A novel and automatic mammographic texture resemblance marker is an independent risk factor for breast cancer

M. Nielsen, G. Karemore, M. Loog, J. Raundahl, N. Karssemeijer, J. Otten, M. Karsdal, C. Vachon and C. Christiansen

Cancer Epidemiology 2011;35(4):381-387.

DOI PMID Cited by ~44

Objective: We investigated whether breast cancer is predicted by a breast cancer risk mammographic texture resemblance (MTR) marker. Methods: A previously published case-control study included 495 women of which 245 were diagnosed with breast cancer. In baseline mammograms, 2-4 years prior to diagnosis, the following mammographic parameters were analysed for relation to breast cancer risk: (C) categorical parenchymal pattern scores; (R) radiologist's percentage density, (P) computer-based percentage density; (H) computer-based breast cancer risk MTR marker; (E) computer-based hormone replacement treatment MTR marker; and (A) an aggregate of P and H. Results: Density scores, C, R, and P correlated (tau=0.3-0.6); no other pair of scores showed large (tau>0.2) correlation. For the parameters, the odds ratios of future incidence of breast cancer comparing highest to lowest categories (146 and 106 subject respectively) were C: 2.4(1.4-4.2), R: 2.4(1.4-4.1), P: 2.5(1.5-4.2), E: non-significant, H: 4.2(2.4-7.2), and A: 5.6(3.2-9.8). The AUC analysis showed a similarly increasing pattern (C: 0.58?0.02, R: 0.57?0.03, P: 0.60?0.03, H: 0.63?0.02, A: 0.66?0.02). The AUC of the aggregate marker (A) surpasses others significantly except H. HRT-MTR (E) did not significantly identify future cancers or correlate with any other marker. Conclusions: Breast cancer risk MTR marker was independent of density scores and more predictive of risk. The hormone replacement treatment MTR marker did not identify patients at risk.