Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems
Identifieur interne : 001B50 ( Main/Merge ); précédent : 001B49; suivant : 001B51Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems
Auteurs : Anya Burton [France] ; Graham Byrnes [France] ; Jennifer Stone [Australie] ; Rulla M. Tamimi [États-Unis] ; John Heine [États-Unis] ; Celine Vachon [États-Unis] ; Vahit Ozmen [Turquie] ; Ana Pereira [Chili] ; Maria Luisa Garmendia [Royaume-Uni] ; Christopher Scott [États-Unis] ; John H. Hipwell [Royaume-Uni] ; Caroline Dickens [Afrique du Sud] ; Joachim Schüz [France] ; Mustafa Erkin Aribal [Turquie] ; Kimberly Bertrand [États-Unis] ; Ava Kwong [République populaire de Chine] ; Graham G. Giles [Australie] ; John Hopper [Australie] ; Beatriz Pérez G Mez [Espagne] ; Marina Pollán [Espagne] ; Soo-Hwang Teo [Malaisie] ; Shivaani Mariapun [Malaisie] ; Nur Aishah Mohd Taib [Malaisie] ; Martín Lajous [États-Unis, Mexique] ; Ruy Lopez-Riduara [Mexique] ; Megan Rice [États-Unis] ; Isabelle Romieu [France] ; Anath Arzee Flugelman [Israël] ; Giske Ursin [Norvège, États-Unis] ; Samera Qureshi [Norvège] ; Huiyan Ma [États-Unis] ; Eunjung Lee [États-Unis] ; Reza Sirous [Iran] ; Mehri Sirous [Iran] ; Jong Won Lee [Corée du Sud] ; Jisun Kim [Corée du Sud] ; Dorria Salem [Égypte] ; Rasha Kamal [Égypte] ; Mikael Hartman [Singapour] ; Hui Miao [Singapour] ; Kee-Seng Chia [Singapour] ; Chisato Nagata [Japon] ; Sudhir Vinayak [Kenya] ; Rose Ndumia [Kenya] ; Carla H. Van Gils [Pays-Bas] ; Johanna O. P. Wanders [Pays-Bas] ; Beata Peplonska [Pologne] ; Agnieszka Bukowska [Pologne] ; Steve Allen [Royaume-Uni] ; Sarah Vinnicombe [Royaume-Uni] ; Sue Moss [Royaume-Uni] ; Anna M. Chiarelli [Canada] ; Linda Linton [Canada] ; Gertraud Maskarinec [États-Unis] ; Martin J. Yaffe [Canada] ; Norman F. Boyd [Canada] ; Isabel Dos-Santos-Silva [Royaume-Uni] ; Valerie A. Mccormack [France]Source :
- Breast Cancer Research : BCR [ 1465-5411 ] ; 2016.
Descripteurs français
- KwdFr :
- MESH :
- anatomopathologie : Tumeurs du sein.
- imagerie diagnostique : Tumeurs du sein.
- Adulte, Adulte d'âge moyen, Densité mammaire, Femelle, Humains, Mammographie, Sujet âgé, Sujet âgé de 80 ans ou plus, Traitement d'image par ordinateur.
English descriptors
- KwdEn :
- MESH :
- diagnostic imaging : Breast Neoplasms.
- methods : Mammography.
- pathology : Breast Neoplasms.
- Adult, Aged, Aged, 80 and over, Breast Density, Female, Humans, Image Processing, Computer-Assisted, Middle Aged.
Abstract
Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types.
We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (
Breast area did not differ in processed images compared with that in raw images, but the percent MD was higher, due to a larger dense area (median 28.5 and 25.4 cm2 respectively, mean √dense area difference 0.44 cm (95% CI: 0.36, 0.52)). This difference in √dense area was significant for direct digital systems (Hologic 0.50 cm (95% CI: 0.39, 0.61), GE 0.56 cm (95% CI: 0.42, 0.69)) but not for Fuji CR (0.06 cm (95% CI: −0.10, 0.23)). Additionally, within each system, reader-specific differences varied in magnitude and direction (
MD was slightly higher when measured on processed than on raw direct digital mammograms. Comparisons of MD on these image formats should ideally control for this non-constant and reader-specific difference.
The online version of this article (doi:10.1186/s13058-016-0787-0) contains supplementary material, which is available to authorized users.
Url:
DOI: 10.1186/s13058-016-0787-0
PubMed: 27993168
PubMed Central: 5168805
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PMC:5168805Le document en format XML
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<author><name sortKey="Burton, Anya" sort="Burton, Anya" uniqKey="Burton A" first="Anya" last="Burton">Anya Burton</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09, France</nlm:aff>
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<author><name sortKey="Stone, Jennifer" sort="Stone, Jennifer" uniqKey="Stone J" first="Jennifer" last="Stone">Jennifer Stone</name>
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<author><name sortKey="Tamimi, Rulla M" sort="Tamimi, Rulla M" uniqKey="Tamimi R" first="Rulla M." last="Tamimi">Rulla M. Tamimi</name>
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<author><name sortKey="Heine, John" sort="Heine, John" uniqKey="Heine J" first="John" last="Heine">John Heine</name>
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<author><name sortKey="Vachon, Celine" sort="Vachon, Celine" uniqKey="Vachon C" first="Celine" last="Vachon">Celine Vachon</name>
<affiliation wicri:level="2"><nlm:aff id="Aff5">Department of Health Sciences Research, Mayo Clinic, Rochester, MN USA</nlm:aff>
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<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic, Rochester</wicri:cityArea>
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<author><name sortKey="Ozmen, Vahit" sort="Ozmen, Vahit" uniqKey="Ozmen V" first="Vahit" last="Ozmen">Vahit Ozmen</name>
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<author><name sortKey="Pereira, Ana" sort="Pereira, Ana" uniqKey="Pereira A" first="Ana" last="Pereira">Ana Pereira</name>
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<author><name sortKey="Garmendia, Maria Luisa" sort="Garmendia, Maria Luisa" uniqKey="Garmendia M" first="Maria Luisa" last="Garmendia">Maria Luisa Garmendia</name>
<affiliation wicri:level="4"><nlm:aff id="Aff8">Centre for Medical Image Computing, University College London, London, UK</nlm:aff>
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<author><name sortKey="Scott, Christopher" sort="Scott, Christopher" uniqKey="Scott C" first="Christopher" last="Scott">Christopher Scott</name>
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<country>États-Unis</country>
<placeName><region type="state">Minnesota</region>
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<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic, Rochester</wicri:cityArea>
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<author><name sortKey="Hipwell, John H" sort="Hipwell, John H" uniqKey="Hipwell J" first="John H." last="Hipwell">John H. Hipwell</name>
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<author><name sortKey="Dickens, Caroline" sort="Dickens, Caroline" uniqKey="Dickens C" first="Caroline" last="Dickens">Caroline Dickens</name>
<affiliation wicri:level="4"><nlm:aff id="Aff9">Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea>
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<author><name sortKey="Schuz, Joachim" sort="Schuz, Joachim" uniqKey="Schuz J" first="Joachim" last="Schüz">Joachim Schüz</name>
