The correlation of background parenchymal enhancement in the contralateral breast with patient and tumor characteristics of MRI-screen detected breast cancers

PLoS One. 2018 Jan 19;13(1):e0191399. doi: 10.1371/journal.pone.0191399. eCollection 2018.


Purpose: Higher background parenchymal enhancement (BPE) could be used for stratification of MRI screening programs since it might be related to a higher breast cancer risk. Therefore, the purpose of this study is to correlate BPE to patient and tumor characteristics in women with unilateral MRI-screen detected breast cancer who participated in an intermediate and high risk screening program. As BPE in the affected breast may be difficult to discern from enhancing cancer, we assumed that BPE in the contralateral breast is a representative measure for BPE in women with unilateral breast cancer.

Materials and methods: This retrospective study was approved by our local institutional board and a waiver for consent was granted. MR-examinations of women with unilateral breast cancers screen-detected on breast MRI were evaluated by two readers. BPE in the contralateral breast was rated according to BI-RADS. Univariate analyses were performed to study associations. Observer variability was computed.

Results: Analysis included 77 breast cancers in 76 patients (age: 48±9.8 years), including 62 invasive and 15 pure ductal carcinoma in-situ cases. A negative association between BPE and tumor grade (p≤0.016) and a positive association with progesterone status (p≤0.021) was found. The correlation was stronger when only considering invasive disease. Inter-reader agreement was substantial.

Conclusion: Lower BPE in the contralateral breast in women with unilateral breast cancer might be associated to higher tumor grade and progesterone receptor negativity. Great care should be taken using BPE for stratification of patients to tailored screening programs.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Breast / pathology
  • Breast Neoplasms / diagnostic imaging*
  • Breast Neoplasms / genetics
  • Breast Neoplasms / pathology
  • Carcinoma, Ductal, Breast / diagnostic imaging
  • Carcinoma, Intraductal, Noninfiltrating / diagnostic imaging
  • Carcinoma, Lobular / diagnostic imaging
  • Contrast Media
  • Early Detection of Cancer
  • Female
  • Humans
  • Magnetic Resonance Imaging / methods*
  • Mass Screening
  • Middle Aged
  • Mutation
  • Retrospective Studies
  • Risk Factors
  • Young Adult


  • Contrast Media

Grant support

This work received funding from the European Union’s Seventh Framework Program for research, technological development and demonstration (grant agreement no 601040). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.