Exploring Dense Breast Density in Mammography: A Comparative Analysis of Breast Cancer Risk

Area of Science:

• Radiology
• Oncology
• Breast Imaging

Background:

• Breast density is a significant breast cancer risk factor.
• Risk differences between heterogeneously dense (C) and extremely dense (D) breasts require further investigation.
• Understanding these differences may refine screening for high-risk individuals.

Purpose of the Study:

• To compare breast cancer risk between BI-RADS (Breast Imaging Reporting and Data System) density categories C and D.
• To analyze mammography and biopsy data from a Colombian tertiary referral hospital.
• To investigate the association between breast density subcategories and malignancy risk.

Main Methods:

• Retrospective cross-sectional study of mammography and biopsy data.
• Analysis of BI-RADS categories, histological, and clinical variables.
• Stratified analysis of lesion malignancy/benignity by density and histology.

Main Results:

• Included 107 patients with density categories C and D; 88.7% had category C.
• Breast cancer frequency was 32%, with infiltrating ductal carcinoma most common.
• Higher BI-RADS categories correlated with density D and malignancy.
• Breast density (C vs. D) showed a significant association with malignancy risk (RR 1.95, p<0.045).
• Positive predictive values (PPV) varied significantly across BI-RADS categories based on density.

Conclusions:

• Focusing resources on extremely dense breasts (category D) is recommended, with emphasis on individualized screening.
• Breast density influences PPV within BI-RADS categories.
• Further research is needed to define risks by subcategory and assess additional screening efficacy for extremely dense breasts.