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Invasive Cancers Detected after Breast Cancer Screening Yielded a Negative Result: Relationship of Mammographic Density to Tumor Prognostic Factors¹

¹ From the Departments of Radiology (M.A.R., J.E.B., M.A.H.) and Medical Education (L.A.W.), University of Michigan Health System, 1500 E Medical Center Dr, 2910 Taubman Center, Ann Arbor, MI 48109-0326. Received May 16, 2002; revision requested July 25; final revision received July 1, 2003; accepted July 28. Address correspondence to M.A.R.

View larger version (23K): [in a new window]   Figure 1. Graph depicts the differences in proportions of the favorable tumor prognostic characteristics estrogen receptor positivity (black bars), grade 1 tumor (gray bars), nonpalpable tumor (white bars), and stage I tumor (diagonally striped bars) according to BI-RADS breast density category.

View larger version (135K): [in a new window]   Figure 2a. (a) Mediolateral oblique and (b) craniocaudal views of the left breast of a 53-year-old woman with BI-RADS category 4 breast density; the images on the left were obtained 10 months before those on the right in both a and b. The images on the left in a and b were interpreted as negative for cancer. At the time the images on the right were obtained, the patient had presented for diagnostic mammography because of a palpable lump. A metallic marker (small arrow) was placed on the skin at the site of the palpable lump. A 2.9-cm mass (large arrow) was identified and proved to be an invasive ductal carcinoma.

View larger version (119K): [in a new window]   Figure 2b. (a) Mediolateral oblique and (b) craniocaudal views of the left breast of a 53-year-old woman with BI-RADS category 4 breast density; the images on the left were obtained 10 months before those on the right in both a and b. The images on the left in a and b were interpreted as negative for cancer. At the time the images on the right were obtained, the patient had presented for diagnostic mammography because of a palpable lump. A metallic marker (small arrow) was placed on the skin at the site of the palpable lump. A 2.9-cm mass (large arrow) was identified and proved to be an invasive ductal carcinoma.