Clinical Significance of Combined Density and Deep-Learning-Based Texture Analysis for Stratifying the Risk of Short-Term and Long-Term Breast Cancer in Screening
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Population
2.2. Image Technique and Interpretation
2.3. Breast Density
2.4. Deep-Learning-Based Texture Model
2.5. Statistical Analysis
3. Results
3.1. Short-Term Cancer
3.2. Long-Term Cancer
4. Discussion
5. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
Appendix A
Number of Women with Baseline Screening n (%) | Person-Years SDC | SDC Rate Per 1000 Person-Years | Person-Years IC | IC Rate Per 1000 Person-Years | Person-Years LTC | LTC Rate Per 1000 Person-Years | |
---|---|---|---|---|---|---|---|
Total | 216,564 (100%) | 106,105.3 | 14 | 424,558.94 | 1.3 | 1,158,577 | 4.05 |
B1 + T1 | 33,392 (15.4%) | 16,413.47 | 6.09 | 65,708.38 | 0.27 | 186,106 | 1.63 |
B1 + T2 | 18,469 (8.5%) | 9064.02 | 9.93 | 362,573 | 0.61 | 102,546 | 2.76 |
B1 + T3 | 11,275 (5.2%) | 5518.79 | 16.49 | 22,059.63 | 0.5 | 63,114 | 4.52 |
B1 + T4 | 4535 (2.1%) | 2214.66 | 22.13 | 8843.84 | 1.13 | 25,763 | 5.28 |
B2 + T1 | 14,118 (6.5%) | 6937.89 | 6.77 | 27,796.89 | 0.36 | 67,106 | 2.16 |
B2 + T2 | 21,892 (10.1%) | 10,737.66 | 11.55 | 42989 | 1.07 | 112,563 | 3.18 |
B2 + T3 | 23,374 (10.8%) | 11,447.95 | 15.02 | 45,782.36 | 1.2 | 129,549 | 3.87 |
B2 + T4 | 22,375 (10.3%) | 10,898.48 | 28.08 | 43,531.16 | 2.16 | 132,586 | 6.32 |
B3 + T1 | 4789 (2.2%) | 2356 | 4.24 | 9442.34 | 1.06 | 19,923 | 1.96 |
B3 + T2 | 11,791 (5.4%) | 5787.83 | 9.85 | 23,205.86 | 0.99 | 52,183 | 3.35 |
B3 + T3 | 16,344 (7.5%) | 8012.83 | 12.48 | 32,090.63 | 1.78 | 79,078 | 4.83 |
B3 + T4 | 21,994 (10.2%) | 10,729.64 | 24.14 | 42,920.38 | 2.47 | 130,195 | 6.81 |
B4 + T1 | 1842 (0.9%) | 906.02 | 3.31 | 3633.15 | 1.38 | 8591 | 4.42 |
B4 + T2 | 1989 (0.9%) | 977.77 | 4.09 | 3911.26 | 4.09 | 8790 | 4.55 |
B4 + T3 | 3148 (1.5%) | 1541.7 | 15.57 | 6162.52 | 3.73 | 13,600 | 5.29 |
B4 + T4 | 5237 (2.4%) | 2560.6 | 19.14 | 10,224.23 | 4.3 | 26,884 | 7.59 |
BI-RADS density and Texture categories | |||||||
B1 | 67,671 (31.2%) | 33,210.93 | 9.94 | 132,869.14 | 0.46 | 377,529 | 2.67 |
B2 | 81,759 (37.8%) | 40,021.98 | 16.22 | 160,099.42 | 1.28 | 441,803 | 4.17 |
B3 | 54,918 (25.4%) | 26,886.29 | 15.84 | 107,659.21 | 1.82 | 281,379 | 5.27 |
B4 | 12,216 (5.6%) | 5986.09 | 13.36 | 23,931.16 | 3.68 | 57,865 | 6.12 |
T1 | 54,141 (25%) | 26,613.39 | 6.01 | 106,580.77 | 0.4 | 281,726 | 1.87 |
