Mammographic variation measures, breast density, and breast cancer risk

John Heine, Erin Fowler, Christopher G. Scott, Matthew R. Jensen, John Shepherd, Carrie B. Hruska, Stacey J. Winham, Kathleen R. Brandt, Fang F. Wu, Aaron D. Norman, Vernon S. Pankratz, Diana L. Miglioretti, Karla Kerlikowske, Celine M. Vachon

Research output: Contribution to journalArticlepeer-review


OBJECTIVE. Our previous work showed that variation measures, which represent breast architecture derived from mammograms, were significantly associated with breast cancer. For replication purposes, we examined the association of three variation measures (variation [V], which is measured in the image domain, and P1 and p1 [a normalized version of P1] which are derived from restricted regions in the Fourier domain) with, breast cancer risk in an independent population. We also compared these measures to volumetric density measures (volumetric percent density [VPD] and dense volume [DV]) from a commercial product. MATERIALS AND METHODS. We examined 514 patients with breast cancer and 1377 control patients from a screening practice who were matched for age, date of examination, mammography unit, facility, and state of residence. Spearman rank-order correlation was used to evaluate the monotonic association between measures. Breast cancer associations were estimated using conditional logistic regression, after adjustment for age and body mass index. Odds ratios were calculated per SD increment in mammographic measure. RESULTS. These variation measures were strongly correlated with VPD (correlation, 0.68–0.80) but not with DV (correlation, 0.31–0.48). Similar to previous findings, all variation measures were significantly associated with breast cancer (odds ratio per SD: 1.30 [95% CI, 1.16–1.46] for V, 1.55 [95% CI, 1.35–1.77] for P1, and 1.51 [95% CI, 1.33–1.72] for p1). Associations of volumetric density measures with breast cancer were similar (odds ratio per SD: 1.54 [95% CI, 1.33–1.78] for VPD and 1.34 [95% CI, 1.20–1.50] for DV). When DV was included with each variation measure in the same model, all measures retained significance. CONCLUSION. Variation measures were significantly associated with breast cancer risk (comparable to the volumetric density measures) but were independent of the DV.

Original languageEnglish (US)
Pages (from-to)326-335
Number of pages10
JournalAmerican Journal of Roentgenology
Issue number2
StatePublished - Aug 2021


  • Breast cancer
  • Risk prediction
  • Variation measures
  • Volumetric breast density

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging


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