COMPARISON OF VISUAL ASSESSMENTS OF MAMMOGRAPHIC BREAST DENSITY FROM MAMMOGRAPHY: ALONG WITH EVALUATION THE CORRELATION OF SOME IMPORTANT RISK FACTORS AND ACR BI-RADS STAGES

Authors

1 Department of Radiology, Shiraz University of Medical Sciences, Shiraz, Iran

2 Medical Imaging Research Center, Shiraz University of Medical Sciences, Shiraz, Iran

3 Shiraz University of Medical Science

4 Department of radiology, Shiraz University of medical Sciences, Shiraz

10.22034/icrj.2020.100842

Abstract

Introduction:
Breast density (BD) is a very important risk factor
for breast cancer. In order to increase the accuracy of determining the BD, mammography equipment uses some image processing algorithms. The objective  of this study was to compare the consistency of BD determined visually and provided by mammography equipment. Besides, the correlation of some risk factors and BDs were assessed.
 
Material and Method:
Using the 4 category- method of assessing the breast composition introduced by American College of Radiology (ACR) Breast Imaging Reporting and Data System (BI-RADS), BD of patients referred for mammography was determined visually and  with the imaging tools. The results of both methods were compared using the Bland–Altman plot and the correlation between these methods were assessed using Pearson correlation test. The correlation of family history of breast cancer, hypertension, having the experience of radiotherapy and chemotherapy, the age of the first pregnancy, the experience of hysterectomy and smoking with the ACRs of BD were assessed. Results:
95 women with the mean age of 51.28 years old ranging from 35 to 75 years old participated in this study. In 55.79%of cases, there was total agreement between the two methods. In 41.05% of cases there was just one score difference and in 3.16% of cases, there was two score difference between visual and machine determined BD. 14.23% of patients had a family history of breast cancer, among these patients 50, 42.86 and 7.14% of them had the ACRs of B, C, and D respectively. 77.89% of patients had normal breast examination among which the BD in 10.81,
52.70 and 36.49 % of cases were A, B and C. 12.63% of patients had a prior experience of radiotherapy and chemotherapy. Among these patients 8.33, 75 and 16.67% had the ACRs of A, B and C. 34.74, 37.88 and 12.63% of patients had the experience of first pregnancy at the ages of under 18, between 18-25 and more than 25 years old respectively. The ACRs of B and C in these three groups were 93.94, 83.33 and 91.67%. 5.26% had the history of hysterectomy among who 60% had the ACR of C and 40% had the ACR of B. 10.53% were smokers and 90% of them had the ACRs of B and C.
 
Discussion:
According to Bland–Altman plot the was a good agreement between the results of visual and device determined BDs and according to PEARSON correlation there was a moderate positive correlation between two methods. The  family  history  of  breast cancer, hypertension, prior experience of radiotherapy and chemotherapy or hysteroscopy, first pregnancy under 18 or above 25 years and smoking lead to a higher ACRs. 89.19% of the patients who had normal breast examination had the ACRs of B and C.
 
Conclusion:
There is a rather good agreement between visually and device determined BD. Also, there is a positive correlation between the risk factors which were studied and having the higher ACRs.

Keywords