Correlation of Mammographic Breast Density (MD) And Background Parenchymal Enhancement (BPE) With Various Factors Especially Receptor Status In Pakistani Population.
DOI:
https://doi.org/10.48111/2021.02.03Keywords:
MRI, Radiology, Breast Cancer, Mammographic Breast Density, Background Parenchymal EnhancementAbstract
Importance:
Breast is one of the most common causes of malignancy-related mortality all over the world accounting for more than 5 million deaths per year. Mammographic dense breast tissue is one of the most common problems in diagnosing breast CA in females. It increases the risk of breast CA up to five times and is also associated with larger tumor size, axillary lymph node involvement, higher stage of tumor owing to delay in the diagnosis.
Background parenchymal enhancement is seen on MRI breast after administration of contrast. The level of BPE is variable among different age groups being higher in young women. It is affected by several factors including age, hormone levels, menstrual cycle phase.
Objective:
This study was done to investigate the correlation between mammographic breast density (MGD) and background parenchymal enhancement (BPE) at breast MRI with receptor status in our population.
Materials and methods:
It is a retrospective study conducted at the women imaging department of Shaukat Khanum memorial cancer hospital from January 2013 till January 2019
All the newly diagnosed breast cancer patients age 20 to 70 years, with dense mammograms who underwent MR imaging prior to treatment will be included. The MR imaging detection rate of additional malignant cancers occult to mammography and ultrasound will be calculated. Data will be analyzed according to the following parameters: histopathological features of the index tumor and mammographic density. The histopathological examination will be taken as the gold standard. The data will be compiled and analyzed using SPSS
Conclusion:
High mammographic density and increased BPE are independent risk factors for the development of breast cancer. Exposure to hormones influences the BPE grade and thus is associated with increased risk of breast CA with a positive correlation between increased MGD and high BPE with both estrogen and progesterone receptors.
Keywords: Background parenchymal enhancement (BPE) mammographic density (MD), MRI, Breast cancer (CA)
References
Torre LA, Siegel RL, Ward EM, Jemal A. Global Cancer Incidence and Mortality Rates and Trends--An Update. Cancer Epidemiol Biomarkers Prev. 2016;25(1):16-27. doi:10.1158/1055-9965.EPI-15-0578
Sprague BL, Gangnon RE, Burt V, et al. Prevalence of mammographically dense breasts in the United States. J Natl Cancer Inst. 2014;106(10):dju255. Published 2014 Sep 12. doi:10.1093/jnci/dju255
Pettersson A, Graff RE, Ursin G, et al. Mammographic density phenotypes and risk of breast cancer: a meta-analysis. J Natl Cancer Inst. 2014;106(5):dju078. Published 2014 May 10. doi:10.1093/jnci/dju078
Aiello EJ, Buist DS, White E, Porter PL. Association between mammographic breast density and breast cancer tumor characteristics. Cancer Epidemiol Biomarkers Prev. 2005;14(3):662-668. doi:10.1158/1055-9965.EPI-04-0327
Balleyguier C, Ayadi S, Van Nguyen K, Vanel D, Dromain C, Sigal R. BIRADS classification in mammography. Eur J Radiol. 2007;61(2):192-194. doi:10.1016/j.ejrad.2006.08.033
Boyd NF, Byng JW, Jong RA, et al. Quantitative classification of mammographic densities and breast cancer risk: results from the Canadian National Breast Screening Study. J Natl Cancer Inst. 1995;87(9):670-675. doi:10.1093/jnci/87.9.670
Giess CS, Yeh ED, Raza S, Birdwell RL. Background parenchymal enhancement at breast MR imaging: normal patterns, diagnostic challenges, and potential for false-positive and false-negative interpretation. Radiographics. 2014;34(1):234-247. doi:10.1148/rg.341135034
Chen S, Parmigiani G. Meta-analysis of BRCA1 and BRCA2 penetrance. J Clin Oncol. 2007;25(11):1329-1333. doi:10.1200/JCO.2006.09.1066
King V, Brooks JD, Bernstein JL, Reiner AS, Pike MC, Morris EA. Background parenchymal enhancement at breast MR imaging and breast cancer risk. Radiology. 2011;260(1):50-60. doi:10.1148/radiol.11102156
Sickles, EA, D’Orsi CJ, Bassett LW, et al. ACR BI-RADS® Mammography. In: ACR BI-RADS® Atlas, Breast Imaging Reporting and Data System. Reston, VA, American College of Radiology; 2013.
Eriksson L, Czene K, Rosenberg L, Humphreys K, Hall P. Possible influence of mammographic density on local and locoregional recurrence of breast cancer. Breast Cancer Res. 2013;15(4):R56. doi:10.1186/bcr3450
Cecchini, Reena S., et al. "Baseline mammographic breast density and the risk of invasive breast cancer in postmenopausal women participating in the NSABP study of tamoxifen and raloxifene (STAR)." Cancer Prevention Research 5.11 (2012): 1321-1329.
