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1 From the Departments of Radiology (J.A.H.) and Health Evaluation Sciences (V.E.B.), University of Virginia, Box 800170, Charlottesville, VA 22908. Received July 18, 2002; revision requested August 27; revision received October 23; accepted January 8, 2003. Address correspondence to J.A.H. (e-mail: jah7w@virginia.edu).
Increased mammographic breast density is a moderate independent risk factor for breast cancer, with findings of published studies in which quantitative methods of assessment were used showing a positive association. Breast density may be quantified by using visual assessment or planimetry. Although the category definitions vary, the odds ratio for developing breast cancer for the most dense compared with the least dense breast tissue categories ranges from 1.8 to 6.0, with most studies yielding an odds ratio of 4.0 or greater. Plausible explanations for the association of breast density with increased breast cancer risk may be the development of premalignant lesions such as atypical ductal hyperplasia, elevated growth factors, or increased estrogen production within the breast due to overactive aromatase. The amount of breast density may be due in part to genetic heredity. However, unlike other risk factors, breast density may be influenced. Specifically, breast density is very hormonally responsive and potentially may be influenced by lifestyle factors such as alcohol intake and diet. Assessment of breast density may become useful in risk assessment and prevention decisions.
© RSNA, 2003
Index terms: Breast, density, 00.92 • Breast neoplasms, diagnosis, 00.30 • Breast neoplasms, radiography, 00.11, 00.1215, 00.30 • Radiography, digital, 00.1215 • Review
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