Ooms E A, Zonderland H M, Eijkemans M J C, Kriege M, Mahdavian Delavary B, Burger C W, Ansink A C
Department of Obstetrics and Gynaecology, Erasmus University Medical Center, P.O. Box 2040, 3000 CA Rotterdam, The Netherlands.
Breast. 2007 Dec;16(6):568-76. doi: 10.1016/j.breast.2007.04.007.
Our objective was to determine the interobserver variability of breast density assessment according to the Breast Imaging Reporting and Data System (BI-RADS) and to examine potential associations between breast density and risk factors for breast cancer. Four experienced breast radiologists received instructions regarding the use of BI-RADS and they assessed 57 mammograms into BI-RADS density categories of 1-4. The weighted kappa values for breast density between pairs of observers were 0.84 (A, B) (almost perfect agreement); 0.75 (A, C), 0.74 (A, D), 0.71 (B, C), 0.77 (B, D), 0.65 (C, D) (substantial agreement). The weighted overall kappa, measured by the intraclass correlation coefficient (ICC), was 0.77 (95% CI: 0.69-0.85). Body mass index was inversely associated with high breast density. In conclusion, overall interobserver agreement in mammographic interpretation of breast density is substantial and therefore, the BI-RADS classification for breast density is useful for standardization in a multicentre study.
我们的目的是根据乳腺影像报告和数据系统（BI-RADS）确定乳腺密度评估的观察者间变异性，并研究乳腺密度与乳腺癌风险因素之间的潜在关联。四位经验丰富的乳腺放射科医生接受了关于使用BI-RADS的指导，他们将57份乳房X光片评估为BI-RADS密度类别1-4。观察者之间乳腺密度的加权kappa值为0.84（A，B）（几乎完全一致）；0.75（A，C），0.74（A，D），0.71（B，C），0.77（B，D），0.65（C，D）（实质性一致）。通过组内相关系数（ICC）测量的加权总体kappa为0.77（95%CI：0.69-0.85）。体重指数与高乳腺密度呈负相关。总之，乳腺密度的乳房X光片解读中观察者间的总体一致性是显著的，因此，BI-RADS乳腺密度分类对于多中心研究的标准化是有用的。