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<author><name sortKey="Aribal, Mustafa Erkin" sort="Aribal, Mustafa Erkin" uniqKey="Aribal M" first="Mustafa Erkin" last="Aribal">Mustafa Erkin Aribal</name>
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<author><name sortKey="Bertrand, Kimberly" sort="Bertrand, Kimberly" uniqKey="Bertrand K" first="Kimberly" last="Bertrand">Kimberly Bertrand</name>
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<author><name sortKey="Kwong, Ava" sort="Kwong, Ava" uniqKey="Kwong A" first="Ava" last="Kwong">Ava Kwong</name>
<affiliation wicri:level="1"><nlm:aff id="Aff12">Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, People’s Republic of China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong</wicri:regionArea>
<wicri:noRegion>Hong Kong</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff13">Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, People’s Republic of China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong</wicri:regionArea>
<wicri:noRegion>Hong Kong</wicri:noRegion>
</affiliation>
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<author><name sortKey="Giles, Graham G" sort="Giles, Graham G" uniqKey="Giles G" first="Graham G." last="Giles">Graham G. Giles</name>
<affiliation><nlm:aff id="Aff14">Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria Australia</nlm:aff>
<wicri:noCountry code="subfield">Victoria Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff15">Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia</nlm:aff>
<orgName type="university">Université de Melbourne</orgName>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
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<author><name sortKey="Hopper, John" sort="Hopper, John" uniqKey="Hopper J" first="John" last="Hopper">John Hopper</name>
<affiliation wicri:level="4"><nlm:aff id="Aff15">Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia</nlm:aff>
<orgName type="university">Université de Melbourne</orgName>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
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</affiliation>
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<author><name sortKey="Perez G Mez, Beatriz" sort="Perez G Mez, Beatriz" uniqKey="Perez G Mez B" first="Beatriz" last="Pérez G Mez">Beatriz Pérez G Mez</name>
<affiliation wicri:level="3"><nlm:aff id="Aff16">Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pollan, Marina" sort="Pollan, Marina" uniqKey="Pollan M" first="Marina" last="Pollán">Marina Pollán</name>
<affiliation wicri:level="3"><nlm:aff id="Aff16">Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Teo, Soo Hwang" sort="Teo, Soo Hwang" uniqKey="Teo S" first="Soo-Hwang" last="Teo">Soo-Hwang Teo</name>
<affiliation wicri:level="1"><nlm:aff id="Aff17">Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur</wicri:regionArea>
<wicri:noRegion>Kuala Lumpur</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff18">Cancer Research Malaysia, Subang Jaya, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Cancer Research Malaysia, Subang Jaya</wicri:regionArea>
<wicri:noRegion>Subang Jaya</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mariapun, Shivaani" sort="Mariapun, Shivaani" uniqKey="Mariapun S" first="Shivaani" last="Mariapun">Shivaani Mariapun</name>
<affiliation wicri:level="1"><nlm:aff id="Aff18">Cancer Research Malaysia, Subang Jaya, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Cancer Research Malaysia, Subang Jaya</wicri:regionArea>
<wicri:noRegion>Subang Jaya</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Taib, Nur Aishah Mohd" sort="Taib, Nur Aishah Mohd" uniqKey="Taib N" first="Nur Aishah Mohd" last="Taib">Nur Aishah Mohd Taib</name>
<affiliation wicri:level="1"><nlm:aff id="Aff17">Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur</wicri:regionArea>
<wicri:noRegion>Kuala Lumpur</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lajous, Martin" sort="Lajous, Martin" uniqKey="Lajous M" first="Martín" last="Lajous">Martín Lajous</name>
<affiliation wicri:level="2"><nlm:aff id="Aff19">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff20">Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lopez Riduara, Ruy" sort="Lopez Riduara, Ruy" uniqKey="Lopez Riduara R" first="Ruy" last="Lopez-Riduara">Ruy Lopez-Riduara</name>
<affiliation wicri:level="1"><nlm:aff id="Aff20">Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Rice, Megan" sort="Rice, Megan" uniqKey="Rice M" first="Megan" last="Rice">Megan Rice</name>
<affiliation wicri:level="2"><nlm:aff id="Aff3">Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Romieu, Isabelle" sort="Romieu, Isabelle" uniqKey="Romieu I" first="Isabelle" last="Romieu">Isabelle Romieu</name>
<affiliation wicri:level="3"><nlm:aff id="Aff21">Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Flugelman, Anath Arzee" sort="Flugelman, Anath Arzee" uniqKey="Flugelman A" first="Anath Arzee" last="Flugelman">Anath Arzee Flugelman</name>
<affiliation wicri:level="1"><nlm:aff id="Aff22">National Cancer Control Center, Haifa, Israel</nlm:aff>
<country xml:lang="fr">Israël</country>
<wicri:regionArea>National Cancer Control Center, Haifa</wicri:regionArea>
<wicri:noRegion>Haifa</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ursin, Giske" sort="Ursin, Giske" uniqKey="Ursin G" first="Giske" last="Ursin">Giske Ursin</name>
<affiliation wicri:level="3"><nlm:aff id="Aff23">Cancer Registry of Norway, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Cancer Registry of Norway, Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="Aff24">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="Aff25">Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Preventive Medicine, University of Southern California, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Qureshi, Samera" sort="Qureshi, Samera" uniqKey="Qureshi S" first="Samera" last="Qureshi">Samera Qureshi</name>
<affiliation wicri:level="3"><nlm:aff id="Aff26">Norwegian Center for Minority and Migrant Health Research (NAKMI), Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Norwegian Center for Minority and Migrant Health Research (NAKMI), Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ma, Huiyan" sort="Ma, Huiyan" uniqKey="Ma H" first="Huiyan" last="Ma">Huiyan Ma</name>
<affiliation wicri:level="2"><nlm:aff id="Aff27">Department of Population Sciences, Beckman Research Institute, City of Hope, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Population Sciences, Beckman Research Institute, City of Hope</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Lee, Eunjung" sort="Lee, Eunjung" uniqKey="Lee E" first="Eunjung" last="Lee">Eunjung Lee</name>
