Association of breast cancer with MRI background parenchymal enhancement: The IMAGINE case-control study Journal Article


Authors: Watt, G. P.; Sung, J.; Morris, E. A.; Buys, S. S.; Bradbury, A. R.; Brooks, J. D.; Conant, E. F.; Weinstein, S. P.; Kontos, D.; Woods, M.; Colonna, S. V.; Liang, X.; Stein, M. A.; Pike, M. C.; Bernstein, J. L.
Article Title: Association of breast cancer with MRI background parenchymal enhancement: The IMAGINE case-control study
Abstract: Background: Background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) may be associated with breast cancer risk, but previous studies of the association are equivocal and limited by incomplete blinding of BPE assessment. In this study, we evaluated the association between BPE and breast cancer based on fully blinded assessments of BPE in the unaffected breast. Methods: The Imaging and Epidemiology (IMAGINE) study is a multicenter breast cancer case-control study of women receiving diagnostic, screening, or follow-up breast MRI, recruited from three comprehensive cancer centers in the USA. Cases had a first diagnosis of unilateral breast cancer and controls had no history of or current breast cancer. A single board-certified breast radiologist with 12 years’ experience, blinded to case-control status and clinical information, assessed the unaffected breast for BPE without view of the affected breast of cases (or the corresponding breast laterality of controls). The association between BPE and breast cancer was estimated by multivariable logistic regression separately for premenopausal and postmenopausal women. Results: The analytic dataset included 835 cases and 963 controls. Adjusting for fibroglandular tissue (breast density), age, race/ethnicity, BMI, parity, family history of breast cancer, BRCA1/BRCA2 mutations, and other confounders, moderate/marked BPE (vs minimal/mild BPE) was associated with breast cancer among premenopausal women [odds ratio (OR) 1.49, 95% CI 1.05–2.11; p = 0.02]. Among postmenopausal women, mild/moderate/marked vs minimal BPE had a similar, but statistically non-significant, association with breast cancer (OR 1.45, 95% CI 0.92–2.27; p = 0.1). Conclusions: BPE is associated with breast cancer in premenopausal women, and possibly postmenopausal women, after adjustment for breast density and confounders. Our results suggest that BPE should be evaluated alongside breast density for inclusion in models predicting breast cancer risk. © 2020, The Author(s).
Keywords: magnetic resonance imaging; breast cancer; risk factors; background parenchymal enhancement; case-control study
Journal Title: Breast Cancer Research
Volume: 22
ISSN: 1465-5411
Publisher: Biomed Central Ltd  
Date Published: 2020-12-07
Start Page: 138
Language: English
DOI: 10.1186/s13058-020-01375-7
PUBMED: 33287857
PROVIDER: scopus
PMCID: PMC7722419
DOI/URL:
Notes: Article -- Export Date: 4 January 2021 -- Source: Scopus
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Citation Impact
MSK Authors
  1. Janice Sinae Sung
    56 Sung
  2. Malcolm Pike
    183 Pike
  3. Elizabeth A Morris
    334 Morris
  4. Jonine L Bernstein
    134 Bernstein
  5. Xiaolin Liang
    55 Liang
  6. Meghan   Woods
    25 Woods
  7. Gordon Patrick Watt
    12 Watt