{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T03:43:07Z","timestamp":1788493387320,"version":"build-2803163510"},"reference-count":16,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,12]],"date-time":"2026-07-12T00:00:00Z","timestamp":1783814400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100001171","name":"Cancer Institute NSW","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001171","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["J Med Imag Rad Onc"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Introduction<\/jats:title>\n                    <jats:p>Breast density is a marker of risk both due to the increased burden of fibroglandular tissue, which may harbour malignancy, and to obscuration of lesions in mammography. This study aims to assess the reliability of Lunit INSIGHT MMG as a tool for estimating breast density compared to breast radiologists, evaluate density on a population level of &gt;\u2009600,000 clients, and compare the density in clients with\/without implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>15,518 mammograms were abstracted to explore the intra\u2010 and inter\u2010reader reliability between AI and breast radiologists. Variation in density was then evaluated by AI from 624,133 mammograms and stratified according to birth country and age. Finally, density was assessed in 4047 clients with implants and compared to 396,301 clients without implants.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>AI vs. breast radiologist inter\u2010reader variability weighted kappa coefficient was 0.72 (95% CI 0.71\u20130.73). Clients with a North\u2010East Asia background had the highest density, whilst clients of Aboriginal background had the lowest density. Density reduced with age across all backgrounds, though at different rates. Clients with implants had higher density than age\u2010matched no\u2010implant strata.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>AI performed adequately in both intra\u2010 and inter\u2010reader reliability. Notable gradients in breast density were observed with increased age but this effect was moderated by ancestry. This study population is significantly larger than any other in the published literature and has considerable diversity in age and ancestry.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1754-9485.70146","type":"journal-article","created":{"date-parts":[[2026,7,13]],"date-time":"2026-07-13T06:30:13Z","timestamp":1783924213000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Measuring Breast Density at Scale With AI: Insights From BreastScreen NSW"],"prefix":"10.1111","author":[{"given":"Richard","family":"Walton","sequence":"first","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9048-0145","authenticated-orcid":false,"given":"Douglas","family":"Dunn","sequence":"additional","affiliation":[{"name":"BreastScreen NSW, Royal North Shore Hospital NSW  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Warner\u2010Smith","sequence":"additional","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"},{"name":"Department of Computer Science Macquarie University NSW  Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chirag","family":"Mistry","sequence":"additional","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kan","family":"Ren","sequence":"additional","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Roder","sequence":"additional","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey","family":"O'Brien","sequence":"additional","affiliation":[{"name":"Cancer Institute NSW  St Leonards New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,12]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","doi-asserted-by":"crossref","first-page":"302","DOI":"10.1148\/rg.352140106","article-title":"Mammographic Breast Density: Impact on Breast Cancer Risk and Implications for Screening","volume":"35","author":"Freer P. E.","year":"2015","journal-title":"Radiographics"},{"key":"e_1_2_11_3_1","volume-title":"ACR BI\u2010RADS Atlas, Breast Imaging Reporting and Data System","author":"Sickles E. A.","year":"2013"},{"issue":"4","key":"e_1_2_11_4_1","doi-asserted-by":"crossref","first-page":"943","DOI":"10.2214\/AJR.16.17518","article-title":"Changes in Breast Density Reporting Patterns of Radiologists After Publication of the 5th Edition BI\u2010RADS Guidelines: A Single Institution Experience","volume":"209","author":"Irshad A.","year":"2017","journal-title":"American Journal of Roentgenology"},{"issue":"3","key":"e_1_2_11_5_1","doi-asserted-by":"crossref","first-page":"e138","DOI":"10.1016\/S2589-7500(20)30003-0","article-title":"Changes in Cancer Detection and False\u2010Positive Recall in Mammography Using Artificial Intelligence: A Retrospective, Multireader Study","volume":"2","author":"Kim H.\u2010E.","year":"2020","journal-title":"Lancet Digital Health"},{"issue":"2","key":"e_1_2_11_6_1","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1007\/s10278-021-00555-x","article-title":"Mammographic Density Assessment by Artificial Intelligence\u2010Based Computer\u2010Assisted Diagnosis: A Comparison With Automated Volumetric Assessment","volume":"35","author":"Lee S. 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J.","year":"2024","journal-title":"Acta Radiologica"},{"key":"e_1_2_11_15_1","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1016\/j.ejro.2018.04.002","article-title":"Comparison of Inter\u2010 and Intra\u2010Observer Variability of Breast Density Assessments Using the Fourth and Fifth Editions of Breast Imaging Reporting and Data System","volume":"5","author":"Alikhassi A.","year":"2018","journal-title":"European Journal of Radiology Open"},{"issue":"1","key":"e_1_2_11_16_1","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1186\/s13058-019-1113-4","article-title":"The Distribution and Determinants of Mammographic Density Measures in Western Australian Aboriginal Women","volume":"21","author":"McLean K.","year":"2019","journal-title":"Breast Cancer Research"},{"issue":"3","key":"e_1_2_11_17_1","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1177\/229255031101900305","article-title":"Contribution of Breast Density to the Volume of the Augmented Breast: A Preliminary Study","volume":"19","author":"Hill S. 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