Prognostic Role of Breast Architecture in Imaging, Histopathology, and Breast Cancer Outcome

Yerbolat Maratovich Iztleuov, Gulbanu Mutigulina, Altyn Almagambetova, Gulmira Iztleuova

Journal of Clinical Medicine of Kazakhstan, 2025

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DOI 10.23950/jcmk/16879
Data confidence 85 high
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Abstract

Aims. This study investigates the prognostic significance of mammographic density in breast cancer detection, histopathological patterns, treatment outcomes, and the diagnostic efficacy of different imaging modalities. Methods. A retrospective analysis was conducted using data from approximately 7,000 women (20% of the annual screening cohort of 35,000) over the 10-year period. Breast density was classified using BI-RADS categories (A–D). The frequency of breast cancer detection in each density category was analyzed. Imaging methods included mammography, ultrasound, and MRI. Recommendations for women with high-density breasts were developed based on findings. Results. High breast density (BI-RADS C and D) was identified in approximately 60% of screened women. Breast cancer detection rates were significantly higher in BI-RADS C (55%) and BI-RADS D (60%) groups compared to BI-RADS A (12%) and BI-RADS B (15%). Tumor sizes were larger in high-density breasts (2.5 cm for BI-RADS C, 2.8 cm for BI-RADS D). Mammography sensitivity decreased in dense breasts, whereas ultrasound and MRI showed higher sensitivity (90–97%). Based on these findings, guidelines for women with high-density breasts were proposed, emphasizing supplemental imaging and personalized screening. Conclusion. High mammographic density is associated with aggressive tumour types, larger tumour sizes, and poorer outcomes. Aims. This study investigates the prognostic significance of mammographic density in breast cancer detection, histopathological patterns, treatment outcomes, and the diagnostic efficacy of different imaging modalities. Methods. A retrospective analysis was conducted using data from approximately 7,000 women (20% of the annual screening cohort of 35,000) over the 10-year period. Breast density was classified using BI-RADS categories (A–D). The frequency of breast cancer detection in each density category was analyzed. Imaging methods included mammography, ultrasound, and MRI. Recommendations for women with high-density breasts were developed based on findings. Results. High breast density (BI-RADS C and D) was identified in approximately 60% of screened women. Breast cancer detection rates were significantly higher in BI-RADS C (55%) and BI-RADS D (60%) groups compared to BI-RADS A (12%) and BI-RADS B (15%). Tumor sizes were larger in high-density breasts (2.5 cm for BI-RADS C, 2.8 cm for BI-RADS D). Mammography sensitivity decreased in dense breasts, whereas ultrasound and MRI showed higher sensitivity (90–97%). Based on these findings, guidelines for women with high-density breasts were proposed, emphasizing supplemental imaging and personalized screening. Conclusion. High mammographic density is associated with aggressive tumour types, larger tumour sizes, and poorer outcomes.