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MRI avoids exposing participants to ionizing radiation and measures breast density not impaired by the high parenchymal breast density typical of young women [ 71].
It measures breast density on a continuous scale and has high between- and within-reader reliability in carefully monitored research settings [ 21], however, this may not be reliably realised in the routine screening context, and the method is time-consuming and costly in terms of staff time.
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Cumulus was used previously to measure breast density from the digitised images, with measurements available for 93% of available cases included in previous analyses [ 24, 33].
A quantitative method of measuring breast density, Cumulus, is illustrated in Figure 1.
Tailored screening strategies would benefit from valid standardised automated methods of measuring breast density.
With this study, we want to contribute to the discussion on measuring breast density in national screening programmes.
We develop an automated method to measure breast density (AutoDensity) and compare it to Cumulus in terms of association with breast cancer risk and breast cancer screening outcomes.
We have measured breast density in cancer cases and controls which had previous analogue screening mammograms in the PROCAS (Predicting Risk Of Cancer At Screening) study.
Current methods of measuring breast density are not suitable for developing tailored screening strategies because they are manual methods that are time-consuming and have inadequate reliability.
The Gail and Tice models have only moderate levels of risk prediction that might be improved by the improvements in measuring breast density described above.
Although this study measured breast density on a continuous scale using the computer-assisted Cumulus method [ 24], the range of physical activity was narrow.
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