T2 | 54,141 (25%) | 26,567.27 | 10.35 | 106,363.41 | 1.01 | 276,083 | 3.1 |
T3 | 54,141 (25%) | 26,521.28 | 14.59 | 106,095.15 | 1.38 | 285,341 | 4.35 |
T4 | 54,141 (25%) | 26,403.37 | 25.11 | 105,519.61 | 2.41 | 315,427 | 6.55 |
50–55 | 55–60 | 60–65 | 65- | Total | |
---|---|---|---|---|---|
Total | 98,516 | 41,413 | 36,985 | 39,650 | 216,564 |
B1 + T1 | 12,412 | 7321 | 6594 | 7065 | 33,392 |
B1 + T2 | 6317 | 3717 | 3916 | 4519 | 18,469 |
B1 + T3 | 3394 | 2115 | 2485 | 3281 | 11,275 |
B1 + T4 | 1312 | 783 | 1042 | 1398 | 4535 |
B2 + T1 | 7874 | 2718 | 1948 | 1578 | 14,118 |
B2 + T2 | 10,519 | 4331 | 3585 | 3457 | 21,892 |
B2 + T3 | 9310 | 4849 | 4385 | 4830 | 23,374 |
B2 + T4 | 7494 | 4583 | 4710 | 5588 | 22,375 |
B3 + T1 | 3297 | 699 | 433 | 360 | 4789 |
B3 + T2 | 7787 | 1789 | 1182 | 1033 | 11,791 |
B3 + T3 | 9871 | 2713 | 2008 | 1752 | 16,344 |
B3 + T4 | 10,377 | 4190 | 3663 | 3764 | 21,994 |
B4 + T1 | 1227 | 278 | 177 | 160 | 1842 |
B4 + T2 | 1476 | 222 | 148 | 143 | 1989 |
B4 + T3 | 2349 | 374 | 205 | 220 | 3148 |
B4 + T4 | 3500 | 731 | 504 | 502 | 5237 |
BI-RADS density and Texture categories | |||||
B1 | 23,435 | 13,936 | 14,037 | 16,263 | 67,671 |
B2 | 35,197 | 16,481 | 14,628 | 15,453 | 81,759 |
B3 | 31,332 | 9391 | 7286 | 6909 | 54,918 |
B4 | 8552 | 1605 | 1034 | 1025 | 12,216 |
T1 | 24,810 | 11,016 | 9152 | 9163 | 54,141 |
T2 | 26,099 | 10,059 | 8831 | 9152 | 54,141 |
T3 | 24,924 | 10,051 | 9083 | 10,083 | 54,141 |
T4 | 22,683 | 10,287 | 9919 | 11,252 | 54,141 |
Screen-Detected Cancer | Interval Cancer | Long-Term Cancer | ||||
---|---|---|---|---|---|---|
Model 1 (95% CI) | Model 2 (95% CI) | Model 1 (95% CI) | Model 2 (95% CI) | Model 1 (95% CI) | Model 2 (95% CI) | |
B1 + T1 | Ref (1.00) | Ref (1.00) | Ref (1.00) | Ref (1.00) | Ref (1.00) | Ref (1.00) |
B1 + T2 | 1.63 (1.22–2.17) | 1.58 (1.19–2.1) | 2.22 (1.19–4.18) | 2.19 (1.18–4.14) | 1.69 (1.44–1.99) | 1.68 (1.43–1.97) |
B1 + T3 | 2.71 (2.04–3.59) | 2.54 (1.91–3.38) | 1.82 (0.83–3.8) | 1.78 (0.81–3.71) | 2.76 (2.35–3.25) | 2.71 (2.31–3.19) |
B1 + T4 | 3.63 (2.56–5.08) | 3.37 (2.37–4.71) | 4.13 (1.83–8.77) | 4.02 (1.78–8.54) | 3.23 (2.63–3.95) | 3.16 (2.57–3.86) |
B2 + T1 | 1.11 (0.78–1.56) | 1.21 (0.85–1.71) | 1.31 (0.58–2.79) | 1.37 (0.61–2.92) | 1.32 (1.08–1.61) | 1.39 (1.14–1.69) |
B2 + T2 | 1.9 (1.46–2.47) | 1.98 (1.52–2.56) | 3.91 (2.31–6.91) | 4 (2.36–7.08) | 1.95 (1.67–2.27) | 2 (1.72–2.34) |
B2 + T3 | 2.47 (1.93–3.16) | 2.47 (1.94–3.17) | 4.39 (2.63–7.68) | 4.41 (2.64–7.71) | 2.37 (2.05–2.73) | 2.39 (2.07–2.75) |
