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We develop an automated method to measure breast density (<jats:italic>AutoDensity<\/jats:italic>) and compare it to <jats:italic>Cumulus<\/jats:italic> in terms of association with breast cancer risk and breast cancer screening outcomes.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Methods<\/jats:title>\n                        <jats:p><jats:italic>AutoDensity<\/jats:italic> automatically identifies the breast area in the mammogram and classifies breast density in a similar way to <jats:italic>Cumulus<\/jats:italic>, through a fast, stand-alone Windows or Linux program. Our sample comprised 985 women with screen-detected cancers, 367 women with interval cancers and 4,975 controls (women who did not have cancer), sampled from first and subsequent screening rounds of a film mammography screening programme. To test the validity of <jats:italic>AutoDensity<\/jats:italic>, we compared the effect estimates using <jats:italic>AutoDensity<\/jats:italic> with those using <jats:italic>Cumulus<\/jats:italic> from logistic regression models that tested the association between breast density and breast cancer risk, risk of small and large screen-detected cancers and interval cancers, and screening programme sensitivity (the proportion of cancers that are screen-detected). As a secondary analysis, we report on correlation between <jats:italic>AutoDensity<\/jats:italic> and <jats:italic>Cumulus<\/jats:italic> measures.<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Results<\/jats:title>\n                        <jats:p><jats:italic>AutoDensity<\/jats:italic> performed similarly to <jats:italic>Cumulus<\/jats:italic> in all associations tested. For example, using <jats:italic>AutoDensity<\/jats:italic>, the odds ratios for women in the highest decile of breast density compared to women in the lowest quintile for invasive breast cancer, interval cancers, large and small screen-detected cancers were 3.2 (95% CI 2.5 to 4.1), 4.7 (95% CI 3.0 to 7.4), 6.4 (95% CI 3.7 to 11.1) and 2.2 (95% CI 1.6 to 3.0) respectively. For <jats:italic>Cumulus<\/jats:italic> the corresponding odds ratios were: 2.4 (95% CI 1.9 to 3.1), 4.1 (95% CI 2.6 to 6.3), 6.6 (95% CI 3.7 to 11.7) and 1.3 (95% CI 0.9 to 1.8). Correlation between <jats:italic>Cumulus<\/jats:italic> and <jats:italic>AutoDensity<\/jats:italic> measures was 0.63 (<jats:italic>P<\/jats:italic> &lt; 0.001).<\/jats:p>\n                     <\/jats:sec><jats:sec>\n                        <jats:title>Conclusions<\/jats:title>\n                        <jats:p>Based on the similarity of the effect estimates for <jats:italic>AutoDensity<\/jats:italic> and <jats:italic>Cumulu<\/jats:italic>s in models of breast density and breast cancer risk and screening outcomes, we conclude that <jats:italic>AutoDensity<\/jats:italic> is a valid automated method for measuring breast density from digitised film mammograms.<\/jats:p>\n                     <\/jats:sec>","DOI":"10.1186\/bcr3474","type":"journal-article","created":{"date-parts":[[2013,9,11]],"date-time":"2013-09-11T11:48:10Z","timestamp":1378900090000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":50,"title":["AutoDensity: an automated method to measure mammographic breast density that predicts breast cancer risk and screening outcomes"],"prefix":"10.1186","volume":"15","author":[{"given":"Carolyn","family":"Nickson","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yulia","family":"Arzhaeva","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zoe","family":"Aitken","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tarek","family":"Elgindy","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mitchell","family":"Buckley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Min","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dallas R","family":"English","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anne M","family":"Kavanagh","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2013,9,11]]},"reference":[{"key":"3263_CR1","doi-asserted-by":"publisher","first-page":"227","DOI":"10.1056\/NEJMoa062790","volume":"356","author":"NF Boyd","year":"2007","unstructured":"Boyd NF, Guo H, Martin LJ, Sun L, Stone J, Fishell E, Jong RA, Hislop G, Chiarelli A, Minkin S, Yaffe MJ: Mammographic density and the risk and detection of breast cancer. 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