Oncology (L.A.K.), University of Washington School of Medicine, Seattle Cancer Care Alliance, 825 Eastlake Ave E, Room G2-600, PO Box 19023, Seattle, WA 98109-1023.
authors.forename: Constance D
authors.initials: CD
authors.lastname: Lehman
mesh_terms: D000328:Adult; D000368:Aged; D001940:Breast / Q000473:pathology*; D000071060:Breast Density; D001943:Breast Neoplasms / Q000453:epidemiology* / Q000473:pathology*; D016022:Case-Control Studies; D005069:Evaluation Studies as Topic; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D042361:Mammary Glands, Human / Q000002:abnormalities*; D008875:Middle Aged; D012189:Retrospective Studies; D012307:Risk Factors