Ko ES, Lee BH, Choi HY, Kim RB, Noh WC. Background enhancement in breast MR: correlation with breast density in mammography and background echotexture in ultrasound. Eur J Radiol. 2011;80(3):719-723. doi:10.1016/j.ejrad.2010.07.019
Arslan G, Çelik L, Çubuk R, Çelik L, Atasoy MM. Background parenchymal enhancement: is it just an innocent effect of estrogen on the breast?. Diagn Interv Radiol. 2017;23(6):414-419. doi:10.5152/dir.2017.17048
Kajihara M, Goto M, Hirayama Y, et al. Effect of the menstrual cycle on background parenchymal enhancement in breast MR imaging. Magn Reson Med Sci. 2013;12(1):39-45. doi:10.2463/mrms.2012-0022
Pike MC, Pearce CL. Mammographic density, MRI background parenchymal enhancement and breast cancer risk. Ann Oncol. 2013;24 Suppl 8(Suppl 8):viii37-viii41. doi:10.1093/annonc/mdt310
Vreemann S, Gubern-Mérida A, Borelli C, Bult P, Karssemeijer N, Mann RM. The correlation of background parenchymal enhancement in the contralateral breast with patient and tumor characteristics of MRI-screen detected breast cancers. PLoS One. 2018;13(1):e0191399. Published 2018 Jan 19. doi:10.1371/journal.pone.0191399
van der Velden BH, Dmitriev I, Loo CE, Pijnappel RM, Gilhuijs KG. Association between Parenchymal Enhancement of the Contralateral Breast in Dynamic Contrast-enhanced MR Imaging and Outcome of Patients with Unilateral Invasive Breast Cancer. Radiology. 2015;276(3):675-685. doi:10.1148/radiol.15142192
Kim, Ji Youn, et al. "Enhancement parameters on dynamic contrast enhanced breast MRI: do they correlate with prognostic factors and subtypes of breast cancers?." Magnetic resonance imaging 33.1 (2015): 72-80.
Woolcott CG, Courneya KS, Boyd NF, et al. Association between sex hormones, glucose homeostasis, adipokines, and inflammatory markers and mammographic density among postmenopausal women. Breast Cancer Res Treat. 2013;139(1):255-265. doi:10.1007/s10549-013-2534-x
Sprague BL, Trentham-Dietz A, Gangnon RE, et al. Circulating sex hormones and mammographic breast density among postmenopausal women. Horm Cancer. 2011;2(1):62-72. doi:10.1007/s12672-010-0056-0.
Aiello EJ, Tworoger SS, Yasui Y, et al. Associations among circulating sex hormones, insulin-like growth factor, lipids, and mammographic density in postmenopausal women. Cancer Epidemiol Biomarkers Prev. 2005;14(6):1411-1417. doi:10.1158/1055-9965.EPI-04-0920
Bulut N, Altundag K. Does estrogen receptor determination affect prognosis in early stage breast cancers?. Int J Clin Exp Med. 2015;8(11):21454-21459. Published 2015 Nov 15.
Ross RK, Paganini-Hill A, Wan PC, Pike MC. Effect of hormone replacement therapy on breast cancer risk: estrogen versus estrogen plus progestin. J Natl Cancer Inst. 2000;92(4):328-332. doi:10.1093/jnci/92.4.328
Lim, Yaeji, et al. "Background parenchymal enhancement on breast MRI: association with recurrence-free survival in patients with newly diagnosed invasive breast cancer." Breast cancer research and treatment 163.3 (2017): 573-586.
Dong JM, Wang HX, Zhong XF, et al. Changes in background parenchymal enhancement in HER2-positive breast cancer before and after neoadjuvant chemotherapy: Association with pathologic complete response. Medicine (Baltimore). 2018;97(43):e12965. doi:10.1097/MD.0000000000012965
Hambly NM, Liberman L, Dershaw DD, Brennan S, Morris EA. Background parenchymal enhancement on baseline screening breast MRI: impact on biopsy rate and short-interval follow-up. AJR Am J Roentgenol. 2011;196(1):218–24.
Dontchos, Brian N., et al. "Are qualitative assessments of background parenchymal enhancement, amount of fibroglandular tissue on MR images, and mammographic density associated with breast cancer risk?." Radiology 276.2 (2015): 371-380.
Downloads
Published
Issue
Section
License
Copyright (c) 2021 Muhammad Omer Altaf, Shahper Aqeel, Eisha Tahir, Imran Khalid Niazi
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
