- An elevation in breast parenchymal enhancement (BPE) on MRI predicts future invasive breast cancer risk.
- Elevated BPE indicates uptake of gadolinium-based intravenous contrast and may reflect increased tissue microvascularity and/or permeability regulated by endogenous hormones.
- The association between BPE and breast cancer is independent of breast density, an established biomarker of breast cancer risk.
Why this matters
- This study adds to the evidence that elevated BPE should be considered for risk prediction in women undergoing breast MRI.
- Prospective cohort of 4247 women without breast cancer in the Breast Cancer Surveillance Consortium.
- BPE was qualitatively assessed by radiologists according to criteria of the American College of Radiology.
- BPE was categorized as minimal, mild, moderate, or marked.
- Funding: NIH; PCORI; AHRQ.
- 176 women developed breast cancer over a median follow-up of 2.8 years.
- Having mild, moderate, or marked BPE (vs minimal BPE) was associated with nearly thrice the risk of invasive breast cancer (HR, 2.73; 95% CI, 1.66-4.49), but not ductal carcinoma in situ.
- Increasing levels of BPE were associated with higher cancer risk, indicating dose-response.
- Low breast density but mild, moderate, or marked BPE was associated with increased breast cancer risk (HR, 2.30; 95% CI, 1.19-4.46).
- Reliance on qualitative assessment.
- Observational design.