Spatial Distribution and Quantification of Mammographic Breast Density, and Its Correlation with BI-RADS Using an Image Segmentation Method.

(1) Background: Mammographic breast density (MBD) and older age are classical breast cancer risk factors. Normally, MBDs are not evenly distributed in the breast, with different women having different spatial distribution and clustering patterns. The presence of MBDs makes tumors and other lesions challenging to be identified in mammograms. The objectives of this study were: (i) to quantify the amount of MBDs-in the whole (overall), different sub-regions, and different zones of the breast using an image segmentation method; (ii) to investigate the spatial distribution patterns of MBD in different sub-regions of the breast. (2) Methods: The image segmentation method was used to quantify the overall amount of MBDs in the whole breast (overall percentage density (PD)), in 48 sub-regions (regional PDs), and three different zones (zonal PDs) of the whole breast, and the results of the amount of MBDs in 48 sub-regional PDs were further analyzed to determine its spatial distribution pattern in the breast using Moran's I values (spatial autocorrelation). (3) Results: The overall PD showed a negative correlation with age ( = 0.008); the younger women tended to have denser breasts (higher overall PD in breasts). We also found a higher proportion ( < 0.001) of positive autocorrelation pattern in the less dense breast group than in the denser breast group, suggesting that MBDs in the less dense breasts tend to be clustered together. Moreover, we also observed that MBDs in the mature women (<65 years old) tended to be clustered in the middle zone, while in older women (>64 years old) they tended to be clustered in both the posterior and middle zones. (4) Conclusions: There is an inverse relationship between the amount of MBD (overall PD in the breast) and age, and a different clustering pattern of MBDs between the older and mature women.