<affiliation wicri:level="2"><nlm:aff id="Aff25">Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Preventive Medicine, University of Southern California, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sirous, Reza" sort="Sirous, Reza" uniqKey="Sirous R" first="Reza" last="Sirous">Reza Sirous</name>
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<wicri:regionArea>Isfahan University of Medical Sciences, Isfahan</wicri:regionArea>
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<author><name sortKey="Sirous, Mehri" sort="Sirous, Mehri" uniqKey="Sirous M" first="Mehri" last="Sirous">Mehri Sirous</name>
<affiliation wicri:level="1"><nlm:aff id="Aff28">Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff>
<country xml:lang="fr">Iran</country>
<wicri:regionArea>Isfahan University of Medical Sciences, Isfahan</wicri:regionArea>
<wicri:noRegion>Isfahan</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lee, Jong Won" sort="Lee, Jong Won" uniqKey="Lee J" first="Jong Won" last="Lee">Jong Won Lee</name>
<affiliation wicri:level="3"><nlm:aff id="Aff29">Department of Surgery, Asan Medical Center, Seoul, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Surgery, Asan Medical Center, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Jisun" sort="Kim, Jisun" uniqKey="Kim J" first="Jisun" last="Kim">Jisun Kim</name>
<affiliation wicri:level="3"><nlm:aff id="Aff29">Department of Surgery, Asan Medical Center, Seoul, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Surgery, Asan Medical Center, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Salem, Dorria" sort="Salem, Dorria" uniqKey="Salem D" first="Dorria" last="Salem">Dorria Salem</name>
<affiliation wicri:level="1"><nlm:aff id="Aff30">Cairo University, Cairo, Egypt</nlm:aff>
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<wicri:regionArea>Cairo University, Cairo</wicri:regionArea>
<wicri:noRegion>Cairo</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kamal, Rasha" sort="Kamal, Rasha" uniqKey="Kamal R" first="Rasha" last="Kamal">Rasha Kamal</name>
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</affiliation>
</author>
<author><name sortKey="Hartman, Mikael" sort="Hartman, Mikael" uniqKey="Hartman M" first="Mikael" last="Hartman">Mikael Hartman</name>
<affiliation wicri:level="1"><nlm:aff id="Aff32">Department of Surgery, Yong Loo Lin School of Medicine, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Department of Surgery, Yong Loo Lin School of Medicine, Singapore</wicri:regionArea>
<wicri:noRegion>Singapore</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff33">Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore</nlm:aff>
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<wicri:regionArea>Saw Swee Hock School of Public Health, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Miao, Hui" sort="Miao, Hui" uniqKey="Miao H" first="Hui" last="Miao">Hui Miao</name>
<affiliation wicri:level="4"><nlm:aff id="Aff33">Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Saw Swee Hock School of Public Health, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Chia, Kee Seng" sort="Chia, Kee Seng" uniqKey="Chia K" first="Kee-Seng" last="Chia">Kee-Seng Chia</name>
<affiliation wicri:level="4"><nlm:aff id="Aff34">NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Nagata, Chisato" sort="Nagata, Chisato" uniqKey="Nagata C" first="Chisato" last="Nagata">Chisato Nagata</name>
<affiliation wicri:level="4"><nlm:aff id="Aff35">Gifu University, Gifu, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Gifu University, Gifu</wicri:regionArea>
<orgName type="university">Université de Gifu</orgName>
<placeName><settlement type="city">Gifu (ville)</settlement>
<region type="province">Région du Chūbu</region>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Vinayak, Sudhir" sort="Vinayak, Sudhir" uniqKey="Vinayak S" first="Sudhir" last="Vinayak">Sudhir Vinayak</name>
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<country xml:lang="fr">Kenya</country>
<wicri:regionArea>Aga Khan University Hospital, Nairobi</wicri:regionArea>
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</author>
<author><name sortKey="Ndumia, Rose" sort="Ndumia, Rose" uniqKey="Ndumia R" first="Rose" last="Ndumia">Rose Ndumia</name>
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<country xml:lang="fr">Kenya</country>
<wicri:regionArea>Aga Khan University Hospital, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
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<author><name sortKey="Van Gils, Carla H" sort="Van Gils, Carla H" uniqKey="Van Gils C" first="Carla H." last="Van Gils">Carla H. Van Gils</name>
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<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
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</placeName>
</affiliation>
</author>
<author><name sortKey="Wanders, Johanna O P" sort="Wanders, Johanna O P" uniqKey="Wanders J" first="Johanna O. P." last="Wanders">Johanna O. P. Wanders</name>
<affiliation wicri:level="3"><nlm:aff id="Aff37">Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
<region nuts="2" type="province">Utrecht (province)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Peplonska, Beata" sort="Peplonska, Beata" uniqKey="Peplonska B" first="Beata" last="Peplonska">Beata Peplonska</name>
<affiliation wicri:level="1"><nlm:aff id="Aff38">Nofer Institute of Occupational Medicine, Łódz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Nofer Institute of Occupational Medicine, Łódz</wicri:regionArea>
<wicri:noRegion>Łódz</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bukowska, Agnieszka" sort="Bukowska, Agnieszka" uniqKey="Bukowska A" first="Agnieszka" last="Bukowska">Agnieszka Bukowska</name>
<affiliation wicri:level="1"><nlm:aff id="Aff38">Nofer Institute of Occupational Medicine, Łódz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Nofer Institute of Occupational Medicine, Łódz</wicri:regionArea>
<wicri:noRegion>Łódz</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Allen, Steve" sort="Allen, Steve" uniqKey="Allen S" first="Steve" last="Allen">Steve Allen</name>
<affiliation wicri:level="3"><nlm:aff id="Aff39">Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Imaging, Royal Marsden NHS Foundation Trust, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vinnicombe, Sarah" sort="Vinnicombe, Sarah" uniqKey="Vinnicombe S" first="Sarah" last="Vinnicombe">Sarah Vinnicombe</name>
<affiliation wicri:level="1"><nlm:aff id="Aff40">Division of Cancer Research, Ninewells Hospital & Medical School, Dundee, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Cancer Research, Ninewells Hospital & Medical School, Dundee</wicri:regionArea>
