Automated assessment of background parenchymal enhancement on breast MRI: Impact on breast cancer risk in a matched cohort study

Motivation: Background parenchymal enhancement (BPE) is assessed on contrast-enhanced breast MRI, but its association with breast cancer risk remains unclear. Goal(s): This study aims to investigate the association between BPE, measured through an automated method, and breast cancer risk. Approach: We analyzed the effect of BPE on breast cancer risk, balancing for age and menopausal state at the time of MRI examination in patients with and without breast cancer. Results: The ratio of BPE-to-fat was strongly associated with breast cancer. Impact: With more robust measurement, BPE alongside with clinical risk factors and breast density could enhance breast cancer risk assessment. This could help optimize breast screening strategy through a multimodal approach.