Possible Breast Cancer Risk Related to Background Parenchymal Enhancement at Breast MRI: A Meta-Analysis Study

BACKGROUND: The higher level of background parenchymal enhancement (BPE) at breast magnetic resonance imaging (MRI) has drawn considerable attention in the early detection and prediction of breast cancer. It has been reported that there is a possible relationship between the level of BPE at breast MRI and the presence of breast cancer. This meta-analysis was performed to evaluate this relationship. METHODS: Through a systematic literature search up to December 2019, 12 studies with 9541 females, 3870 of them were breast cancer. They were identified reporting relationships between breast cancer and BPE at breast MRI with its different categories (10 related to minimal or mild BPE, eight related to moderate BPE and nine related to high BPE). Odd ratio(OR) with 95% confidence intervals (CIs) was calculated comparing breast cancer prevalence and BPE at breast MRI using dichotomous method with a random or fixed effect model. RESULTS: Females with high (OR, 2.93; 95% CI, 1.24-6.88) and moderate (OR, 2.89; 95% CI, 1.51-5.52) BPE at breast MRI was related with high odds to breast cancer compared to control females. However, females with minimal or mild BPE at breast MRI (OR, 1.33; 95% CI, 0.56-3.17) did not have such risk on breast cancer. The impact of BPE on breast cancer may have a great influence as a tool for improving early detection and prevention of breast cancer. CONCLUSIONS: Based on this meta-analysis, females with high or moderate BPE at breast MRI may have an independent relationship with the risk of breast cancer. This relationship forces us to recommend follow up with those with high or moderate BPE at breast MRI to avoid any complication.