Imperfect Correlation of Mammographic and Clinical Breast Tissue Density

  • Alipour, Sadaf (Surgery Department, Arash Women's Hospital) ;
  • Bayani, Leila (Radiology Department, Arash Women's Hospital) ;
  • Saberi, Azin (Surgery Department, Arash Women's Hospital) ;
  • Alikhassi, Afsaneh (Radiology Department, Arash Women's Hospital) ;
  • Hosseini, Ladan (Research Development Center, Arash Women's Hospital) ;
  • Eslami, Bita (Vali-e-Asr Reproductive Health Research Center, Tehran University of Medical Sciences)
  • Published : 2013.06.30


Background: Clinicians determine degree of mammographic density based on tissue firmness on breast examination. The study aimed to compare breast density in mammography and clinical breast examination. Materials and Methods: Six-hundred sixty three women 40 years of age or older were studied. The breast exam density was graded from 1 to 4 by two expert surgeons and the mammographic parenchymal density by two expert radiologists. Then for practical reasons, grades 1 and 2 were considered as low-density and grades 3 and 4 as high-density. Results: High and low densities were detected in 84.5% and 15.5% of clinical breast examinations and 59.7% and 40.3% of mammographies, respectively. The statistical analysis showed a significant difference between the breast tissue densities in breast examination with those in mammography. Conclusions: A clinically dense breast does not necessarily imply a dense mammographic picture.


  1. Boren WL, Hunter TB, Bjelland JC, Hunt KR (1990). Comparison of breast consistency at palpation with breast density at mammography. Invest Radiol, 25, 1010-1.
  2. Brisson J, Diorio C, Masse B (2003). Wolfe's parenchymal pattern and percentage of the breast with mammographic densities: redundant or complementary classifications? Cancer Epidemiol Biomarkers Prev, 12, 728-32.
  3. Bryan T, Snyder E (2013). The clinical breast exam: a skill that should not be abandoned. J Gen Intern Med, 28, 719-22.
  4. Corbex M, Burton R, Sancho-Garnier H (2012). Breast cancer early detection methods for low and middle income countries, a review of the evidence. Breast, 21, 428-34.
  5. Drukteinis JS, Mooney BP, Flowers CI, Gatenby RA (2013). Beyond mammography: New frontiers in breast cancer screening. Am J Med, 126, 472-9.
  6. Galukande M, Kiguli-Malwadde E (2012). Mammographic breast density patterns among a group of women in sub saharan africa. Afr Health Sci, 12, 422-5.
  7. Garcia-Manso A, Garcia-Orellana CJ, Gonzalez-Velasco HM, Gallardo-Caballero R, Macias-Macias M (2013). Study of the effect of breast tissue density on detection of masses in mammograms. Comput Math Methods Med, 2013, 213794.
  8. Hanna M, Diorio C (2013). Does mammographic density reflect the expression of breast cancer markers? Climacteric, [Epub ahead of print].
  9. Heine JJ, Carston MJ, Scott CG, et al (2008). An automated approach for estimation of breast density. Cancer Epidemiol Biomarkers Prev, 17, 3090-7.
  10. Kim WH, Moon WK, Kim SJ, et al (2013). Ultrasonographic assessment of breast density. Breast Cancer Res Treat, 138, 851-9.
  11. Manning MA, Duric N, Littrup P, et al (2013). Knowledge of breast density and awareness of related breast cancer risk. J Cancer Educ, 28, 270-4.
  12. Mccormack VA, Dos Santos Silva I (2006). Breast density and parenchymal patterns as markers of breast cancer risk: a meta-analysis. Cancer Epidemiol Biomarkers Prev, 15, 1159-69.
  13. Phipps AI, Buist DS, Malone KE, et al (2012). Breast density, body mass index, and risk of tumor marker-defined subtypes of breast cancer. Ann Epidemiol, 22, 340-8.
  14. Swann CA, Kopans DB, Mccarthy KA, White G, Hall DA (1987). Mammographic density and physical assessment of the breast. AJR Am J Roentgenol, 148, 525-6.
  15. Vachon CM, Pankratz VS, Scott CG, et al (2007). Longitudinal trends in mammographic percent density and breast cancer risk. Cancer Epidemiol Biomarkers Prev, 16, 921-8.
  16. Yaghjyan L, Colditz GA, Rosner B, Tamimi RM (2013). Mammographic breast density and subsequent risk of breast cancer in postmenopausal women according to the time since the mammogram. Cancer Epidemiol Biomarkers Prev, 22, 1110-7.
  17. Zulfiqar M, Rohazly I, Rahmah M (2011). Do the majority of malaysian women have dense breasts on mammogram? Biomed Imaging Interv J, 7, 14.

Cited by

  1. Association of Mammographic Breast Density with Dairy Product Consumption, Sun Exposure, and Daily Activity vol.2014, pp.2090-567X, 2014,
  2. The relationship between breast density and bone mineral density in never users of postmenopausal hormone therapy vol.29, pp.3, 2017,