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Intercountry analysis of breast density classification using visual grading.

Christine N Damases1,2, Peter Hogg3, Mark F McEntee1

  • 11 Faculty of Health Sciences, University of Sydney, Discipline of Medical Radiation Sciences and Brain and Mind Research Center, Sydney, NSW, Australia.

The British Journal of Radiology
|June 15, 2017
PubMed
Summary
This summary is machine-generated.

Mammographic breast density assessment shows significant international variability, impacting cancer risk assessment. Automation and standardization are crucial for consistent MBD evaluations and improved patient care.

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Area of Science:

  • Radiology and Medical Imaging
  • Oncology
  • Biostatistics

Background:

  • Mammographic breast density (MBD) assessment variability can affect breast cancer risk stratification and screening decisions.
  • Standardized MBD assessment is essential for accurate risk stratification and appropriate patient management.

Purpose of the Study:

  • To investigate intercountry differences and variability in MBD assessment among radiologists from the US, UK, and Australia/New Zealand.
  • To determine if assessment approaches and expectations influence MBD evaluation consistency.

Main Methods:

  • 20 American Board of Radiology (ABR) examiners, 24 UK practitioners, and 26 Royal Australian and New Zealand College of Radiologists (RANZCR) radiologists assessed 40 mammogram cases.
  • The 4th edition BI-RADS® lexicon was used for MBD assessment.
  • Interobserver correlation (Spearman's ρ) and agreement (weighted kappa, κw) were statistically analyzed.

Main Results:

  • Strong positive correlations were observed between all study cohorts on a binary MBD scale (1-2 vs 3-4).
  • Interobserver agreement varied: slight (κw=0.10) between ABR and RANZCR, fair (κw=0.25) between ABR and UK, and almost perfect (κw=0.95) between RANZCR and UK.
  • Less variation was noted on the binary scale compared to the 4-point scale.

Conclusions:

  • Significant international and interobserver variability exists in MBD assessment.
  • The findings highlight the urgent need for automated and standardized MBD assessment tools.
  • Standardization is critical to reduce assessment discrepancies and improve the reliability of breast cancer risk stratification.