Impact of Mammographic Breast Density on Breast Cancer Risk

The context, scientific evidence, and controversies surrounding the topic of breast density as a risk factor for breast cancer are presented. The current state of evidence regarding supplemental imaging is also considered.

Course ID: Q00470 Category:
Modalities: , , ,

2.5

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Targeted CE per ARRT’s Discipline, Category, and Subcategory classification:
[Note: Discipline-specific Targeted CE credits may be less than the total Category A credits approved for this course.]

Mammography: 2.00
Patient Care: 1.00
Patient Interactions and Management: 1.00
Procedures: 1.00
Anatomy, Physiology, and Pathology: 1.00

Outline

  1. Introduction
  2. What is Mammographic Density
  3. Accuracy and Variability of Density Classification
  4. Breast Density and the Risk for Breast Cancer
    1. Masking Effect
    2. Density as an Independent Risk Factor
    3. Current State of Legislation Regarding Breast Density Notification
  5. Evidence for Supplemental Screening
    1. Digital Mammography
    2. Digital Breast Tomosynthesis
    3. Whole-Breast US
    4. MR Imaging
  6. Expert Guidelines on Supplemental Screening
  7. The Information Age and Evidence-based Medicine
  8. Conclusion

Objectives

Upon completion of this course, students will:

  1. state the number of states with recent legislative changes in regard to patient notification of breast density
  2. list the critical concepts regarding breast density that radiologists must understand in depth
  3. define breast density
  4. express who first described different parenchymal density patterns
  5. articulate what the acronym BIRADS stands for
  6. specify the four categories of the BIRADS lexicon
  7. differentiate between percentages from data about breast density
  8. describe inter-reader percentages between different studies
  9. discriminate between classification system types to measure breast density
  10. describe how positioning of the breast affects objective measurements of breast density
  11. select the factors that cause breast density to decrease
  12. state how breast density affects mammographic screening
  13. contrast mammographic sensitivity and breast density
  14. describe the method used to make the comparison between mammographic sensitivity and breast density
  15. define interval cancer
  16. verbalize the benefit to shorter screening intervals for women with dense breasts
  17. specify the type of cells most conducive to breast cancer development
  18. list the major risk factors for breast cancer
  19. list the breast density classification systems
  20. name the state where breast density legislation was first passed
  21. specify the year federal legislation regarding breast density notification was first introduced
  22. differentiate between imaging characteristics that effect digital mammograms
  23. express the percentage of facilities in the United States that utilize digital mammography
  24. state the year digital breast tomosynthesis was approved by the FDA
  25. describe how digital breast tomosynthesis creates breast images
  26. list the limiting factors affecting the true impact of digital breast tomosynthesis
  27. state supplemental screening tools that have not been evaluated via randomized trials
  28. note the study providing the most relevant data regarding the benefit of whole-breast ultrasound
  29. list the benefits of automated whole-breast ultrasound
  30. state the year when the FDA approved automated whole-breast ultrasound
  31. state the supplemental breast screening modality that is neither recommended for or against in women with the risk factor of dense breasts
  32. list the obstacles that can limit the use of MR imaging as a breast cancer screening tool
  33. express screening tests that have been shown to reduce the mortality from breast cancer
  34. state the driving factors for breast density legislation
  35. state the benefit of increased information to patients in regard to breast healthcare options