Background parenchymal enhancement: is it just an innocent effect of estrogen on the breast?

Abstract

PURPOSE:We aimed to retrospectively analyze whether background parenchymal enhancement (BPE) on breast magnetic resonance imaging (MRI) correlates with menarche, menopause, reproductive period, menstrual cycle, gravidity-parity, family history of breast cancer, and the Breast Imaging-Reporting and Data System (BI-RADS) category of the patient.METHODS:The study included 126 pre- and 78 postmenopausal women who underwent breast MRI in our institute between 2011 and 2016. Patients had filled a questionnaire form before the MRI. Two radiologists blinded to patient history graded the BPEs and the results were compared and analyzed.RESULTS:The BPE was correlated with patient age and the day of menstrual cycle (P < 0.01 for both). No correlation was found with menarche age, menopause age, total number of reproductive years, and family history of breast cancer. In the moderate BPE group, only 1 out of 35 patients and in the marked BPE group only 1 out of 13 patients were postmenopausal and had BI-RADS scores of 4 and 5, respectively.CONCLUSION:Increased symmetrical BPE is mainly due to current hormonal status in the premenopausal women. High-grade BPE, whether symmetrical or not, is rarely seen in postmenopausal women; hence, these patients should be further investigated or closely followed up.