Building a Better Model: A Personalized Breast Cancer Risk Model Incorporating Breast Density to Stratify Risk and Improve Application of Resources

Abstract : Purpose: Development and validation of a personalized breast cancer risk assessment model that includes automated measurement of breast density. Scope: Assemble a cohort of women with known breast cancer risk factors and digital mammogram files for women diagnosed with breast cancer using existing data sources and match them to controls (Harvey/Knaus). Validate and refine automated breast density software (Yaffe/Harvey). Build and validate the initial comprehensive model (Knaus/Yaffe/Harvey). Major Findings: During this second year, we have recruited over 3200 women (622 cases). Breast density measurement has been evaluated for accuracy using a second test set showing very good correlation with 2D methods, for precision using repeated measures with excellent correlation, and variation between vendors. A survey instrument was developed, vetted using focus groups, and administered (nearing completion) to evaluate screening knowledge, practices, and willingness to change practice.

[1]  Carl J D'Orsi,et al.  To seek perfection or not? That is the question. , 2012, Radiology.

[2]  Karla Kerlikowske,et al.  Using Clinical Factors and Mammographic Breast Density to Estimate Breast Cancer Risk: Development and Validation of a New Predictive Model , 2008, Annals of Internal Medicine.

[3]  D. Miglioretti,et al.  Individual and Combined Effects of Age, Breast Density, and Hormone Replacement Therapy Use on the Accuracy of Screening Mammography , 2003, Annals of Internal Medicine.

[4]  Jennifer A Harvey,et al.  Quantitative assessment of mammographic breast density: relationship with breast cancer risk. , 2004, Radiology.

[5]  Karla Kerlikowske,et al.  Compositional breast imaging using a dual-energy mammography protocol. , 2009, Medical physics.

[6]  Nico Karssemeijer,et al.  Volumetric Breast Density Estimation from Full-Field Digital Mammograms: A Validation Study , 2014, IEEE Transactions on Medical Imaging.

[7]  Daniel B Kopans,et al.  Basic physics and doubts about relationship between mammographically determined tissue density and breast cancer risk. , 2008, Radiology.

[8]  M. Blettner,et al.  Study design in medical research: part 2 of a series on the evaluation of scientific publications. , 2009, Deutsches Arzteblatt international.

[9]  Gordon E Mawdsley,et al.  Measurement of compressed breast thickness by optical stereoscopic photogrammetry. , 2009, Medical physics.

[10]  M J Yaffe,et al.  Volumetric breast density characteristics as determined from digital mammograms , 2012, Physics in medicine and biology.

[11]  Karla Kerlikowske,et al.  Benign breast disease, mammographic breast density, and the risk of breast cancer. , 2013, Journal of the National Cancer Institute.

[12]  N. Boyd,et al.  Mammographic density and the risk and detection of breast cancer. , 2007, The New England journal of medicine.

[13]  D. Miglioretti,et al.  Reported mammographic density: film-screen versus digital acquisition. , 2013, Radiology.

[14]  Karla Kerlikowske,et al.  Agreement of Mammographic Measures of Volumetric Breast Density to MRI , 2013, PloS one.

[15]  C. Merritt.  Combined Screening With Ultrasound and Mammography vs Mammography Alone in Women at Elevated Risk of Breast Cancer , 2009 .

[16]  C. Lehman,et al.  Comparative Effectiveness of Digital Versus Film-Screen Mammography in Community Practice in the United States , 2011, Annals of Internal Medicine.

[17]  N F Boyd,et al.  Mammographic densities and breast cancer risk. , 1998, Breast disease.

[18]  J. Fleiss,et al.  Approximate interval estimation for a certain intraclass correlation coefficient , 1978 .

[19]  Konstantin Strauch,et al.  Breast cancer risk assessment across the risk continuum: genetic and nongenetic risk factors contributing to differential model performance , 2012, Breast Cancer Research.

[20]  P. Narula.  MAMMOGRAPHIC DENSITY AND THE RISK AND DETECTION OF BREAST CANCER , 2016 .

[21]  Nico Karssemeijer,et al.  Robust Breast Composition Measurement - VolparaTM , 2010, Digital Mammography / IWDM.

[22]  S. Cummings,et al.  Personalizing Mammography by Breast Density and Other Risk Factors for Breast Cancer: Analysis of Health Benefits and Cost-Effectiveness , 2011, Annals of Internal Medicine.

[23]  Gina R Petroni,et al.  Accuracy of assigned BI-RADS breast density category definitions. , 2006, Academic radiology.

[24]  M. Yaffe,et al.  Validation of a method for measuring the volumetric breast density from digital mammograms , 2010, Physics in medicine and biology.

[25]  D. Altman,et al.  Measuring agreement in method comparison studies , 1999, Statistical methods in medical research.

[26]  Gordon E Mawdsley,et al.  Accurate estimation of compressed breast thickness in mammography. , 2009, Medical physics.

[27]  N. Boyd,et al.  Analysis of mammographic density and breast cancer risk from digitized mammograms. , 1998, Radiographics : a review publication of the Radiological Society of North America, Inc.

[28]  Katy Szczepura,et al.  The readout thickness versus the measured thickness for a range of screen film mammography and full-field digital mammography units. , 2011, Medical physics.