The reliability of the computerassisted breast density estimation was assessed in terms of. The software packages calculate percentage mammographic density pmd as the ratio of the dense tissue and the total breast area multiplied by 100. Abstract mammographic density has conventionally been defined as the area of the mammographic image of the breast that is white or bright, and is presumed to reflect differing amo. Methods for assessing and representing mammographic density. We conducted a nested casecontrol study within the melbourne collaborative cohort study involving 168 interval breast cancer patients and 498 matched control subjects. Conventional mammographic density, adjusted for age and body mass index, is at most weakly associated with the other known lifestylebased breast. Jul 23, 2008 mammographic density is known to be a strong risk factor for breast cancer. High mammographic density is associated with both risk of cancers. Countless integrations available the restful cumulus api enables integration with virtually any business software pim, erp and other systems. Breast density change as a predictive surrogate for response. A deep learning method for classifying mammographic breast. The association between mammographic density and breast cancer risk in western australian aboriginal women.
To perform the cumulus assessment, the operator adjusts a window and level to display the image optimally. A comparison of five methods of measuring mammographic. We hypothesized that the grey scale of film mammograms is normalized to volume breast density but not pectoral density and thus pectoral. Breast cancer risk and mammographic density assessed with. Breast density change as a predictive surrogate for. Cumulus is a digital asset management software designed as a clientserver system developed by canto software. Current volumetric methods use only unprocessed, raw mammograms, which is a problematic.
Nowadays, breast density is preferably scored using the semiautomated software cumulus 5. State laws share the common theme of notification to women of the possible limitations of. Automatic software breast density measurement methods to estimate percent change in mammographic breast density time frame. Volpara and cumulus were the only tools that produced breast density measures for all images in the study, with other methods failing to produce readings for up to 11% of the participants. The distribution of mammographic density has been shown to be significantly lower in western australian aboriginal women compared to age and screening locationmatched nonaboriginal women. Cumulus is a software program requiring manual input to outline and measure the area of breast tissue relative to overall breast area 3. Autodensity automatically identifies the breast area in the mammogram and classifies breast density in a similar way to cumulus, through a fast, stand. Sawyer abstractthis project is to develop an automated breast density segmentation system. Cumulus estimated mammographic density values are lower on dbt than on dm. This, however, is a labourintensive process for largescale studies. Volpara, densitas and cumulus gave ors for the highest vs lowest. High breast density means a greater amount of breast and connective tissue as compared to fat.
A more recent paper on high risk women using semiquantitative cumulus software as density measurement, work et al. Cumulus on premise digital asset management is the original dam solution with 30 years of experience for 2,500 customers. A comparative study of volumetric and areabased breast density. Current volumetric methods use only unprocessed, raw mammograms, which is a problematic restriction since such raw mammograms are. Explaining variance in the cumulus mammographic measures that. Cumulus abd method, the volumetric density software first defines the area of the breast by defining the skin line and excluding the. Qualitative versus quantitative mammographic breast.
Our aim was to determine the performance of visually assessed percent breast density as an. Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. Hologics quantra is the other breast density assessment software currently available. Currently the primary computational system for analyzing breast density is a semi. Women in the extreme density group are 4to 6times more likely to develop breast cancer than. Breast density has been shown to be a key indicator of breast cancer risk. Epidemiologic studies have consistently found that women with high breast density have 46 times higher risk of breast cancer than women with low breast density 2, 3. May 01, 2017 cumulus is a software program requiring manual input to outline and measure the area of breast tissue relative to overall breast area 3. Abstract mammographic density has conventionally been defined as the area of the mammographic image of the breast that is white or bright, and is. In this paper we compare a new volumetric breast density software package, volparatm to an experts birads visual assessment and cumulus and show that all. Volparadensity is a fully automated breast density assessment software that. Visually assessed breast density, breast cancer risk and the. For 544 mz and 339 dz twin pairs and 1,558 nontwin sisters from 1,564 families, mammographic density was.
Computeraided thresholding programs, such as cumulus, are seen as the gold standard for breast density measurement in this paper we compare a new volumetric breast density software package, volpara tm to an experts birads visual assessment and cumulus and show that all are closely related, whilst there is a less close relationship between cumulus percent breast. In this paper we compare a new volumetric breast density software package, volparatm to an experts birads visual assessment and cumulus and show that all are closely related, whilst there is a. Additionally, this software is intended for use with digitized filmscreen mammograms. Interval breast cancer risk associations with breast. Quantitative breast density analysis using tomosynthesis. As the cumulus method has been used in major studies in which strong risk associations were obtained, it is currently considered to be the best way to measure breast density boyd et al 2010. In addition to being a very strong independent breast cancer risk factor 24, high mammographic density is thus also associated with a decreased sensitivity of mammographic screening 2, 5. Automated segmentation of breast density rebecca l. Mammographic density was measured by using the cumulus software, a computerassisted technique. Computeraided thresholding programs, such as cumulus, are seen as the gold standard for breast density measurement.
