Background

Consistency in reporting Breast Imaging Reporting and Data System (BI-RADS) breast density on mammograms is important because breast density is used for breast cancer risk assessment and is reported directly to women and clinicians to inform decisions about supplemental screening.

Purpose

To assess the consistency of BI-RADS density reporting between digital breast tomosynthesis (DBT) and digital mammography (DM) and evaluate density as a breast cancer risk factor when assessed using DM versus DBT.

Materials and Methods

The Breast Cancer Surveillance Consortium is a prospective cohort study of women undergoing mammography with DM or DBT. This secondary analysis included women aged 40–79 years who underwent at least two screening mammography examinations less than 36 months apart. Percentage agreement and κ statistic were estimated for pairs of BI-RADS density assessments. Cox proportional hazards regression was used to calculate hazard ratios (HRs) of breast density as a risk factor for invasive breast cancer.

Results

A total of 403 326 pairs of mammograms from 342 149 women were evaluated. There were no significant differences in breast density assessment in pairs consisting of one DM and one DBT examination (57 516 of 74 729 [77%]; κ = 0.64), two DM examinations (238 678 of 301 743 [79%]; κ = 0.67), and two DBT examinations (20 763 of 26 854 [77%]; κ = 0.65). Results were similar when restricting the analyses to pairs read by the same radiologist. The breast cancer HRs for breast density were similar for DM and DBT (P = .45 for interaction). The HRs for density acquired using DM and DBT, respectively, were 0.55 (95% CI: 0.49, 0.63) and 0.37 (95% CI: 0.21, 0.66) for almost entirely fat, 1.47 (95% CI: 1.37, 1.58) and 1.36 (95% CI: 1.02, 1.82) for heterogeneously dense, and 1.72 (95% CI: 1.54, 1.93) and 2.05 (95% CI: 1.25, 3.36) for extremely dense breasts.

Conclusion

Radiologist reporting of Breast Imaging Reporting and Data System density obtained with digital breast tomosynthesis did not differ from that obtained with digital mammography.

© RSNA, 2021

Online supplemental material is available for this article.

中文翻译：

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比较通过数字乳房断层合成或数字乳房 X 线摄影评估的乳房 X 线密度：乳腺癌监测联盟

背景

乳房成像报告和数据系统 (BI-RADS) 乳房 X 光检查中乳腺密度报告的一致性非常重要，因为乳腺密度用于乳腺癌风险评估，并直接报告给女性和临床医生，为有关补充筛查的决策提供信息。

目的

评估数字乳腺断层合成 (DBT) 和数字乳腺 X 线摄影 (DM) 之间 BI-RADS 密度报告的一致性，并在使用 DM 与 DBT 进行评估时将密度作为乳腺癌危险因素进行评估。

材料和方法

乳腺癌监测联盟是一项针对接受 DM 或 DBT 乳房 X 光检查的女性的前瞻性队列研究。这项二次分析包括年龄在 40-79 岁之间的女性，她们至少接受过两次乳房 X 光检查，间隔时间小于 36 个月。估计成对 BI-RADS 密度评估的百分比一致性和 κ 统计量。Cox 比例风险回归用于计算乳腺密度作为浸润性乳腺癌危险因素的风险比 (HR)。

结果

总共评估了 342 149 名女性的 403 326 对乳房 X 光检查。由一项 DM 和一项 DBT 检查（74 729 例中的 57 516 例 [77%]；κ = 0.64）、两项 DM 检查（301 743 例中的 238 678 例 [79%]；κ = 0.64）组成的对的乳腺密度评估没有显着差异。 = 0.67），以及两次 DBT 检查（26 854 次中的 20 763 次 [77%]；κ = 0.65）。当将分析限制为由同一位放射科医生读取的配对时，结果相似。DM 和 DBT 的乳腺密度乳腺癌 HR 相似（交互作用P = 0.45）。使用 DM 和 DBT 获得的密度的 HR 分别为 0.55 (95% CI: 0.49, 0.63) 和 0.37 (95% CI: 0.21, 0.66)（几乎完全是脂肪），1.47（95% CI: 1.37, 1.58）和对于不均匀致密的乳房，该值为 1.36（95% CI：1.02、1.82）；对于极其致密的乳房，该值为 1.72（95% CI：1.54、1.93）和 2.05（95% CI：1.25、3.36）。

结论

放射科医生对通过数字乳房断层合成获得的乳房成像报告和数据系统密度的报告与通过数字乳房X线照相术获得的没有不同。

© 北美放射学会，2021

本文提供在线补充材料。