For this reason, reproducibility and consistency in the objective assessment of these parameters are clinically relevant. Breast density, as depicted at mammography, and fibroglandular tissue and background parenchymal enhancement (BPE), as identified at magnetic resonance (MR) imaging, are now recognized as independent biomarkers for breast cancer risk and have become parameters incorporated into some models for overall personal risk assessment. Although many risk markers are assessed clinically or genetically, imaging-based risk markers have also been identified. Interest is increasing in predicting an individual woman’s personal risk of developing breast cancer ( 1).
FIBROGLANDULAR DENSITY UPDATE
The purpose of this review article is therefore to review key features and means of evaluating breast density, fibroglandular tissue, and BPE at imaging to detail how endogenous and exogenous hormonal stimuli may affect breast density, fibroglandular tissue, and BPE, potentially affecting radiologic interpretation and, finally, to provide an update regarding current hormone treatment guidelines and indications that may result in imaging changes through hormone modulation. It is therefore important for the radiologist to recognize settings in which hormonal stimulation may alter the appearance of these biomarkers at imaging and to appreciate how such changes may affect risk assessment, cancer detection, and even prognosis. However, breast density, fibroglandular tissue, and BPE are manifestations of dynamic physiologic processes and may change in response to both endogenous and exogenous hormonal stimulation. For this reason, reproducibility and consistency in objective assessment of these parameters at mammography (breast density) and at magnetic resonance imaging (fibroglandular tissue and BPE) are clinically relevant. Breast density, fibroglandular tissue, and background parenchymal enhancement (BPE) are recognized independent biomarkers for breast cancer risk.
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