Currently, the American Cancer Society recommend that women with a 20% or greater lifetime risk of developing breast cancer should have annual MRI scans and mammography.
"To date, it's been difficult to assess the future risk of breast cancer for women, so there is a strong desire in the oncology community to identify ways to better determine this risk," says study co-author Dr. Habib Rahbar, a breast imaging expert at Seattle Cancer Care Alliance and assistant professor at the University of Washington.
Previous studies have linked dense breast tissue - or tissue containing more fibroglandular tissue than fatty tissue - to increased risk for breast cancer. The University of Washington study examined the relationship between imaging features and risk factors including tissue density, family history and genetic mutations.
"While breast density is loosely associated with the risk of developing breast cancer," says Dr. Rahbar, "it is unclear whether it or other imaging features can improve upon current risk assessment methods."
Currently, the American Cancer Society recommend that women with a 20% or greater lifetime risk of developing breast cancer should have annual magnetic resonance imaging (MRI) scans in addition to routine annual screening mammography.
Is there a link between breast cancer and background parenchymal enhancement?
In the new study, the researchers were interested in determining whether there was an association between imaging features, such as breast density and background parenchymal enhancement (BPE) - where normal background breast tissue appears white on the scans - and cancer risk.
Dr. Rahbar and colleagues found that women who displayed elevated levels of BPE were nine times more likely to be diagnosed with breast cancer during the study's follow-up period of 2 years. Interestingly, however, density of breast tissue was not found to have a significant relationship to cancer risk in this study.
From these results, the authors suggest that factoring in BPE may help improve breast cancer screening and management strategies. If the finding is validated in larger studies, then BPE could be used to help guide important treatment decisions, such as whether preventive drugs or a preventive mastectomy might better suit a patient.
Dr. Rahbar says:
"MRI could be used in a broader group of women to determine who most needs supplemental screening based on their BPE levels. This is important as we move into an era of more personalized medicine.
Breast cancer needs a supportive environment to grow, and recent research suggests that areas of inflammation are particularly conducive for such growth."
Next, the team will attempt to validate the findings among a larger group of patients and investigate what drives the association between BPE and breast cancer risk. One theory the researchers propose to examine is that BPE may be related to inflammation that occurs in the early stages of breast cancer.