Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer

Kathleen R. Brandt, Christopher G. Scott, Diana L. Miglioretti, Matthew R. Jensen, Amir P. Mahmoudzadeh, Carrie Hruska, Lin Ma, Fang Fang Wu, Steven R. Cummings, Aaron D. Norman, Natalie J. Engmann, John A. Shepherd, Stacey J. Winham, Karla Kerlikowske, Celine M. Vachon

Research output: Contribution to journalArticlepeer-review

2 Scopus citations


Background: Given that breast cancer and normal dense fibroglandular tissue have similar radiographic attenuation, we examine whether automated volumetric density measures identify a differential change between breasts in women with cancer and compare to healthy controls. Methods: Eligible cases (n = 1160) had unilateral invasive breast cancer and bilateral full-field digital mammograms (FFDMs) at two time points: within 2 months and 1-5 years before diagnosis. Controls (n = 2360) were matched to cases on age and date of FFDMs. Dense volume (DV) and volumetric percent density (VPD) for each breast were assessed using Volpara™. Differences in DV and VPD between mammograms (median 3 years apart) were calculated per breast separately for cases and controls and their difference evaluated by using the Wilcoxon signed-rank test. To simulate clinical practice where cancer laterality is unknown, we examined whether the absolute difference between breasts can discriminate cases from controls using area under the ROC curve (AUC) analysis, adjusting for age, BMI, and time. Results: Among cases, the VPD and DV between mammograms of the cancerous breast decreased to a lesser degree (-0.26% and-2.10 cm3) than the normal breast (-0.39% and-2.74 cm3) for a difference of 0.13% (p value < 0.001) and 0.63 cm3 (p = 0.002), respectively. Among controls, the differences between breasts were nearly identical for VPD (-0.02 [p = 0.92]) and DV (0.05 [p = 0.77]). The AUC for discriminating cases from controls using absolute difference between breasts was 0.54 (95% CI 0.52, 0.56) for VPD and 0.56 (95% CI, 0.54, 0.58) for DV. Conclusion: There is a small relative increase in volumetric density measures over time in the breast with cancer which is not found in the normal breast. However, the magnitude of this difference is small, and this measure alone does not appear to be a good discriminator between women with and without breast cancer.

Original languageEnglish (US)
Article number118
JournalBreast Cancer Research
Issue number1
StatePublished - Oct 28 2019


  • Breast cancer
  • Breast density
  • Risk
  • Tissue asymmetry
  • Volumetric density

ASJC Scopus subject areas

  • Oncology
  • Cancer Research


Dive into the research topics of 'Automated volumetric breast density measures: Differential change between breasts in women with and without breast cancer'. Together they form a unique fingerprint.

Cite this