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SA Journal of Radiology

On-line version ISSN 2078-6778
Print version ISSN 1027-202X

Abstract

PRINSLOO, Erica; MINNE, Cornelia  and  GREEFF, Wim. Measuring breast density: Comparing computer-automated breast density quantification with an observer-based method in a South African academic context. S. Afr. J. radiol. (Online) [online]. 2018, vol.22, n.2, pp.1-5. ISSN 2078-6778.  http://dx.doi.org/10.4102/sajr.v22i2.1358.

BACKGROUND: Dense breast tissue may not only 'mask' small, non-calcified cancers but also represents an independent risk factor for the development of breast cancer. Computer-automated breast density quantification (CABD) software tools have been developed for the calculation of volumetric breast density. OBJECTIVES: This study sought: (1) to compare observer-based breast density scores, using the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS), with the breast density scores calculated using CABD quantification software tools, (2) to determine inter-reader variability in breast density scoring between qualified radiologists, between radiologists in training (registrars) and between these two groups and (3) to determine intra-reader reliability in breast density scoring. METHODS: A cross-sectional study was performed using the data of 100 patients (200 breasts). Three qualified radiologists and three registrars were asked to review the mammograms in question and to assign a breast density score according to the fifth edition of the Breast Imaging Reporting and Data System (BI-RADS) reporting system. Two readings took place at a minimum of 30 days apart. The percentage agreement between the automated and observer-based scores was calculated and intra-reader and inter-reader reliability values were determined. RESULTS: The study found that there was poor agreement between the breast densities calculated by CABD and the more subjective observer-based BI-RADS density scores. These results further reflect a statistically significant degree of inter-reader and intra-reader variability in the evaluation of breast density. CONCLUSION: We conclude that the use of automated breast density quantification (i.e. CABD) is a valuable tool for the reduction of variability in breast density ratings.

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