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KMID : 1114620200170020085
Journal of the Korean Society for Breast Screening
2020 Volume.17 No. 2 p.85 ~ p.92
Positive Predictive Value of Breast Ultrasonography BI-RADS Category 4 and 5 Lesions in One Institution at 2018
Lee Min-Ah

Kim Ga-Ram
Park Young-Jean
Yoon Jung-Hyun
Kim Min-Jung
Abstract
Purpose: To retrospectively analyze the positive predictive values (PPVs) of the breast lesions classified as categories 4 and 5 by using Breast Imaging reporting and Date System (BI-RADS) ultrasonography (US).

Materials and Methods: Between January 2018 and December 2018, 1,914 breast lesions of 1,826 patients were reported as BI-RADS US category 4 and 5. We reviewed the frequency of diagnosis, pathologic result, and clinical course. The positive predictive values (PPVs) for category 4a, 4b, 4c and 5 were evaluated.

Results: Among the 1,914 lesions, 1,800 lesions were pathologically diagnosed. Among them, the 1,145 lesions were pathologically confirmed as benign lesions and the 655 lesions were pathologically confirmed as malignant lesions. The PPV for category 4 was 26.1% and the PPVs for subcategory 4a, 4b and 4c were 13.2%, 54.2%, and 89.0%. When we excluded 4a lesions detected on second look US, the PPV became 9.4%. And the PPV for category 5 was 98.1%.

Conclusion: The PPVs for category 4 and 5 lesions in 2018 were mostly within the reference range of BIRADS. Although the PPV for category 4a was slightly higher than the recommended value, it was appropriately decreased when we excluded category 4a lesions detected on second look US.
KEYWORD
Breast Imaging Reporting and Data System (BI-RADS), Breast, Ultrasonography, Image-guided biopsy
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