6th International Workshop on Breast Densitometry and Breast ...

6 th <strong>International</strong> <strong>Workshop</strong> on Breast Densitometry
and Breast Cancer Risk Assessment
NEXT GENERATION MEASUREMENTS OF BREAST DENSITY – TOMOSYNTHESIS
Despina Kontos, PhD
Department of Radiology, University of Pennsylvania
ABSTRACTS FOR SPEAKERS
Growing evidence suggests that breast density is an independent risk factor for breast cancer. Currently,
the most widely used methods to estimate breast density rely on semi-automated thresholding of
mammograms to estimate the percent of the dense tissue area versus the entire area of the breast.
Although useful for breast cancer risk estimation, these methods have limitations. Mammography is a
projection imaging technique that visualizes the admixture of superimposed breast tissues.
Therefore, such thresholding methods do not allow for estimating volumetric density, but instead provide
an area-based estimate measured from the projection image of the breast. Digital breast tomosynthesis
(DBT) is an emerging 3D x-ray imaging modality in which tomographic breast images are reconstructed
from multiple low-dose x-ray source projections. Measures of volumetric breast density from DBT
images could provide more accurate measures of the dense breast tissue and ultimately result in more
accurate measures of risk.
This talk will provide an overview of the state-of-the art in the current research on developing volumetric
breast density estimation techniques for DBT, including both semi-automated and fully-automated
approaches, and new approaches to characterize the volumetric complexity of the breast tissue using DBT
parenchymal texture analysis. DBT breast density measures will be compared to other volumetric and
area-based multi-modality breast density estimation approaches, including Digital Mammography and
Breast MRI, and implications will be discussed for breast cancer risk estimation.
We envision a unique setting in which breast cancer risk assessment and patient education can be
combined to empower women with knowledge about their personal risk and provide a fully automated
risk assessment tool for physicians. The tomosynthesis FDA approval coupled with a rapidly evolving
technology and a potential for superior clinical performance will soon determine the emerging role of
DBT in clinical practice.
Early trials suggest a significant benefit from DBT in reducing unnecessary recalls for women in the
screening setting, including a potential for improving cancer detection. Fully-automated approaches for
estimating volumetric breast density in DBT could provide a tool for incorporating quantitative measures
of volumetric breast density in clinical breast cancer risk assessment.
14