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Scientific Session 16 — SS16: Breast Imaging - Screening and New Technologies

Wednesday, May 8, 2019

Abstracts 1307-3099

2909. Background Parenchymal Enhancement on Contrast Enhanced Mammography: Influence of Breast Tissue Density and Menstrual Cycle

Karimi Z*,  Phillips J,  Lotfi P,  Dialani V,  Mehta T. Beth Israel Deaconess Medical Center, Boston, MA

Address correspondence to Z. Karimi (

Objective: Evaluate the relationship between breast tissue density, menstrual status, and background parenchymal enhancement (BPE) on contrast enhanced mammography (CEM).

Materials and Methods: Patients who underwent CEM from 12/18/2014 through 3/30/2018 were retrospectively reviewed. Information on tissue density (fatty, scattered fibro glandular densities [SFGD], heterogeneously dense [HD], extremely dense [ED]), BPE (minimal, mild, moderate, marked), and menstrual status (pre- and postmenopausal) based on last menstrual period (LMP) was documented per case. Premenopausal was defined as any patient with LMP within the past 90 days. Fatty and SFGD were considered nondense, and HD and ED were considered dense. Minimal and mild were considered low BPE and moderate and marked were considered high BPE. Comparison was performed with Pearson's chi-square test.

Results: In total, 172 patients (mean age=53 years, range=25-77 years) were identified. The breast density was fatty in 2 of 172 (1%), SFGD in 48 of 172 (28%), HD in 98 of 172 (57%), and ED in 24 of 172 (14%). BPE was minimal in 62 of 172 (36%), mild in 69 of 172 (40%), moderate in 28 of 172 (16%), and marked in 13 of 172 (8%). Fifty-nine of 172 (34%) were premenopausal (mean time from LMP to CEM =17 days, range=0-73 days). In this group, 35 of 59 (59%) had low BPE, and 24 of 59 (41%) had high BPE. Fifteen of 59 (25%) had nondense, and 44 of 59 (75%) had dense breast tissue. In total, 113 of 172 (66%) patients were postmenopausal. In this group, 96 of 113 (85%) had low BPE, and 17 of 113 (15%) had high BPE. Thirty-five of 113 (31%) had nondense, and 78 of 113 (69%) had dense breast tissue. Dense breast tissue was significantly associated with high BPE as compared to nondense breast tissue (p=0.01). Premenopausal status was significantly associated with high BPE compared to postmenopausal status (p<.001). There was no association between tissue density and menstrual status or between BPE and time from LMP to CEM in premenopausal patients.

Conclusion: Our results suggest BPE is higher in patients with dense breasts and premenopausal status. Further study regarding BPE role in interpretation and breast cancer risk is warranted.