B2 + T4 | 4.61 (3.69–5.8) | 4.46 (3.57–5.62) | 7.88 (4.89–13.48) | 7.79 (4.83–13.32) | 3.87 (3.4–4.42) | 3.84 (3.37–4.39) |
B3 + T1 | 0.7 (0.34–1.27) | 0.79 (0.39–1.44) | 3.87 (1.72–8.22) | 3.87 (1.72–8.22) | 1.2 (0.85–1.65) | 1.31 (0.93–1.81) |
B3 + T2 | 1.62 (1.16–2.23) | 1.81 (1.3–2.5) | 3.61 (1.96–6.79) | 3.85 (2.08–7.24) | 2.05 (1.7–2.47) | 2.24 (1.85–2.69) |
B3 + T3 | 2.05 (1.55–2.7) | 2.24 (1.7–2.96) | 6.48 (3.9–11.33) | 6.82 (4.09–11.92) | 2.96 (2.54–3.44) | 3.16 (2.57–3.86) |
B3 + T4 | 3.96 (3.16–5.01) | 4.1 (3.27–5.19) | 9.02 (5.62–15.35) | 9.2 (5.73–15.67) | 4.17 (3.67–4.76) | 4.32 (3.79–4.92) |
B4 + T1 | 0.54 (0.13–1.44) | 0.61 (0.15–1.62) | 5.02 (1.66–12.59) | 5.35 (1.77–13.43) | 2.71 (1.9–3.74) | 2.71 (1.9–3.74) |
B4 + T2 | 0.67 (0.21–1.6) | 0.76 (0.23–1.81) | 14.93 (7.53–29.34) | 16.13 (8.11–31.78) | 2.79 (1.97–3.82) | 3.12 (2.21–4.29) |
B4 + T3 | 2.56 (1.6–3.92) | 2.91 (1.82–4.47) | 13.62 (7.37–25.57) | 14.74 (7.95–27.76) | 3.24 (2.49–4.16) | 3.65 (2.8–4.7) |
B4 + T4 | 3.4 (2.21–4.39) | 3.49 (2.45–4.89) | 15.71 (9.24–27.87) | 16.71 (9.81–29.71) | 4.65 (3.89–5.54) | 5.11 (4.27–6.11) |
Number of Women with Baseline Screening n (%) | All STC, n | Screen-Detected Cancer, n (%) | Interval Cancer, n (%) | |
---|---|---|---|---|
Total | 216,564 (100%) | 2035 | 1485 (100%) | 550 (100%) |
B1 + T1 | 33,392 (15.4%) | 118 | 100 (6.7%) | 18 (3.3%) |
B1 + T2 | 18,469 (8.5%) | 112 | 90 (6.6%) | 22 (4%) |
B1 + T3 | 11,275 (5.2%) | 102 | 91 (6.1%) | 11 (2%) |
B1 + T4 | 4535 (2.1%) | 59 | 49 (3.3%) | 10 (1.8%) |
B2 + T1 | 14,118 (6.5%) | 57 | 47 (3.2%) | 10 (1.8%) |
B2 + T2 | 21,892 (10.1%) | 170 | 124 (8.4%) | 46 (8.4%) |
B2 + T3 | 23,374 (10.8%) | 227 | 172 (11.6%) | 55 (10%) |
B2 + T4 | 22,375 (10.3%) | 400 | 306 (20.6%) | 94 (17.1%) |
B3 + T1 | 4789 (2.2%) | 20 | 10 (0.7%) | 10 (1.8%) |
B3 + T2 | 11,791 (5.4%) | 80 | 57 (3.8%) | 23 (4.2%) |
B3 + T3 | 16,344 (7.5%) | 157 | 100 (6.7%) | 57 (10.4%) |
B3 + T4 | 21,994 (10.2%) | 365 | 259 (17.4%) | 106 (19.3%) |
B4 + T1 | 1842 (0.9%) | 8 | 3 (0.2%) | 5 (0.9%) |
B4 + T2 | 1989 (0.9%) | 20 | 4 (0.3%) | 16 (2.9%) |
B4 + T3 | 3148 (1.5%) | 47 | 24 (1.6%) | 23 (4.2%) |
B4 + T4 | 5237 (2.4%) | 93 | 49 (3.3%) | 44 (8%) |
BI-RADS density and Texture categories | ||||
B1 | 67,671 (31.2%) | 391 | 330 (22.2%) | 61 (11.1%) |
B2 | 81,759 (37.8%) | 854 | 649 (43.7%) | 205 (37.3%) |
B3 | 54,918 (25.4%) | 622 | 426 (28.7% | 196 (35.6%) |
B4 | 12,216 (5.6%) | 168 | 80 (5.4%) | 88 (16%) |
