Clinical Significance of Background Parenchymal Enhancement in Breast Cancer Risk Stratification
© 2023 International Society for Magnetic Resonance in Medicine..
BACKGROUND: Background parenchymal enhancement (BPE) is an established breast cancer risk factor. However, the relationship between BPE levels and breast cancer risk stratification remains unclear.
PURPOSE: To evaluate the clinical relationship between BPE levels and breast cancer risk with covariate adjustments for age, ethnicity, and hormonal status.
STUDY TYPE: Retrospective.
POPULATION: 954 screening breast MRI datasets representing 721 women divided into four cohorts: women with pathogenic germline breast cancer (BRCA) mutations (Group 1, N = 211), women with non-BRCA germline mutations (Group 2, N = 60), women without high-risk germline mutations but with a lifetime breast cancer risk of ≥20% using the Tyrer-Cuzick model (Group 3, N = 362), and women with <20% lifetime risk (Group 4, N = 88).
FIELD STRENGTH/SEQUENCE: 3 T/axial non-fat-saturated T1, short tau inversion recovery, fat-saturated pre-contrast, and post-contrast T1-weighted images.
ASSESSMENT: Data on age, body mass index, ethnicity, menopausal status, genetic predisposition, and hormonal therapy use were collected. BPE levels were evaluated by two breast fellowship-trained radiologists independently in accordance with BI-RADS, with a third breast fellowship-trained radiologist resolving any discordance.
STATISTICAL TESTS: Propensity score matching (PSM) was utilized to adjust covariates, including age, ethnicity, menopausal status, hormonal treatments, and prior bilateral oophorectomy. The Mann-Whitney U test, chi-squared test, and univariate and multiple logistic regression analysis were performed, with an odds ratio (OR) and corresponding 95% confidence interval. Weighted Kappa statistic was used to assess inter-reader variation. A P value <0.05 indicated a significant result.
RESULTS: In the assessment of BPE, there was substantial agreement between the two interpreting radiologists (κ = 0.74). Patient demographics were not significantly different between patient groups after PSM. The BPE of Group 1 was significantly lower than that of Group 4 and Group 3 among premenopausal women. In estimating the BPE level, the OR of gene mutations was 0.35.
DATA CONCLUSION: Adjusting for potential confounders, the BPE level of premenopausal women with BRCA mutations was significantly lower than that of non-high-risk women.
LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 3.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:59 |
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| Enthalten in: |
Journal of magnetic resonance imaging : JMRI - 59(2024), 5 vom: 01. Apr., Seite 1742-1757 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Murakami, Wakana [VerfasserIn] |
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| Links: |
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| Themen: |
BRCA |
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| Anmerkungen: |
Date Completed 08.04.2024 Date Revised 08.04.2024 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1002/jmri.29015 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| 245 | 1 | 0 | |a Clinical Significance of Background Parenchymal Enhancement in Breast Cancer Risk Stratification |
| 264 | 1 | |c 2024 | |
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| 500 | |a Date Completed 08.04.2024 | ||
| 500 | |a Date Revised 08.04.2024 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a © 2023 International Society for Magnetic Resonance in Medicine. | ||
| 520 | |a BACKGROUND: Background parenchymal enhancement (BPE) is an established breast cancer risk factor. However, the relationship between BPE levels and breast cancer risk stratification remains unclear | ||
| 520 | |a PURPOSE: To evaluate the clinical relationship between BPE levels and breast cancer risk with covariate adjustments for age, ethnicity, and hormonal status | ||
| 520 | |a STUDY TYPE: Retrospective | ||
| 520 | |a POPULATION: 954 screening breast MRI datasets representing 721 women divided into four cohorts: women with pathogenic germline breast cancer (BRCA) mutations (Group 1, N = 211), women with non-BRCA germline mutations (Group 2, N = 60), women without high-risk germline mutations but with a lifetime breast cancer risk of ≥20% using the Tyrer-Cuzick model (Group 3, N = 362), and women with <20% lifetime risk (Group 4, N = 88) | ||
| 520 | |a FIELD STRENGTH/SEQUENCE: 3 T/axial non-fat-saturated T1, short tau inversion recovery, fat-saturated pre-contrast, and post-contrast T1-weighted images | ||
| 520 | |a ASSESSMENT: Data on age, body mass index, ethnicity, menopausal status, genetic predisposition, and hormonal therapy use were collected. BPE levels were evaluated by two breast fellowship-trained radiologists independently in accordance with BI-RADS, with a third breast fellowship-trained radiologist resolving any discordance | ||
| 520 | |a STATISTICAL TESTS: Propensity score matching (PSM) was utilized to adjust covariates, including age, ethnicity, menopausal status, hormonal treatments, and prior bilateral oophorectomy. The Mann-Whitney U test, chi-squared test, and univariate and multiple logistic regression analysis were performed, with an odds ratio (OR) and corresponding 95% confidence interval. Weighted Kappa statistic was used to assess inter-reader variation. A P value <0.05 indicated a significant result | ||
| 520 | |a RESULTS: In the assessment of BPE, there was substantial agreement between the two interpreting radiologists (κ = 0.74). Patient demographics were not significantly different between patient groups after PSM. The BPE of Group 1 was significantly lower than that of Group 4 and Group 3 among premenopausal women. In estimating the BPE level, the OR of gene mutations was 0.35 | ||
| 520 | |a DATA CONCLUSION: Adjusting for potential confounders, the BPE level of premenopausal women with BRCA mutations was significantly lower than that of non-high-risk women | ||
| 520 | |a LEVEL OF EVIDENCE: 3 TECHNICAL EFFICACY: Stage 3 | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a BRCA | |
| 650 | 4 | |a background parenchymal enhancement (BPE) | |
| 650 | 4 | |a breast MRI | |
| 650 | 4 | |a high‐risk screening | |
| 650 | 4 | |a lifetime risk | |
| 700 | 1 | |a Mortazavi, Shabnam |e verfasserin |4 aut | |
| 700 | 1 | |a Yu, Tiffany |e verfasserin |4 aut | |
| 700 | 1 | |a Kathuria-Prakash, Nikhita |e verfasserin |4 aut | |
| 700 | 1 | |a Yan, Ran |e verfasserin |4 aut | |
| 700 | 1 | |a Fischer, Cheryce |e verfasserin |4 aut | |
| 700 | 1 | |a McCann, Kelly E |e verfasserin |4 aut | |
| 700 | 1 | |a Lee-Felker, Stephanie |e verfasserin |4 aut | |
| 700 | 1 | |a Sung, Kyunghyun |e verfasserin |4 aut | |
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