High background parenchymal enhancement (BPE) on breast MRI is related to increased breast cancer risk. In this study, we investigate possible differences in BPE among different breast cancer risk groups stratified based on BRCA 1/2 mutation status and lifetime risks. We use propensity score matching to adjust for potential confounders. We performed a quantitative BPE analysis on the 3D volume of the breast and fibroglandular tissue based on the enhancement maps and principal component analysis. The results showed a significant difference in BPE among different risk groups, indicating that BPE may improve breast cancer risk stratification.
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