T1 | 54,141 (25%) | 203 | 160 (10.8%) | 43 (7.8%) |
T2 | 54,141 (25%) | 382 | 275 (18.5%) | 107 (19.5%) |
T3 | 54,141 (25%) | 533 | 387 (26.1%) | 146 (26.6%) |
T4 | 54,141 (25%) | 917 | 663 (44.7%) | 254 (46.2%) |
Number of Women with Baseline Screening, n (%) | LTC, n | LTC, of Which Invasive Carcinoma, n | LTC, of Which DCIS, n | Median Time to LTC, Counted from Baseline, Months (Q1–Q3) | |
---|---|---|---|---|---|
Total | 214,501 (100%) | 4687 (100%) | 4088 | 599 | 56.3 (36.3–80.2) |
B1 + T1 | 33,271 (15.5%) | 304 (6.4%) | 276 | 28 | 52.8 (34.2–78.3) |
B1 + T2 | 18,357 (8.6%) | 283 (6%) | 255 | 28 | 54.1 (32.7–78.3) |
B1 + T3 | 11,171 (5.2%) | 285 (6.1%) | 252 | 33 | 53.4 (35.6–80.3) |
B1 + T4 | 4476 (2.1%) | 136 (2.9%) | 120 | 16 | 52.9 (31.9–79) |
B2 + T1 | 14,056 (6.6%) | 145 (3.1%) | 125 | 20 | 61.8 (34.2–83.2) |
B2 + T2 | 21,717 (10.1%) | 358 (7.6%) | 309 | 49 | 56 (35.8–79.3) |
B2 + T3 | 23,146 (10.8%) | 501 (10.7%) | 439 | 62 | 54.8 (34.5–81.1) |
B2 + T4 | 21,975 (10.2%) | 838 (17.9%) | 746 | 92 | 58.1 (38.7–82.8) |
B3 + T1 | 4767 (2.2%) | 39 (0.8%) | 30 | 9 | 60.3 (32.2–82.6) |
B3 + T2 | 11,706 (5.5%) | 175 (3.7%) | 141 | 34 | 51.6 (31.4–75.3) |
B3 + T3 | 16,184 (7.5%) | 382 (8.2%) | 319 | 63 | 53.5 (33.5–77.4) |
B3 + T4 | 21,628 (10.1%) | 887 (18.9%) | 777 | 110 | 60.6 (44.1–83.6) |
B4 + T1 | 1834 (0.9%) | 38 (0.8%) | 34 | 4 | 57 (42.4–78) |
B4 + T2 | 1968 (0.9%) | 40 (0.9%) | 31 | 9 | 57.5 (38.2–75.5) |
B4 + T3 | 3101 (1.4%) | 72 (1.5%) | 58 | 14 | 54.5 (32–78.3) |
B4 + T4 | 5144 (2.5%) | 204 (4.4%) | 176 | 28 | 58.8 (41–79.8) |
BI-RADS density and Texture categories | |||||
B1 | 67,275 (31.4%) | 1008 (21.5%) | 903 | 105 | 53 (34.2–78.6) |
B2 | 80,894 (37.7%) | 1842 (39.3%) | 1619 | 223 | 57.3 (36.1–81.9) |
B3 | 54,285 (25.3%) | 1483 (31.6%) | 1267 | 216 | 57.5 (36.8–80.4) |
B4 | 12,047 (5.6%) | 354 (7.6%) | 299 | 55 | 57.1 (39.1–78.6) |
T1 | 53,928 (25.1%) | 526 (11.2%) | 465 | 61 | 55.6 (34.3–80.1) |
T2 | 53,748 (25.1%) | 856 (18.3%) | 736 | 120 | 53.3 (34–78.2) |
T3 | 53,602 (25%) | 1240 (26.5%) | 1068 | 172 | 54.1 (34.2–78.9) |
T4 | 53,223 (24.8%) | 2065 (44.1%) | 1819 | 246 | 59.4 (40.6–82.7) |
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Women at Risk of Short-Term Cancer (Invasive + DCIS) | Women at Risk of Long-Term Cancer (Invasive + DCIS) | |
---|---|---|
No. of women with baseline screenings | 216,564 | 214,501 |
Median age, years (Q1–Q3) | 56.2 (51.7–63.0) | 56.1 (51.7–63.0) |
SDC, n | 1485 | - |
