Mammographic Breast Density and its Relationship to Breast Cancer Risk

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.]

Breast Sonography: 2.50
Patient Care: 2.50
Patient Interactions and Management: 2.50

Mammography: 3.50
Patient Care: 2.75
Patient Interactions and Management: 2.75
Procedures: 0.75
Anatomy, Physiology, and Pathology: 0.75

Magnetic Resonance Imaging: 1.75
Procedures: 1.75
Body: 1.75

Registered Radiologist Assistant: 3.50
Procedures: 3.50
Thoracic Section: 3.50

Sonography: 1.75
Procedures: 1.75
Superficial Structures and Other Sonographic Procedures: 1.75

Radiation Therapy: 2.50
Patient Care: 2.50
Patient and Medical Record Management: 2.50

Outline

1. Introduction
2. Methods of Measuring Breast Density
3. Relationship of Breast Density and Breast Cancer Risk
4. Alternative Explanations for the Link Between Breast Density and Cancer Risk
5. Relationship Between Nonhormonal Factors and Breast Density and Breast Cancer Risk
6. Relationship Between Hormonal Factors and Breast Density and Breast Cancer Risk
7. Plausible Factors That May Explain the Association of Breast Density with Breast Cancer Risk
8. Future Directions

Objectives

Upon completion of this course, students will:

1. understand the relationship between breast density and breast cancer risk
2. know the characteristics of the follicular phase of the menstrual cycle
3. be familiar with the most common form of breast lumps during premenopause for women between the ages of 40-49
4. understand the characteristics of breast density measurement
5. know the characteristics of breast tissue in the post-menopause woman
6. understand the Wolfe classification of parenchymal patterns
7. know the reason for including breast density in the BI-RADS report
8. be familiar with the Breast Imaging Reporting and Data System utilized in the United States
9. know the methods of quantifying and qualifying breast density
10. know how many categories BI-RADS has
11. understand which method used an acetate overlay that was placed over the mammogram and traced with a wax pencil
12. know which method of assessing breast density shows agreement of 90% or greater
13. know the limitations of the current planimetry method of measuring breast density
14. be familiar with which imaging modalities are being explored as a possible means of measuring breast density
15. know the major problem with the Wolfe classification system
16. understand the relationship between breast density and cancer risk based on the twelve studies examined
17. be familiar with the author’s conclusion regarding the twelve studies in which quantitative methods were employed
18. know what percentage of breast cancer risk is attributable to higher breast density
19. know the future trend of the incidence of breast cancers
20. know what percentage of breast cancers are attributable to the breast cancer gene
21. know the causes of involution of the breast
22. understand the factors which may influence breast density
23. be familiar with the masking hypothesis
24. be familiar with the risk factors for breast cancer
25. thoroughly understand the “masking” hypothesis
26. understand the clinical significance between past and current density
27. understand the relationship between aging and breast density
28. understand the relationship between body weight and breast density
29. understand the relationship between body weight, breast density and breast cancer risk
30. be familiar with the relationship between aging, body weight, parity and breast cancer risk
31. know the relationship between other risk factors and breast density
32. understand the relationship between nulliparous women and breast cancer risk
33. be familiar with the risk factors for breast cancer
34. be familiar with the use of hormone replace therapy and how often it alters and slows normal breast involution
35. know the clinical significance of HRT regimens
36. understand the relationship between HRT and breast density
37. understand the effect on breast density when HRT is used cyclically as compared to continuous usage
38. know the estrogen receptor modulators
39. understand the effects of selective estrogen receptor modulators and other hormonal agents
40. be familiar with the role of estrogen and breast cancer risk
41. understand the relationship between genetics and breast density
42. know why digital mammography may be ideal for density assessment
43. know the impact of breast density on the future of risk assessment management
44. be familiar with the author’s conclusion regarding risk factors and breast density