<wicri:noRegion>Dundee</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moss, Sue" sort="Moss, Sue" uniqKey="Moss S" first="Sue" last="Moss">Sue Moss</name>
<affiliation wicri:level="4"><nlm:aff id="Aff41">Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Wolfson Institute of Preventive Medicine, Queen Mary University of London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">Université de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Chiarelli, Anna M" sort="Chiarelli, Anna M" uniqKey="Chiarelli A" first="Anna M." last="Chiarelli">Anna M. Chiarelli</name>
<affiliation wicri:level="1"><nlm:aff id="Aff42">Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Ontario Breast Screening Program, Cancer Care Ontario, Toronto</wicri:regionArea>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Linton, Linda" sort="Linton, Linda" uniqKey="Linton L" first="Linda" last="Linton">Linda Linton</name>
<affiliation wicri:level="1"><nlm:aff id="Aff43">Princess Margaret Cancer Centre, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Princess Margaret Cancer Centre, Toronto</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Maskarinec, Gertraud" sort="Maskarinec, Gertraud" uniqKey="Maskarinec G" first="Gertraud" last="Maskarinec">Gertraud Maskarinec</name>
<affiliation wicri:level="2"><nlm:aff id="Aff44">University of Hawaii Cancer Center, Honolulu, HI USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Hawaï</region>
</placeName>
<wicri:cityArea>University of Hawaii Cancer Center, Honolulu</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Yaffe, Martin J" sort="Yaffe, Martin J" uniqKey="Yaffe M" first="Martin J." last="Yaffe">Martin J. Yaffe</name>
<affiliation wicri:level="4"><nlm:aff id="Aff45">Medical Biophysics, University of Toronto, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Medical Biophysics, University of Toronto, Toronto</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
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</placeName>
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</author>
<author><name sortKey="Boyd, Norman F" sort="Boyd, Norman F" uniqKey="Boyd N" first="Norman F." last="Boyd">Norman F. Boyd</name>
<affiliation wicri:level="1"><nlm:aff id="Aff43">Princess Margaret Cancer Centre, Toronto, Canada</nlm:aff>
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<author><name sortKey="Dos Santos Silva, Isabel" sort="Dos Santos Silva, Isabel" uniqKey="Dos Santos Silva I" first="Isabel" last="Dos-Santos-Silva">Isabel Dos-Santos-Silva</name>
<affiliation wicri:level="3"><nlm:aff id="Aff46">Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mccormack, Valerie A" sort="Mccormack, Valerie A" uniqKey="Mccormack V" first="Valerie A." last="Mccormack">Valerie A. Mccormack</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09</wicri:regionArea>
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<sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Mammographic density assessed on paired raw and processed digital images and on paired screen-film and digital images across three mammography systems</title>
<author><name sortKey="Burton, Anya" sort="Burton, Anya" uniqKey="Burton A" first="Anya" last="Burton">Anya Burton</name>
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<country xml:lang="fr">France</country>
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</affiliation>
</author>
<author><name sortKey="Byrnes, Graham" sort="Byrnes, Graham" uniqKey="Byrnes G" first="Graham" last="Byrnes">Graham Byrnes</name>
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<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09</wicri:regionArea>
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</affiliation>
</author>
<author><name sortKey="Stone, Jennifer" sort="Stone, Jennifer" uniqKey="Stone J" first="Jennifer" last="Stone">Jennifer Stone</name>
<affiliation wicri:level="1"><nlm:aff id="Aff2">Centre for Genetic Origins of Health and Disease, Curtin University and the University of Western Australia, Perth, Australia</nlm:aff>
<country xml:lang="fr">Australie</country>
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</affiliation>
</author>
<author><name sortKey="Tamimi, Rulla M" sort="Tamimi, Rulla M" uniqKey="Tamimi R" first="Rulla M." last="Tamimi">Rulla M. Tamimi</name>
<affiliation wicri:level="2"><nlm:aff id="Aff3">Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA</nlm:aff>
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<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Heine, John" sort="Heine, John" uniqKey="Heine J" first="John" last="Heine">John Heine</name>
<affiliation wicri:level="2"><nlm:aff id="Aff4">Moffitt Cancer Center, Tampa, FL USA</nlm:aff>
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<placeName><region type="state">Floride</region>
</placeName>
<wicri:cityArea>Moffitt Cancer Center, Tampa</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Vachon, Celine" sort="Vachon, Celine" uniqKey="Vachon C" first="Celine" last="Vachon">Celine Vachon</name>
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<country>États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Ozmen, Vahit" sort="Ozmen, Vahit" uniqKey="Ozmen V" first="Vahit" last="Ozmen">Vahit Ozmen</name>
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<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Department of Surgery, Istanbul Faculty of Medicine, Istanbul University, Istanbul</wicri:regionArea>
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</author>
<author><name sortKey="Pereira, Ana" sort="Pereira, Ana" uniqKey="Pereira A" first="Ana" last="Pereira">Ana Pereira</name>
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</author>
<author><name sortKey="Garmendia, Maria Luisa" sort="Garmendia, Maria Luisa" uniqKey="Garmendia M" first="Maria Luisa" last="Garmendia">Maria Luisa Garmendia</name>
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<wicri:regionArea>Centre for Medical Image Computing, University College London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Scott, Christopher" sort="Scott, Christopher" uniqKey="Scott C" first="Christopher" last="Scott">Christopher Scott</name>
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<country>États-Unis</country>
<placeName><region type="state">Minnesota</region>
</placeName>
<wicri:cityArea>Department of Health Sciences Research, Mayo Clinic, Rochester</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Hipwell, John H" sort="Hipwell, John H" uniqKey="Hipwell J" first="John H." last="Hipwell">John H. Hipwell</name>