Of which invasive | 1226 | - |
Of which DCIS | 259 | - |
IC, n | 550 | - |
LTC, n | - | 4687 |
BI-RADS 1, no. of women (%) | 67,671 (31.2%) | 67,275 (31.4%) |
BI-RADS 2, no. of women (%) | 81,759 (37.8%) | 80,894 (37.7%) |
BI-RADS 3, no. of women (%) | 54,918 (25.4%) | 54,285 (25.3%) |
BI-RADS 4, no. of women (%) | 12,216 (5.6%) | 12,047 (5.6%) |
Texture 1, no. of women (%) (0.000696–0.0513) | 54,141 (25%) | 53,928 (25.1%) |
Texture 2, no. of women (%) (0.0513–0.0925) | 54,141 (25%) | 53,748 (25.1%) |
Texture 3, no. of women (%) (0.0925–0.157) | 54,141 (25%) | 53,602 (25%) |
Texture 4, no. of women (%) (0.157–0.929) | 54,141 (25%) | 53,223 (24.8%) |
Screen-Detected Cancer Rate Per 1000 Women | BI-RADS 1 | BI-RADS 2 | BI-RADS 3 | BI-RADS 4 | Any BI-RADS |
---|---|---|---|---|---|
Texture 1 | 2.99 | 3.33 | 2.09 | 1.63 | 4.88 |
Texture 2 | 4.87 | 5.66 | 4.83 | 2.01 | 7.94 |
Texture 3 | 8.07 | 7.36 | 6.12 | 7.62 | 7.76 |
Texture 4 | 10.8 | 13.68 | 11.78 | 9.36 | 6.55 |
Any Texture | 2.96 | 5.08 | 7.15 | 12.25 | 6.86 |
Interval Cancer Rate Per 1000 Women | BI-RADS 1 | BI-RADS 2 | BI-RADS 3 | BI-RADS 4 | Any BI-RADS |
---|---|---|---|---|---|
Texture 1 | 0.54 | 0.71 | 2.09 | 2.71 | 0.9 |
Texture 2 | 1.19 | 2.1 | 1.95 | 8.04 | 2.51 |
Texture 3 | 0.98 | 2.35 | 3.49 | 7.31 | 3.57 |
Texture 4 | 2.21 | 4.2 | 4.82 | 8.4 | 7.2 |
Any Texture | 0.79 | 1.98 | 2.7 | 4.69 | 2.54 |
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Vilmun, B.M.; Napolitano, G.; Lauritzen, A.; Lynge, E.; Lillholm, M.; Nielsen, M.B.; Vejborg, I. Clinical Significance of Combined Density and Deep-Learning-Based Texture Analysis for Stratifying the Risk of Short-Term and Long-Term Breast Cancer in Screening. Diagnostics 2024, 14, 1823. https://doi.org/10.3390/diagnostics14161823
Vilmun BM, Napolitano G, Lauritzen A, Lynge E, Lillholm M, Nielsen MB, Vejborg I. Clinical Significance of Combined Density and Deep-Learning-Based Texture Analysis for Stratifying the Risk of Short-Term and Long-Term Breast Cancer in Screening. Diagnostics. 2024; 14(16):1823. https://doi.org/10.3390/diagnostics14161823
Chicago/Turabian StyleVilmun, Bolette Mikela, George Napolitano, Andreas Lauritzen, Elsebeth Lynge, Martin Lillholm, Michael Bachmann Nielsen, and Ilse Vejborg. 2024. "Clinical Significance of Combined Density and Deep-Learning-Based Texture Analysis for Stratifying the Risk of Short-Term and Long-Term Breast Cancer in Screening" Diagnostics 14, no. 16: 1823. https://doi.org/10.3390/diagnostics14161823