Reported mammographic density: film-screen versus digital acquisition

Area of Science:

• Radiology
• Medical Imaging
• Breast Health

Background:

• Breast density assessment is crucial for mammography interpretation and breast cancer risk stratification.
• The American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) provides standardized categories for reporting breast density.
• Advancements in imaging technology, such as digital mammography, raise questions about consistency with older film-screen (FS) methods.

Purpose of the Study:

• To investigate whether BI-RADS breast density categories differ when reported from digital mammography versus film-screen (FS) mammography.
• To test the hypothesis that digital mammography leads to lower reported breast density categories compared to FS mammography.

Main Methods:

• Retrospective analysis of mammography registries from the Breast Cancer Surveillance Consortium.
• Inclusion of women aged 40+ with at least two screening mammograms within 36 months, including both FS and digital modalities.
• Exclusion of women with prior breast cancer, augmentation, or density-altering medications.

Main Results:

• No significant difference was observed in BI-RADS breast density categories between digital and FS mammography.
• Lower density classifications were reported in a similar percentage of women regardless of the mammographic acquisition order (FS then digital, or digital then FS).
• The percentage of agreement between density readings remained consistent across different mammographic pairings.

Conclusions:

• Reported BI-RADS breast density categories are consistent regardless of whether digital or film-screen mammography is used.
• These findings support the continued use of BI-RADS density categories for breast cancer risk models, irrespective of the mammographic acquisition method employed.