<affiliation wicri:level="4"><nlm:aff id="Aff8">Centre for Medical Image Computing, University College London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Centre for Medical Image Computing, University College London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">University College de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Dickens, Caroline" sort="Dickens, Caroline" uniqKey="Dickens C" first="Caroline" last="Dickens">Caroline Dickens</name>
<affiliation wicri:level="4"><nlm:aff id="Aff9">Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa</nlm:aff>
<country xml:lang="fr">Afrique du Sud</country>
<wicri:regionArea>Faculty of Health Sciences, University of the Witwatersrand, Johannesburg</wicri:regionArea>
<orgName type="university">Université du Witwatersrand</orgName>
<placeName><settlement type="city">Johannesbourg</settlement>
<region type="region" nuts="2">Gauteng</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Schuz, Joachim" sort="Schuz, Joachim" uniqKey="Schuz J" first="Joachim" last="Schüz">Joachim Schüz</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09</wicri:regionArea>
<wicri:noRegion>Cedex 09</wicri:noRegion>
<wicri:noRegion>69372 Lyon, Cedex 09</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Aribal, Mustafa Erkin" sort="Aribal, Mustafa Erkin" uniqKey="Aribal M" first="Mustafa Erkin" last="Aribal">Mustafa Erkin Aribal</name>
<affiliation wicri:level="1"><nlm:aff id="Aff10">Marmara University School of Medicine Department of Radiology, Istanbul, Turkey</nlm:aff>
<country xml:lang="fr">Turquie</country>
<wicri:regionArea>Marmara University School of Medicine Department of Radiology, Istanbul</wicri:regionArea>
<wicri:noRegion>Istanbul</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bertrand, Kimberly" sort="Bertrand, Kimberly" uniqKey="Bertrand K" first="Kimberly" last="Bertrand">Kimberly Bertrand</name>
<affiliation wicri:level="2"><nlm:aff id="Aff11">Slone Epidemiology Center, Boston University, Boston, MA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Slone Epidemiology Center, Boston University, Boston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Kwong, Ava" sort="Kwong, Ava" uniqKey="Kwong A" first="Ava" last="Kwong">Ava Kwong</name>
<affiliation wicri:level="1"><nlm:aff id="Aff12">Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong, People’s Republic of China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Division of Breast Surgery, Department of Surgery, The University of Hong Kong, Hong Kong</wicri:regionArea>
<wicri:noRegion>Hong Kong</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff13">Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong, People’s Republic of China</nlm:aff>
<country xml:lang="fr">République populaire de Chine</country>
<wicri:regionArea>Department of Surgery, Hong Kong Sanatorium and Hospital, Hong Kong</wicri:regionArea>
<wicri:noRegion>Hong Kong</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Giles, Graham G" sort="Giles, Graham G" uniqKey="Giles G" first="Graham G." last="Giles">Graham G. Giles</name>
<affiliation><nlm:aff id="Aff14">Cancer Epidemiology Centre, Cancer Council Victoria, Melbourne, Victoria Australia</nlm:aff>
<wicri:noCountry code="subfield">Victoria Australia</wicri:noCountry>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff15">Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia</nlm:aff>
<orgName type="university">Université de Melbourne</orgName>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Hopper, John" sort="Hopper, John" uniqKey="Hopper J" first="John" last="Hopper">John Hopper</name>
<affiliation wicri:level="4"><nlm:aff id="Aff15">Centre for Epidemiology and Biostatistics, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia</nlm:aff>
<orgName type="university">Université de Melbourne</orgName>
<country>Australie</country>
<placeName><settlement type="city">Melbourne</settlement>
<region type="état">Victoria (État)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Perez G Mez, Beatriz" sort="Perez G Mez, Beatriz" uniqKey="Perez G Mez B" first="Beatriz" last="Pérez G Mez">Beatriz Pérez G Mez</name>
<affiliation wicri:level="3"><nlm:aff id="Aff16">Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Pollan, Marina" sort="Pollan, Marina" uniqKey="Pollan M" first="Marina" last="Pollán">Marina Pollán</name>
<affiliation wicri:level="3"><nlm:aff id="Aff16">Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid, Spain</nlm:aff>
<country xml:lang="fr">Espagne</country>
<wicri:regionArea>Cancer Epidemiology Unit, Instituto de Salud Carlos III and CIBERESP, Madrid</wicri:regionArea>
<placeName><settlement type="city">Madrid</settlement>
<region nuts="2" type="region">Communauté de Madrid</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Teo, Soo Hwang" sort="Teo, Soo Hwang" uniqKey="Teo S" first="Soo-Hwang" last="Teo">Soo-Hwang Teo</name>
<affiliation wicri:level="1"><nlm:aff id="Aff17">Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur</wicri:regionArea>
<wicri:noRegion>Kuala Lumpur</wicri:noRegion>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff18">Cancer Research Malaysia, Subang Jaya, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Cancer Research Malaysia, Subang Jaya</wicri:regionArea>
<wicri:noRegion>Subang Jaya</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Mariapun, Shivaani" sort="Mariapun, Shivaani" uniqKey="Mariapun S" first="Shivaani" last="Mariapun">Shivaani Mariapun</name>
<affiliation wicri:level="1"><nlm:aff id="Aff18">Cancer Research Malaysia, Subang Jaya, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Cancer Research Malaysia, Subang Jaya</wicri:regionArea>
<wicri:noRegion>Subang Jaya</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Taib, Nur Aishah Mohd" sort="Taib, Nur Aishah Mohd" uniqKey="Taib N" first="Nur Aishah Mohd" last="Taib">Nur Aishah Mohd Taib</name>
<affiliation wicri:level="1"><nlm:aff id="Aff17">Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur, Malaysia</nlm:aff>
<country xml:lang="fr">Malaisie</country>
<wicri:regionArea>Breast Cancer Research Group, University Malaya Medical Centre, University Malaya, Kuala Lumpur</wicri:regionArea>
<wicri:noRegion>Kuala Lumpur</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lajous, Martin" sort="Lajous, Martin" uniqKey="Lajous M" first="Martín" last="Lajous">Martín Lajous</name>
<affiliation wicri:level="2"><nlm:aff id="Aff19">Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, MA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston</wicri:cityArea>
</affiliation>
<affiliation wicri:level="1"><nlm:aff id="Aff20">Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lopez Riduara, Ruy" sort="Lopez Riduara, Ruy" uniqKey="Lopez Riduara R" first="Ruy" last="Lopez-Riduara">Ruy Lopez-Riduara</name>
