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Background  The purpose of this study was to investigate the relationship between breast density, age, and mammographic lesion type among Chinese breast cancer patients included in a large clinical dataset.    Methods  A review of mammographic images acquired between July 2014 and June 2017 from a total of 9716 retrospectively registered breast cancer patients was conducted. Mammographic breast density was defined according to the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS) 4-class density rating. Mammographic lesion types were defined according to the ACR BI-RADS, including mass, mass with calcifications, calcifications, architectural distortion/asymmetries, and architectural distortion/asymmetries with calcifications. Three experienced breast radiologists interpreted all mammograms. The chi-square (χ 2 ) test and Pearson correlation analyses were performed to assess the relationship between breast density, age, and mammographic lesion type.    Results  A significant inverse relationship was observed between the BI-RADS breast density rating given by radiologists and patient age (r = − 0.521,  p  < 0.01). The breast density distribution in breast cancer patients from China reversed at the age of 55 years, and exhibited one age peak in the age 55–59 year group. The percentage of lesions with calcifications decreased with increasing age ( p  < 0.01), and increased with increasing breast density ( p  < 0.01).    Conclusions  In general, we identified a relationship between patient breast density, age, and mammographic lesion type. This finding may provide a basis for clinical diagnoses and support development of breast cancer screening programs in China.

The relationship between breast density, age, and mammographic lesion type among Chinese breast cancer patients from a large clinical dataset