Increased background parenchymal enhancement on peri-menopausal breast magnetic resonance imaging

<h2>Abstract</h2><h3>Objectives</h3> To examine the background parenchymal enhancement (BPE) levels in peri-menopausal breast MRI compared with pre- and post-menopausal breast MRI. <h3>Methods</h3> This study included 562 patients (55.8±12.3 years) who underwent contrast-enhanced dynamic breast MRI between 2011 and 2015 for clinical indications. We evaluated the BPE level, amount of fibroglandular tissue (FGT), and social and clinical variables. The inter-reader agreement for the amount of FGT and the BPE level was evaluated using interclass correlation coefficients. Associations between the BPE level and body mass index (BMI), ages of menarche and menopause, childbirth history, number of children, and the amount of FGT were determined using Spearman's correlation coefficients or Mann-Whitney <i>U</i>-test. Pearson's χ² test was used to assess the difference in the frequency of BPE categories among the age-groups. <h3>Results</h3> The inter-reader agreement was 0.864 for the amount of FGT and 0.840 for the BPE level, both indicating almost perfect agreement. The BPE level showed a weak positive correlation with the amount of FGT (Spearman's ρ=0.271, <i>P</i><0.001). BPE was not significantly correlated with BMI, childbirth history, number of births, or ages of menarche or menopause. BPE was greater in the peri-menopausal age-group compared with the corresponding pre- and post-menopausal age-groups, both with benign and malignant lesions. <h3>Conclusions</h3> BPE was greater in the peri-menopausal stage than in the pre- and post-menopausal stages. Our results suggest that BPE showed a non-linear decrease with age and that the hormonal disbalance in the peri-menopausal period has a greater effect on the BPE level than was previously assumed.