<affiliation wicri:level="1"><nlm:aff id="Aff20">Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City, Mexico</nlm:aff>
<country xml:lang="fr">Mexique</country>
<wicri:regionArea>Center for Research on Population Health, Instituto Nacional de Salud Pública, Mexico City</wicri:regionArea>
<wicri:noRegion>Mexico City</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Rice, Megan" sort="Rice, Megan" uniqKey="Rice M" first="Megan" last="Rice">Megan Rice</name>
<affiliation wicri:level="2"><nlm:aff id="Aff3">Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Massachusetts</region>
</placeName>
<wicri:cityArea>Channing Division of Network Medicine, Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Romieu, Isabelle" sort="Romieu, Isabelle" uniqKey="Romieu I" first="Isabelle" last="Romieu">Isabelle Romieu</name>
<affiliation wicri:level="3"><nlm:aff id="Aff21">Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Nutrition and Metabolism, International Agency for Research on Cancer, Lyon</wicri:regionArea>
<placeName><region type="region">Auvergne-Rhône-Alpes</region>
<region type="old region">Rhône-Alpes</region>
<settlement type="city">Lyon</settlement>
</placeName>
</affiliation>
</author>
<author><name sortKey="Flugelman, Anath Arzee" sort="Flugelman, Anath Arzee" uniqKey="Flugelman A" first="Anath Arzee" last="Flugelman">Anath Arzee Flugelman</name>
<affiliation wicri:level="1"><nlm:aff id="Aff22">National Cancer Control Center, Haifa, Israel</nlm:aff>
<country xml:lang="fr">Israël</country>
<wicri:regionArea>National Cancer Control Center, Haifa</wicri:regionArea>
<wicri:noRegion>Haifa</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ursin, Giske" sort="Ursin, Giske" uniqKey="Ursin G" first="Giske" last="Ursin">Giske Ursin</name>
<affiliation wicri:level="3"><nlm:aff id="Aff23">Cancer Registry of Norway, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Cancer Registry of Norway, Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
<affiliation wicri:level="3"><nlm:aff id="Aff24">Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Department of Nutrition, Institute of Basic Medical Sciences, University of Oslo, Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
<affiliation wicri:level="2"><nlm:aff id="Aff25">Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Preventive Medicine, University of Southern California, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Qureshi, Samera" sort="Qureshi, Samera" uniqKey="Qureshi S" first="Samera" last="Qureshi">Samera Qureshi</name>
<affiliation wicri:level="3"><nlm:aff id="Aff26">Norwegian Center for Minority and Migrant Health Research (NAKMI), Oslo, Norway</nlm:aff>
<country xml:lang="fr">Norvège</country>
<wicri:regionArea>Norwegian Center for Minority and Migrant Health Research (NAKMI), Oslo</wicri:regionArea>
<placeName><settlement type="city">Oslo</settlement>
<region nuts="2">Østlandet</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Ma, Huiyan" sort="Ma, Huiyan" uniqKey="Ma H" first="Huiyan" last="Ma">Huiyan Ma</name>
<affiliation wicri:level="2"><nlm:aff id="Aff27">Department of Population Sciences, Beckman Research Institute, City of Hope, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Population Sciences, Beckman Research Institute, City of Hope</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Lee, Eunjung" sort="Lee, Eunjung" uniqKey="Lee E" first="Eunjung" last="Lee">Eunjung Lee</name>
<affiliation wicri:level="2"><nlm:aff id="Aff25">Department of Preventive Medicine, University of Southern California, Los Angeles, CA USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Californie</region>
</placeName>
<wicri:cityArea>Department of Preventive Medicine, University of Southern California, Los Angeles</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Sirous, Reza" sort="Sirous, Reza" uniqKey="Sirous R" first="Reza" last="Sirous">Reza Sirous</name>
<affiliation wicri:level="1"><nlm:aff id="Aff28">Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff>
<country xml:lang="fr">Iran</country>
<wicri:regionArea>Isfahan University of Medical Sciences, Isfahan</wicri:regionArea>
<wicri:noRegion>Isfahan</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Sirous, Mehri" sort="Sirous, Mehri" uniqKey="Sirous M" first="Mehri" last="Sirous">Mehri Sirous</name>
<affiliation wicri:level="1"><nlm:aff id="Aff28">Isfahan University of Medical Sciences, Isfahan, Iran</nlm:aff>
<country xml:lang="fr">Iran</country>
<wicri:regionArea>Isfahan University of Medical Sciences, Isfahan</wicri:regionArea>
<wicri:noRegion>Isfahan</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Lee, Jong Won" sort="Lee, Jong Won" uniqKey="Lee J" first="Jong Won" last="Lee">Jong Won Lee</name>
<affiliation wicri:level="3"><nlm:aff id="Aff29">Department of Surgery, Asan Medical Center, Seoul, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Surgery, Asan Medical Center, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Kim, Jisun" sort="Kim, Jisun" uniqKey="Kim J" first="Jisun" last="Kim">Jisun Kim</name>
<affiliation wicri:level="3"><nlm:aff id="Aff29">Department of Surgery, Asan Medical Center, Seoul, Republic of Korea</nlm:aff>
<country xml:lang="fr">Corée du Sud</country>
<wicri:regionArea>Department of Surgery, Asan Medical Center, Seoul</wicri:regionArea>
<placeName><settlement type="city">Séoul</settlement>
<region type="capital">Région capitale de Séoul</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Salem, Dorria" sort="Salem, Dorria" uniqKey="Salem D" first="Dorria" last="Salem">Dorria Salem</name>
<affiliation wicri:level="1"><nlm:aff id="Aff30">Cairo University, Cairo, Egypt</nlm:aff>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Cairo University, Cairo</wicri:regionArea>
<wicri:noRegion>Cairo</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Kamal, Rasha" sort="Kamal, Rasha" uniqKey="Kamal R" first="Rasha" last="Kamal">Rasha Kamal</name>
<affiliation wicri:level="1"><nlm:aff id="Aff31">Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo, Egypt</nlm:aff>
<country xml:lang="fr">Égypte</country>
<wicri:regionArea>Woman Imaging Unit, Radiodiagnosis Department, Kasr El Aini, Cairo University Hospitals, Cairo</wicri:regionArea>
<wicri:noRegion>Cairo</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Hartman, Mikael" sort="Hartman, Mikael" uniqKey="Hartman M" first="Mikael" last="Hartman">Mikael Hartman</name>
<affiliation wicri:level="1"><nlm:aff id="Aff32">Department of Surgery, Yong Loo Lin School of Medicine, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Department of Surgery, Yong Loo Lin School of Medicine, Singapore</wicri:regionArea>
