Review of Prognostic Significance of Quantitative BPE Measurements

Background/Objectives: Background parenchymal enhancement (BPE) on breast magnetic resonance imaging reflects hormonal and vascular activity of fibroglandular tissue and is studied as a prognostic marker for breast cancer. This paper serves as a review that evaluates quantitative methods for BPE measurements for predicting treatment outcomes. Methods: PubMed was searched for papers on evaluating BPE with outcomes to compare, such as pathologic complete response, recurrence-free survival, disease-free survival, and overall survival, from 2015 to 2025. In total, eleven papers using quantitative methods to measure BPE were selected. Results: Quantitative results showed that BPE reduction during neoadjuvant chemotherapy and high pre-treatment/baseline BPE are linked to improved treatment response and reduced risk of recurrence. Conclusions: Quantitative assessment methods yield objective and reproducible prognostic information. Incorporating quantitative BPE measurements alongside tumor-focused imaging features may further improve predictive accuracy in clinical settings.