There are several means of measuring mammographic density, among which are areabased and volumetricbased approaches. Reliability of computerassisted breast density estimation. The measurement of density has changed dramatically since its inception. The association between density readings taken from one single mlo and breast cancer risk was weaker for the imagejbased method than for cumulus agebody mass indexadjusted odds ratio or. To estimate and compare the percent change in mammographic breast density using cumulus software from baseline to month 12 in women applying 2 mg afimoxifene 4hydroxytamoxifen 4oht gel per breast versus placebo. A particularly strong association with risk has been observed when density is measured using interactive threshold software. Breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer. Comparing a new volumetric breast density method volpara tm. Baseline up to 12 months will be summarized using descriptive statistics, such as mean. Despite being a proven predictor of breast cancer risk, the semiautomated nature of cumulus breast density assessments is susceptible to inter and intraobserver variability and could be improved by a fully automated method. More recently, automated programs have been developed that measure percent density as a function of area or volume.
Interval breast cancer risk associations with breast density. Readers mark along a continuous scale that represents 0100% density, and these score sheets can then be scanned through software to obtain the percent breast density. Mammographic density was assessed by visual analogue scale vas, thresholding cumulus and fullyautomated methods densitas, quantra, volpara in contralateral breasts of 366 women with unilateral breast cancer cases detected at screening on entry to the study cumulus 3166 and in 338 women with cancer detected subsequently. Afimoxifene in reducing the risk of breast cancer in women. Comparison of fully and semiautomated areabased methods for. Introduction mammographic density, the white radiolucent part of a mammogram, is a marker of breast cancer risk and mammographic sensitivity.
In 2010, a single reader reassessed all images for mammographic density using cumulus software sunnybrook health sciences centre, toronto, ontario, canada. Mammographic density will be calculated using cumulus software the boyd method. Volpara, one of two commercially available density software solutions, meets these criteria by providing an objective volumetric assessment of breast tissue density, and is cleared for use with all digital mammography units. Area and volumetric density estimation in processed full. A comparison of five methods of measuring mammographic density. Mammographic density remains one of the strongest predictors of breast cancer risk among women in the general population. Mammographic density, the area of the mammographic image that appears white or bright, predicts breast cancer risk. The quantitative areabased cumulus measurement is a particularly good measure because of its consistently strong. Current assessment of breast density by qualitative birads categories is subjective, with substantial inter and intrareader variability. The semiautomated density software cumulus is a promising research tool but limited in its clinical utility because of the time it takes. Based on these associations, breast density could potentially be. Statistical evaluation of a fully automated mammographic.
We use a public domain imageprocessing software for the fully automated analysis of md and penalized regression to construct a measure that. Mammographic density is a strong risk factor for breast cancer. We develop an automated method to measure breast density autodensity and compare it to cumulus in terms of association with breast cancer risk and breast cancer screening outcomes. Thus, we evaluated the association between reproductive, hormonal, and lifestyle risk factors and mammographic density among women with a strong family history of. Finally, percent of breast density and breast volume were calculated and the results were compared with mri.
Objective md measurement in a highthroughput fashion would enable its wider use as a biomarker for breast cancer. Predictors of mammographic density among women with a strong. Percent change in mammographic density md using cumulus software in women applying 4mg 4oht gel per breast versus placebo time frame. In this paper we compare a new volumetric breast density software package, volparatm to an experts birads visual assessment and cumulus and show that. Baseline up to 12 months compared to cumulus method in women applying 4mg of 4oht gel per breast vs. Fibroglandular breast tissue, which is referred to as dense tissue, is known to mask breast carcinomas on mammograms 1, 2. Another semiquantitative approach involves a visual estimation of the breast density using a visual analogue scale vas. Mammographic density is an established breast cancer risk factor within many ethnically different populations. Visually assessed breast density, breast cancer risk and. The semiautomated density software cumulus is a promising research tool but limited in its.
The association between mammographic density and breast. Initial qualitative measurement methods have been found to have limited consistency between readers, and in. About 40% of women over the age of 40 years have dense breasts 1. Explaining variance in the cumulus mammographic measures. Pdf explaining variance in the cumulus mammographic.