<wicri:noRegion>Singapore</wicri:noRegion>
</affiliation>
<affiliation wicri:level="4"><nlm:aff id="Aff33">Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Saw Swee Hock School of Public Health, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Miao, Hui" sort="Miao, Hui" uniqKey="Miao H" first="Hui" last="Miao">Hui Miao</name>
<affiliation wicri:level="4"><nlm:aff id="Aff33">Saw Swee Hock School of Public Health, National University of Singapore, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Saw Swee Hock School of Public Health, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Chia, Kee Seng" sort="Chia, Kee Seng" uniqKey="Chia K" first="Kee-Seng" last="Chia">Kee-Seng Chia</name>
<affiliation wicri:level="4"><nlm:aff id="Aff34">NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore, Singapore</nlm:aff>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>NUS Graduate School for Integrative Sciences and Engineering, National University of Singapore, Singapore</wicri:regionArea>
<orgName type="university">Université nationale de Singapour</orgName>
</affiliation>
</author>
<author><name sortKey="Nagata, Chisato" sort="Nagata, Chisato" uniqKey="Nagata C" first="Chisato" last="Nagata">Chisato Nagata</name>
<affiliation wicri:level="4"><nlm:aff id="Aff35">Gifu University, Gifu, Japan</nlm:aff>
<country xml:lang="fr">Japon</country>
<wicri:regionArea>Gifu University, Gifu</wicri:regionArea>
<orgName type="university">Université de Gifu</orgName>
<placeName><settlement type="city">Gifu (ville)</settlement>
<region type="province">Région du Chūbu</region>
<region type="prefecture">Préfecture de Gifu</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vinayak, Sudhir" sort="Vinayak, Sudhir" uniqKey="Vinayak S" first="Sudhir" last="Vinayak">Sudhir Vinayak</name>
<affiliation wicri:level="1"><nlm:aff id="Aff36">Aga Khan University Hospital, Nairobi, Kenya</nlm:aff>
<country xml:lang="fr">Kenya</country>
<wicri:regionArea>Aga Khan University Hospital, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Ndumia, Rose" sort="Ndumia, Rose" uniqKey="Ndumia R" first="Rose" last="Ndumia">Rose Ndumia</name>
<affiliation wicri:level="1"><nlm:aff id="Aff36">Aga Khan University Hospital, Nairobi, Kenya</nlm:aff>
<country xml:lang="fr">Kenya</country>
<wicri:regionArea>Aga Khan University Hospital, Nairobi</wicri:regionArea>
<wicri:noRegion>Nairobi</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Van Gils, Carla H" sort="Van Gils, Carla H" uniqKey="Van Gils C" first="Carla H." last="Van Gils">Carla H. Van Gils</name>
<affiliation wicri:level="3"><nlm:aff id="Aff37">Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
<region nuts="2" type="province">Utrecht (province)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Wanders, Johanna O P" sort="Wanders, Johanna O P" uniqKey="Wanders J" first="Johanna O. P." last="Wanders">Johanna O. P. Wanders</name>
<affiliation wicri:level="3"><nlm:aff id="Aff37">Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, The Netherlands</nlm:aff>
<country xml:lang="fr">Pays-Bas</country>
<wicri:regionArea>Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht</wicri:regionArea>
<placeName><settlement type="city">Utrecht</settlement>
<region nuts="2" type="province">Utrecht (province)</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Peplonska, Beata" sort="Peplonska, Beata" uniqKey="Peplonska B" first="Beata" last="Peplonska">Beata Peplonska</name>
<affiliation wicri:level="1"><nlm:aff id="Aff38">Nofer Institute of Occupational Medicine, Łódz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Nofer Institute of Occupational Medicine, Łódz</wicri:regionArea>
<wicri:noRegion>Łódz</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Bukowska, Agnieszka" sort="Bukowska, Agnieszka" uniqKey="Bukowska A" first="Agnieszka" last="Bukowska">Agnieszka Bukowska</name>
<affiliation wicri:level="1"><nlm:aff id="Aff38">Nofer Institute of Occupational Medicine, Łódz, Poland</nlm:aff>
<country xml:lang="fr">Pologne</country>
<wicri:regionArea>Nofer Institute of Occupational Medicine, Łódz</wicri:regionArea>
<wicri:noRegion>Łódz</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Allen, Steve" sort="Allen, Steve" uniqKey="Allen S" first="Steve" last="Allen">Steve Allen</name>
<affiliation wicri:level="3"><nlm:aff id="Aff39">Department of Imaging, Royal Marsden NHS Foundation Trust, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Imaging, Royal Marsden NHS Foundation Trust, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Vinnicombe, Sarah" sort="Vinnicombe, Sarah" uniqKey="Vinnicombe S" first="Sarah" last="Vinnicombe">Sarah Vinnicombe</name>
<affiliation wicri:level="1"><nlm:aff id="Aff40">Division of Cancer Research, Ninewells Hospital & Medical School, Dundee, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Division of Cancer Research, Ninewells Hospital & Medical School, Dundee</wicri:regionArea>
<wicri:noRegion>Dundee</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Moss, Sue" sort="Moss, Sue" uniqKey="Moss S" first="Sue" last="Moss">Sue Moss</name>
<affiliation wicri:level="4"><nlm:aff id="Aff41">Wolfson Institute of Preventive Medicine, Queen Mary University of London, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Wolfson Institute of Preventive Medicine, Queen Mary University of London, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
<settlement type="city">Londres</settlement>
</placeName>
<orgName type="university">Université de Londres</orgName>
</affiliation>
</author>
<author><name sortKey="Chiarelli, Anna M" sort="Chiarelli, Anna M" uniqKey="Chiarelli A" first="Anna M." last="Chiarelli">Anna M. Chiarelli</name>
<affiliation wicri:level="1"><nlm:aff id="Aff42">Ontario Breast Screening Program, Cancer Care Ontario, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Ontario Breast Screening Program, Cancer Care Ontario, Toronto</wicri:regionArea>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Linton, Linda" sort="Linton, Linda" uniqKey="Linton L" first="Linda" last="Linton">Linda Linton</name>
<affiliation wicri:level="1"><nlm:aff id="Aff43">Princess Margaret Cancer Centre, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Princess Margaret Cancer Centre, Toronto</wicri:regionArea>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Maskarinec, Gertraud" sort="Maskarinec, Gertraud" uniqKey="Maskarinec G" first="Gertraud" last="Maskarinec">Gertraud Maskarinec</name>
<affiliation wicri:level="2"><nlm:aff id="Aff44">University of Hawaii Cancer Center, Honolulu, HI USA</nlm:aff>
<country>États-Unis</country>
<placeName><region type="state">Hawaï</region>
</placeName>
