Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view

Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim...
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Autor*in:	Duffy, Stephen W [verfasserIn] Nagtegaal, Iris D Astley, Susan M Gillan, Maureen GC McGee, Magnus A Boggis, Caroline RM Wilson, Mary Beetles, Ursula M Griffiths, Miriam A Jain, Anil K Johnson, Jill Roberts, Rita Deans, Heather Duncan, Karen A Iyengar, Geeta Griffiths, Pam M Warwick, Jane Cuzick, Jack Gilbert, Fiona J

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2008

Schlagwörter:	Breast Cancer Risk Mammographic Density Breast Density Interval Cancer Population Attributable Fraction

Anmerkung:	© Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (

Übergeordnetes Werk:	Enthalten in: Breast cancer research - London : BioMed Central, 1999, 10(2008), 4 vom: 23. Juli
Übergeordnetes Werk:	volume:10 ; year:2008 ; number:4 ; day:23 ; month:07

Links:	Volltext

DOI / URN:	10.1186/bcr2123

Katalog-ID:	SPR029933374

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520			\|a Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals.
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allfields	10.1186/bcr2123 doi (DE-627)SPR029933374 (SPR)bcr2123-e DE-627 ger DE-627 rakwb eng Duffy, Stephen W verfasserin aut Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213 Nagtegaal, Iris D aut Astley, Susan M aut Gillan, Maureen GC aut McGee, Magnus A aut Boggis, Caroline RM aut Wilson, Mary aut Beetles, Ursula M aut Griffiths, Miriam A aut Jain, Anil K aut Johnson, Jill aut Roberts, Rita aut Deans, Heather aut Duncan, Karen A aut Iyengar, Geeta aut Griffiths, Pam M aut Warwick, Jane aut Cuzick, Jack aut Gilbert, Fiona J aut Enthalten in Breast cancer research London : BioMed Central, 1999 10(2008), 4 vom: 23. Juli (DE-627)326645950 (DE-600)2041618-0 1465-542X nnns volume:10 year:2008 number:4 day:23 month:07 https://dx.doi.org/10.1186/bcr2123 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2008 4 23 07
spelling	10.1186/bcr2123 doi (DE-627)SPR029933374 (SPR)bcr2123-e DE-627 ger DE-627 rakwb eng Duffy, Stephen W verfasserin aut Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213 Nagtegaal, Iris D aut Astley, Susan M aut Gillan, Maureen GC aut McGee, Magnus A aut Boggis, Caroline RM aut Wilson, Mary aut Beetles, Ursula M aut Griffiths, Miriam A aut Jain, Anil K aut Johnson, Jill aut Roberts, Rita aut Deans, Heather aut Duncan, Karen A aut Iyengar, Geeta aut Griffiths, Pam M aut Warwick, Jane aut Cuzick, Jack aut Gilbert, Fiona J aut Enthalten in Breast cancer research London : BioMed Central, 1999 10(2008), 4 vom: 23. Juli (DE-627)326645950 (DE-600)2041618-0 1465-542X nnns volume:10 year:2008 number:4 day:23 month:07 https://dx.doi.org/10.1186/bcr2123 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2008 4 23 07
allfields_unstemmed	10.1186/bcr2123 doi (DE-627)SPR029933374 (SPR)bcr2123-e DE-627 ger DE-627 rakwb eng Duffy, Stephen W verfasserin aut Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213 Nagtegaal, Iris D aut Astley, Susan M aut Gillan, Maureen GC aut McGee, Magnus A aut Boggis, Caroline RM aut Wilson, Mary aut Beetles, Ursula M aut Griffiths, Miriam A aut Jain, Anil K aut Johnson, Jill aut Roberts, Rita aut Deans, Heather aut Duncan, Karen A aut Iyengar, Geeta aut Griffiths, Pam M aut Warwick, Jane aut Cuzick, Jack aut Gilbert, Fiona J aut Enthalten in Breast cancer research London : BioMed Central, 1999 10(2008), 4 vom: 23. Juli (DE-627)326645950 (DE-600)2041618-0 1465-542X nnns volume:10 year:2008 number:4 day:23 month:07 https://dx.doi.org/10.1186/bcr2123 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2008 4 23 07
allfieldsGer	10.1186/bcr2123 doi (DE-627)SPR029933374 (SPR)bcr2123-e DE-627 ger DE-627 rakwb eng Duffy, Stephen W verfasserin aut Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213 Nagtegaal, Iris D aut Astley, Susan M aut Gillan, Maureen GC aut McGee, Magnus A aut Boggis, Caroline RM aut Wilson, Mary aut Beetles, Ursula M aut Griffiths, Miriam A aut Jain, Anil K aut Johnson, Jill aut Roberts, Rita aut Deans, Heather aut Duncan, Karen A aut Iyengar, Geeta aut Griffiths, Pam M aut Warwick, Jane aut Cuzick, Jack aut Gilbert, Fiona J aut Enthalten in Breast cancer research London : BioMed Central, 1999 10(2008), 4 vom: 23. Juli (DE-627)326645950 (DE-600)2041618-0 1465-542X nnns volume:10 year:2008 number:4 day:23 month:07 https://dx.doi.org/10.1186/bcr2123 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2008 4 23 07