At least 15 studies demonstrate at least a moderate association of mammographic density and breast cancer risk 6. Reliability of automated breast density measurements rsna. Volumetric breast density estimates from dm and mri are highly correlated r0. Breast density scoringwith multiscale denoising autoencoders. In addition, fully automated breast density estimation software was used to generate objective breast density estimates. In this paper we compare a new volumetric breast density software package, volpara tm to an experts birads visual assessment and cumulus and show that all are closely related, whilst there is a less close relationship between cumulus percent. Quantitative breast density analysis using tomosynthesis and. Mammographic density is the area of the mammographic image of the breast that appears white or bright. Dec 09, 2016 high breast density means a greater amount of breast and connective tissue as compared to fat.
Enhancement of mammographic density measures in breast. We present a novel approach to enhance area density measures that takes advantage of the relative density of the pectoral muscle that appears in lateral mammographic views. Jul 06, 2012 breast density change as a predictive surrogate for response to adjuvant endocrine therapy in hormone receptor positive breast cancer jisun kim, 1 wonshik han, 1, 2 hyeonggon moon, 1 soo kyung ahn, 1 heechul shin, 3 jeeman you, 4 saewon han, 5 seockah im, 5 taeyou kim, 5 hye ryoung koo, 6 jung min chang, 6 nariya cho, 6 woo. Mammographic density is an important risk factor for breast cancer, but. Enhancement of mammographic density measures in breast cancer. Initial qualitative measurement methods have been found to have limited consistency between readers, and in regards to breast cancer risk. Comparing a new volumetric breast density method volparatm.
Qualitative versus quantitative mammographic breast density. As a digital asset management software, cumulus aims to cover the complete usage cycle of a file. Positive results have been reported in evaluation of cumulus with digital breast tomosynthesis dbt in the us. We estimated the proportions of variance explained by questionnairemeasured breast cancer risk factors and by unmeasured residual familial factors. Computeraided thresholding programs, such as cumulus, are seen as the gold standard for breast density measurement in this paper we compare a new volumetric breast density software package, volpara tm to an experts birads visual assessment and cumulus and show that all are closely related, whilst there is a less close relationship between cumulus percent breast density and absolute volume.
Readers mark along a continuous scale that represents 0100% density, and these score sheets can then be scanned through software. In addition, the percent of breast density and breast area of digital mammography calculated using the software cumulus university of toronto, toronto, on, canada. Volpara breast density measurement methods to estimate percent. The product line includes editions targeted to smaller organizations and larger enterprises.
We aimed to develop a risk model for interval breast cancer. Jun 26, 2019 mammographic density is one of the strongest risk factors for breast cancer. The pooled analysis included 1,699 cases and 2,422 controls from california 19901998, hawaii 19962003, minnesota 19922001, and japan 19992003. We hypothesized that the grey scale of film mammograms is normalized to volume breast density. Reliability of automated breast density measurements. In this paper we compare a new volumetric breast density software package, volpara tm to an experts birads visual assessment and cumulus and show that all are closely related, whilst there is a less close relationship between cumulus percent breast density and.
To estimate and compare the percent change in mammographic breast density using cumulus software from baseline to month 12 in women applying 2mg 4oht gel per breast versus placebo. This method, which is implemented in the cumulus software byng et al 1994, provides breast density measurements on a continuous scale. Mammographic density md is a strong, independent risk factor for breast cancer, but measuring md is time consuming and reader dependent. Mammographic density is known to be a strong risk factor for breast cancer. Predictors of mammographic density among women with a. Our accrual goal is 458 patients 229 per arm and with an assumption of 20% drop out due to drug intolerance and another 20% due to ineligibility. Comparing visually assessed birads breast density and. Forms were read using custom software and visual percentage density calculated. The stateoftheart method for measuring mammographic density is a computerassisted thresholding technique called cumulus.
Of the six methods studied, the association of breast density with breast cancer risk was highest for volpara and cumulus a semiautomated areabased method. Conventional mammographic density, adjusted for age and body mass index, is at most weakly associated with the other known lifestylebased breast cancer risk factors 5, as mentioned in section 1. To perform twodimensional breast density assessment, the percentage of density measurements were estimated on the basis of the processed ffdm images in digital imaging and communications in medicine format by using cumulus 6 software 9. Cumulus as a semiautomated computerized measure of dense area 37. This measures the total area of the breast image and the absolute area covered by dense tissue, as determined by the. Comparison of fully and semiautomated areabased methods. Mammographic breast density mbd has been proven to be an important risk factor for breast cancer and an important determinant of mammographic screening performance. There is great interest in studying mammographic density because it is strongly associated with breast cancer risk 1, 2 and is modifiable. Mammographic density can be assessed using several different metrics.