Black-White Racial Differences in Background Parenchymal Enhancement at Breast MRI.

Area of Science:

• Radiology and Medical Imaging
• Oncology
• Racial Disparities in Health

Background:

• High background parenchymal enhancement (BPE) on contrast-enhanced MRI is linked to increased breast cancer risk.
• Black women face higher breast cancer mortality and typically have lower breast density, yet BPE has not been studied in this group.

Purpose of the Study:

• To investigate racial differences in contrast-enhanced MRI-derived BPE between Black and White women.
• To assess if breast density mediates racial disparities in BPE.

Main Methods:

• Retrospective cross-sectional study of Black and White women without a history of breast cancer undergoing mammography and MRI.
• Qualitative assessment of BPE (high vs. low) using Breast Imaging Reporting and Data System criteria.
• Logistic regression and mediation analysis to evaluate race, BPE, and breast density associations.

Main Results:

• Fewer Black women had extremely dense breasts compared to White women (11% vs. 21%).
• Similar proportions of Black and White women exhibited high BPE (38% vs. 33%).
• After controlling for breast density, Black women were 31% more likely to have high BPE (OR, 1.28; 95% CI: 1.01, 1.64).

Conclusions:

• Black women are more likely to have high BPE on MRI than White women, irrespective of breast density.
• BPE may serve as an independent breast cancer risk marker, particularly in diverse populations.
• Further research is warranted to understand the clinical implications of BPE in Black women.