Breast Density Assessment with High-resolution Ultrasonography: A Reliability Study

JOURNAL TITLE: Journal of Postgraduate Medicine, Education and Research

Author
1. Deeksha Bhalla
2. Shruti Kumar
3. Tulika Singh
4. Veenu Singla
ISSN
2277-8969
DOI
10.5005/jp-journals-10028-1587
Volume
56
Issue
4
Publishing Year
2022
Pages
5
Author Affiliations
    1. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    1. Department of Radio Diagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
    1. PGIMER, Chandigarh, India
    2. Postgraduate Institute of Medical Education and Research, Chandigarh, India
    1. Department of Radiodiagnosis, Postgraduate Institute of Medical Education and Research, Chandigarh, India
  • Article keywords
    BI-RADS, Breast density, Breast neoplasms, Mammography, Mass screening, Ultrasonography

    Abstract

    Objective: To determine the accuracy of ultrasonic (US) assessment of breast density vs mammography, and its interobserver reliability. Methods: One hundred consecutive adult women were scanned using a high-frequency ultrasound transducer in the upper outer quadrant of a single breast. Breast density was recorded as one of four categories: < 25%, 25–50%, 50–75%, and > 75% by two radiologists. Digital mammography was performed on the same day and density was assigned to one of four breast imaging-reporting and data system (BI-RADS) categories by a third radiologist. Cohen\'s Kappa was used to compute inter-rater reliability for US assessment and intermodality agreement among mammographic and US density. Results: The most frequent mammographic density group was ACR B (43%). US density category B had the highest frequency of readings (49% and 51% readings of radiologists 1 and 2, respectively). Excellent interobserver agreement was seen for the measurements of US density; k = 0.968 [95% confidence interval (CI): 0.925–1]. Substantial intermodality agreement was seen for both radiologists 1 and 2; k = 0.675 (95% CI: 0.552–0.798) and 0.673 (95% CI: 0.551–0.796) respectively (p < 0.001). The US overestimated breast density in 14.5%, while underestimation was seen in 6.5% of cases. Conclusion: The US provides accurate and reproducible estimates of breast density. This enables personalized screening, particularly in young women and high-density breasts.

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