Department of Radiology, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.
Department of Breast Surgery, National Hospital Organization Nagoya Medical Center, 4-1-1 Sannomaru, Naka-ku, Nagoya, 460-0001, Japan.
Breast Cancer. 2023 Jul;30(4):541-551. doi: 10.1007/s12282-023-01444-7. Epub 2023 Mar 15.
The volumetric measurement system for mammographic breast density is a high-precision objective method for evaluating the percentage of fibroglandular tissue volume (FG%). Nonetheless, FG% does not precisely correlate with subjective visual estimation (SVE) and shows poor evaluation performance regarding masking risk in patients with comparatively thin compressed breast thickness (CBT), commonly found in Japanese women. We considered that the mean compressed fibroglandular tissue thickness (mCGT), which incorporates the CBT element into the evaluation of breast density, may better predict masking risk.
Volumetric measurements and SVEs were performed on mammograms of 108 breast cancer patients from our center. mCGT was calculated as the product of CBT and FG%. SVE was classified using the Breast Imaging-Reporting and Data System classification, 5th edition. Subsequently, the performance of mCGT, SVE, and FG% in predicting masking risk was estimated using the AUC.
The AUC values of mCGT and SVE were 0.84 (95% confidence interval, 0.71-0.92) and 0.78 (0.66-0.86), respectively (P = 0.16). The AUC of the FG% was 0.65 (0.52-0.77), which was significantly lower than that of mCGT (P < 0.001). The sensitivity and specificity of mCGT in predicting negative detection were 89% and 71%, respectively; of SVE 83% and 61% (versus 72% and 57% with FG%), suggesting that mCGT was superior to FG% in both sensitivity and specificity, and comparable with SVE.
Objective mCGT calculated from the volumetric measurement system will highly likely be useful in evaluating breast density and supporting visual assessment for masking risk stratification.
乳腺密度的容积测量系统是一种评估纤维腺体组织体积百分比（FG%）的高精度客观方法。然而，FG%与主观视觉评估（SVE）并不完全相关，并且在评估比较薄的压缩乳腺厚度（CBT）患者的隐匿风险方面表现不佳，这种情况在日本女性中很常见。我们认为，将 CBT 元素纳入乳腺密度评估的平均压缩纤维腺体组织厚度（mCGT）可能更好地预测隐匿风险。
对来自我们中心的 108 名乳腺癌患者的乳腺 X 线照片进行容积测量和 SVE。mCGT 计算为 CBT 与 FG%的乘积。SVE 使用乳腺影像报告和数据系统分类，第 5 版进行分类。然后，使用 AUC 评估 mCGT、SVE 和 FG%在预测隐匿风险方面的性能。
mCGT 和 SVE 的 AUC 值分别为 0.84（95%置信区间，0.71-0.92）和 0.78（0.66-0.86）（P=0.16）。FG%的 AUC 为 0.65（0.52-0.77），明显低于 mCGT（P<0.001）。mCGT 预测阴性检出的灵敏度和特异性分别为 89%和 71%；SVE 为 83%和 61%（与 FG%分别为 72%和 57%），提示 mCGT 在灵敏度和特异性方面均优于 FG%，与 SVE 相当。
从容积测量系统计算出的客观 mCGT 很可能有助于评估乳腺密度，并支持视觉评估进行隐匿风险分层。
