We present a fully-automated method for deriving quantitative measures of background parenchymal enhancement (BPE) from breast dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) and perform a preliminary evaluation of these measures to assess the effect of risk-reducing salpingo-oophorectomy (RRSO) in a cohort of BReast CAncer susceptibility gene 1/2 (BRCA1/2) mutation carriers.
Breast DCE-MRI data from 50 BRCA1/2 carriers were retrospectively analyzed under the Health Insurance Portability and Accountability Act (HIPAA) and institutional review board approval. Both the absolute (| |) and relative ( %) measures of BPE and fibroglandular tissue (FGT) were computed from the MRI scans acquired before and after RRSO. These pre- and post-RRSO measures were compared using paired Student's t-test. The area under the curve (AUC) of the receiver operating characteristic (ROC) were used to evaluate the performance of relative changes in the BPE and FGT measures in predicting breast cancer developed among these women after the RRSO surgery.
For the 44 women who did not develop breast cancer after RRSO, absolute volume of BPE and FGT has a significant decrease (p < 0.05) post-RRSO, while for the 6 women who developed breast cancer there are no significant changes in these measures. Higher values in all BPE and FGT measures are also observed post-RRSO for the women who developed breast cancer, compared to women who did not. Relative changes in BPE % are most predictive of women who develop breast cancer after RRSO (p < 0.05), while combining BPE % and |FGT| yields an AUC of 0.80, higher than BPE % (AUC = 0.78) or |FGT| (AUC = 0.66) alone (both p > 0.02).
Quantitative measures of BPE and FGT are different before and after RRSO, and their relative changes are associated with prediction of developing breast cancer, potentially indicative of women who are more susceptible to develop breast cancer after RRSO in BRCA1/2 mutation carriers.