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KMID : 0378020070500090037
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New Medical Journal
2007 Volume.50 No. 9 p.37 ~ p.41
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Various Reasons for BI-RADS Category 4 on ultrasonography and Their Positive Predictive Values for Malignancy
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Choi Bo-Bae
Lee Jae-Hee
Yim Hyeon-Woo
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Abstract
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Background and Objectives : BI-RADS Category 4 (C4) has a wide probability of malignancy ranging from 3% to 94%. Several factors are considered for categorization. The purpose of this study is to analysis of the factors of C4, and evaluate the positive predictive value (PPV)s of these factors.
Material and Methods : We retrospectively reviewed ultrasonographic (US) images and reports of 286 breast lesions of 275 patients categorized as C4 between Mar 1 2004 and Feb 28 2005. Pathologic reports of biopsies and/or operations were available in 238 lesions among 286 lesions. Positive predictive values of each factor were obtained with pathologic results by SAS program.
Results: Among pathologically proven 238 lesions, final pathologic reports were malignant in 52 lesions (21.9%) and benign in 186 lesions (78.1%). Frequencies of factors on 238 lesions were as follows: margin in 149, shape in 135, orientation in 40, echogenicity in 32, comparison with the prior exams in 25, correlation with mammography in 21, ductal distribution in 17, palpation in 21, calcification in 14 and boundary in 12.Boundary showed the highest PPV (66.7%), and PPV of other factors were as the following in descending order: correlation with mammography (42.9%), calcification (42.9%), orientation (32.5%), margin (27.5%), shape (26.7%), ductal distribution (23.5%), palpation (9.5%), echogenicity (9.4%), and comparison with previous examinations (8%).
Conclusion: There were several factors with different PPVs to diagnose C4 and would be helpful in subdivision of C4a, 4b, 4c.
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KEYWORD
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ACR BI-RADS category 4, Ultrasonography
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