<wicri:cityArea>University of Hawaii Cancer Center, Honolulu</wicri:cityArea>
</affiliation>
</author>
<author><name sortKey="Yaffe, Martin J" sort="Yaffe, Martin J" uniqKey="Yaffe M" first="Martin J." last="Yaffe">Martin J. Yaffe</name>
<affiliation wicri:level="4"><nlm:aff id="Aff45">Medical Biophysics, University of Toronto, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Medical Biophysics, University of Toronto, Toronto</wicri:regionArea>
<orgName type="university">Université de Toronto</orgName>
<placeName><settlement type="city">Toronto</settlement>
<region type="state">Ontario</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Boyd, Norman F" sort="Boyd, Norman F" uniqKey="Boyd N" first="Norman F." last="Boyd">Norman F. Boyd</name>
<affiliation wicri:level="1"><nlm:aff id="Aff43">Princess Margaret Cancer Centre, Toronto, Canada</nlm:aff>
<country xml:lang="fr">Canada</country>
<wicri:regionArea>Princess Margaret Cancer Centre, Toronto</wicri:regionArea>
<wicri:noRegion>Toronto</wicri:noRegion>
</affiliation>
</author>
<author><name sortKey="Dos Santos Silva, Isabel" sort="Dos Santos Silva, Isabel" uniqKey="Dos Santos Silva I" first="Isabel" last="Dos-Santos-Silva">Isabel Dos-Santos-Silva</name>
<affiliation wicri:level="3"><nlm:aff id="Aff46">Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London, UK</nlm:aff>
<country xml:lang="fr">Royaume-Uni</country>
<wicri:regionArea>Department of Non-Communicable Disease Epidemiology, London School of Hygiene & Tropical Medicine, London</wicri:regionArea>
<placeName><settlement type="city">Londres</settlement>
<region type="country">Angleterre</region>
<region type="région" nuts="1">Grand Londres</region>
</placeName>
</affiliation>
</author>
<author><name sortKey="Mccormack, Valerie A" sort="Mccormack, Valerie A" uniqKey="Mccormack V" first="Valerie A." last="Mccormack">Valerie A. Mccormack</name>
<affiliation wicri:level="1"><nlm:aff id="Aff1">Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09, France</nlm:aff>
<country xml:lang="fr">France</country>
<wicri:regionArea>Section of Environment and Radiation, International Agency for Research on Cancer, 150 cours Albert Thomas, 69372 Lyon, Cedex 09</wicri:regionArea>
<wicri:noRegion>Cedex 09</wicri:noRegion>
<wicri:noRegion>69372 Lyon, Cedex 09</wicri:noRegion>
</affiliation>
</author>
</analytic>
<series><title level="j">Breast Cancer Research : BCR</title>
<idno type="ISSN">1465-5411</idno>
<idno type="eISSN">1465-542X</idno>
<imprint><date when="2016">2016</date>
</imprint>
</series>
</biblStruct>
</sourceDesc>
</fileDesc>
<profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Breast Density</term>
<term>Breast Neoplasms (diagnostic imaging)</term>
<term>Breast Neoplasms (pathology)</term>
<term>Female</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted</term>
<term>Mammography (methods)</term>
<term>Middle Aged</term>
</keywords>
<keywords scheme="KwdFr" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Densité mammaire</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mammographie ()</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Traitement d'image par ordinateur</term>
<term>Tumeurs du sein (anatomopathologie)</term>
<term>Tumeurs du sein (imagerie diagnostique)</term>
</keywords>
<keywords scheme="MESH" qualifier="anatomopathologie" xml:lang="fr"><term>Tumeurs du sein</term>
</keywords>
<keywords scheme="MESH" qualifier="diagnostic imaging" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" qualifier="imagerie diagnostique" xml:lang="fr"><term>Tumeurs du sein</term>
</keywords>
<keywords scheme="MESH" qualifier="methods" xml:lang="en"><term>Mammography</term>
</keywords>
<keywords scheme="MESH" qualifier="pathology" xml:lang="en"><term>Breast Neoplasms</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Breast Density</term>
<term>Female</term>
<term>Humans</term>
<term>Image Processing, Computer-Assisted</term>
<term>Middle Aged</term>
</keywords>
<keywords scheme="MESH" xml:lang="fr"><term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Densité mammaire</term>
<term>Femelle</term>
<term>Humains</term>
<term>Mammographie</term>
<term>Sujet âgé</term>
<term>Sujet âgé de 80 ans ou plus</term>
<term>Traitement d'image par ordinateur</term>
</keywords>
</textClass>
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<front><div type="abstract" xml:lang="en"><sec><title>Background</title>
<p>Inter-women and intra-women comparisons of mammographic density (MD) are needed in research, clinical and screening applications; however, MD measurements are influenced by mammography modality (screen film/digital) and digital image format (raw/processed). We aimed to examine differences in MD assessed on these image types.</p>
</sec>
<sec><title>Methods</title>
<p>We obtained 1294 pairs of images saved in both raw and processed formats from Hologic and General Electric (GE) direct digital systems and a Fuji computed radiography (CR) system, and 128 screen-film and processed CR-digital pairs from consecutive screening rounds. Four readers performed Cumulus-based MD measurements (<italic>n</italic>
= 3441), with each image pair read by the same reader. Multi-level models of square-root percent MD were fitted, with a random intercept for woman, to estimate processed–raw MD differences.</p>
</sec>
<sec><title>Results</title>
<p>Breast area did not differ in processed images compared with that in raw images, but the percent MD was higher, due to a larger dense area (median 28.5 and 25.4 cm<sup>2</sup>
respectively, mean √dense area difference 0.44 cm (95% CI: 0.36, 0.52)). This difference in √dense area was significant for direct digital systems (Hologic 0.50 cm (95% CI: 0.39, 0.61), GE 0.56 cm (95% CI: 0.42, 0.69)) but not for Fuji CR (0.06 cm (95% CI: −0.10, 0.23)). Additionally, within each system, reader-specific differences varied in magnitude and direction (<italic>p</italic>
< 0.001). Conversion equations revealed differences converged to zero with increasing dense area. MD differences between screen-film and processed digital on the subsequent screening round were consistent with expected time-related MD declines.</p>
</sec>
<sec><title>Conclusions</title>
<p>MD was slightly higher when measured on processed than on raw direct digital mammograms. Comparisons of MD on these image formats should ideally control for this non-constant and reader-specific difference.</p>
</sec>
<sec><title>Electronic supplementary material</title>
<p>The online version of this article (doi:10.1186/s13058-016-0787-0) contains supplementary material, which is available to authorized users.</p>
</sec>
</div>
</front>
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