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KMID : 1134120170200030304
Journal of Breast Cancer
2017 Volume.20 No. 3 p.304 ~ p.309
Follow-up Outcomes of Benign Pathology Initially Assigned as Breast Imaging Reporting and Data System Category 4A and 3
You Ji-Young

Suh Hee-Jung
Kim Yun-Jung
Jun Jae-Kwan
Ojeda-Fournier Haydee
Ko Kyoung-Lan
Abstract
Purpose: This retrospective study investigated if the initially assigned category 4A or 3 in concordant benign lesions, after ultrasound (US)-guided core needle biopsy, could affect follow-up compliance.

Methods: Eight hundred thirty-eight concordant benign lesions, after core needle biopsy (674, initial category 4A group and 164, category 3 group) and follow-up US, were included in our study. If an immediate surgical excision?a surgical excision before the next follow-up?exists, those cases with pathologic reports were collected. Statistical comparisons for the result of follow-up US compliance, additional biopsy, and malignant rates among 6-month, 12-month, and long-term intervals were performed by using the chi-square test. The log-rank test was used to compare compliance rates in the timing of first follow-up between the two groups, with a significance level of 0.05.

Results: The number of immediate surgical excision was higher in the category 4A group (11.1%) than in the category 3 group (6.1%); only one cancer was found in the category 4A group. The patients' compliance rate in a 6-month follow-up showed an increase (p=0.003) in the category 4A group. The additional biopsy rate was higher in the initial category 4A group (10.9%) than in the category 3 group (1.9%) with statistical significance (p=0.001); four cancers were found on additional biopsy in the category 4 group. No cancer was detected in the initial category 3 group, both on immediate surgical excision and follow-up.

Conclusion: The initial category 4A or 3 of the Breast Imaging Reporting and Data System could be a significant factor that affects immediate surgical excision and follow-up compliance. Cancers were detected only in the initial category 4A group of concordant benign lesions. More attention should be paid to the concordant benign lesions from the initial category 4A group than from the category 3 group.
KEYWORD
Breast neoplasms, Diagnostic imaging, Follow-up studies, Imageguided biopsy
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