Breast cancer prediction and the Wolfe classification of mammograms
T. Carlile, K. J. Kopecky, D. J. Thompson, J. R. Whitehead, F. I. Gilbert Jr, A. J. Present, B. A. Threatt, P. Krook and E. Hadaway
Mammographic parenchymal patterns have been proposed as a method of
determining women at high risk of developing breast cancer. Wolfe's
original report of relative risks as high as 37:1 for "dysplastic" breasts
(DY) as compared with adipose breasts (N1), with intermediate values of P1
and P2, were not uniformly confirmed by others. (Relative risks are used
here as the equivalent of odds ratios.) A case-control study of 706 breast
cancers, each with two matching controls, drawn from 40,000 participants in
four Breast Cancer Detection Demonstration Project clinics, was conducted
to assess the role of the Wolfe classification of breast parenchymal
patterns as a breast-cancer risk factor together with a set of
well-established risk factors for breast cancer. Relative risks of 3.1 for
DY to N1, 3.5 for P2 to N1, and 2.0 for P1 to N1 were determined. These are
comparable to or greater than other known risk factors found in the same
population. The Wolfe classification of parenchymal patterns strengthens
the basis for clinical judgment, but should not be used exclusively to
determine intervention in an individual patient's care.
