Correlation of Background Parenchymal Enhancement on Breast Magnetic Resonance Imaging with Quantitative Mammographic Parameters Derived using fully Automated Volumetric Software

Abstract Background: Background parenchymal enhancement (BPE) and mammographic breast density are risk factors for breast cancer. However, existing evidence regarding the association between these risk factors is inconclusive. This study aimed to evaluate the relationship between BPE and quantitative and subdivided mammographic density parameters, such as fibroglandular tissue (FGT) volume, entire breast volume, and volumetric density (%), measured using a fully automated volumetric software.Methods: From July 2017 to August 2018, patients with newly diagnosed breast cancer who had undergone preoperative mammography and magnetic resonance imaging (MRI) at our hospital were identified. Mammographic density analysis was performed using a fully automated volumetric software. Two breast radiologists consensually rated BPE and the amount of FGT in each contralateral normal breast MRI based on four categories of the Breast Imaging-Reporting and Data System. The Pearson correlation coefficient was used to analyze the relationship between mammographic density and the FGT and BPE observed on breast MRI.Results: A total of 364 women were included, of whom 153 (42%) were premenopausal (mean age, 44.22±6.29 years) and 211 (58%) were postmenopausal (mean age, 57.91±9.59 years).The premenopause group had significantly higher levels of BPE and FGT on MRI and FGT volume and volumetric density (%) on mammography. FGT and BPE observed on breast MRI were correlated in the overall sample and postmenopause group(r=0.352and 0.265, respectively). The FGT volume on mammography was significantly correlated with BPE in the overall sample and in the pre- and postmenopause groups (r=0.290, 0.166, and 0.294, respectively). Volumetric density (%) on mammography and BPE were correlated in the total sample and postmenopause group(r=0.369 and 0.281, respectively). Conclusion: Mammographic breast density and BPE on MRI are significantly correlated in patients with breast cancer. The mammographic FGT volume is particularly correlated with BPE on MRI, regardless of the patient’s menopausal state.