allfieldsSound	10.1186/bcr2123 doi (DE-627)SPR029933374 (SPR)bcr2123-e DE-627 ger DE-627 rakwb eng Duffy, Stephen W verfasserin aut Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view 2008 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License ( Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213 Nagtegaal, Iris D aut Astley, Susan M aut Gillan, Maureen GC aut McGee, Magnus A aut Boggis, Caroline RM aut Wilson, Mary aut Beetles, Ursula M aut Griffiths, Miriam A aut Jain, Anil K aut Johnson, Jill aut Roberts, Rita aut Deans, Heather aut Duncan, Karen A aut Iyengar, Geeta aut Griffiths, Pam M aut Warwick, Jane aut Cuzick, Jack aut Gilbert, Fiona J aut Enthalten in Breast cancer research London : BioMed Central, 1999 10(2008), 4 vom: 23. Juli (DE-627)326645950 (DE-600)2041618-0 1465-542X nnns volume:10 year:2008 number:4 day:23 month:07 https://dx.doi.org/10.1186/bcr2123 kostenfrei Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_11 GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_95 GBV_ILN_105 GBV_ILN_110 GBV_ILN_151 GBV_ILN_161 GBV_ILN_170 GBV_ILN_206 GBV_ILN_213 GBV_ILN_230 GBV_ILN_285 GBV_ILN_293 GBV_ILN_602 GBV_ILN_2003 GBV_ILN_2014 GBV_ILN_4012 GBV_ILN_4037 GBV_ILN_4112 GBV_ILN_4125 GBV_ILN_4126 GBV_ILN_4249 GBV_ILN_4305 GBV_ILN_4306 GBV_ILN_4307 GBV_ILN_4313 GBV_ILN_4322 GBV_ILN_4323 GBV_ILN_4324 GBV_ILN_4325 GBV_ILN_4338 GBV_ILN_4367 GBV_ILN_4700 AR 10 2008 4 23 07
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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. 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spellingShingle	Duffy, Stephen W misc Breast Cancer Risk misc Mammographic Density misc Breast Density misc Interval Cancer misc Population Attributable Fraction Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view
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topic_title	Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view Breast Cancer Risk (dpeaa)DE-He213 Mammographic Density (dpeaa)DE-He213 Breast Density (dpeaa)DE-He213 Interval Cancer (dpeaa)DE-He213 Population Attributable Fraction (dpeaa)DE-He213
topic	misc Breast Cancer Risk misc Mammographic Density misc Breast Density misc Interval Cancer misc Population Attributable Fraction
topic_unstemmed	misc Breast Cancer Risk misc Mammographic Density misc Breast Density misc Interval Cancer misc Population Attributable Fraction
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title_sort	visually assessed breast density, breast cancer risk and the importance of the craniocaudal view
title_auth	Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view
abstract	Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
abstractGer	Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
abstract_unstemmed	Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. This observation needs to be confirmed by studies applying the different measurement methods to the same individuals. © Duffy et al.; licensee BioMed Central Ltd. 2008. This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (
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title_short	Visually assessed breast density, breast cancer risk and the importance of the craniocaudal view
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This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (</subfield></datafield><datafield tag="520" ind1=" " ind2=" "><subfield code="a">Introduction Mammographic density is known to be a strong risk factor for breast cancer. A particularly strong association with risk has been observed when density is measured using interactive threshold software. This, however, is a labour-intensive process for large-scale studies. Methods Our aim was to determine the performance of visually assessed percent breast density as an indicator of breast cancer risk. We compared the effect on risk of density as measured with the mediolateral oblique view only versus that estimated as the average density from the mediolateral oblique view and the craniocaudal view. Density was assessed using a visual analogue scale in 10,048 screening mammograms, including 311 breast cancer cases diagnosed at that screening episode or within the following 6 years. Results Where only the mediolateral oblique view was available, there was a modest effect of breast density on risk with an odds ratio for the 76% to 100% density relative to 0% to 25% of 1.51 (95% confidence interval 0.71 to 3.18). When two views were available, there was a considerably stronger association, with the corresponding odds ratio being 6.77 (95% confidence interval 2.75 to 16.67). Conclusion This indicates that a substantial amount of information on risk from percentage breast density is contained in the second view. It also suggests that visually assessed breast density has predictive potential for breast cancer risk comparable to that of density measured using the interactive threshold software when two views are available. 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