Chotiyano A1, Srinakarin J2, Triamwittayanont T1, Wongsiri T1, Koonmee S1. 1Department of Pathology and 2Department of Radiology, Faculty of Medicine, Khon Kaen University,Thailand.
Received: 16 July 2013; Accepted: 21 September 2013.
Purpose: To assess the pathologic outcome of BI-RADS mammographic classification and the success of stereotactic biopsy for such lesions. Materials and
Methods: A retrospective study of 250 consecutive patients undergoing breast biopsy for mammographic abnormalities from January 2004 to December 2008 at the Breast Diagnostic Center, Faculty of Medicine of the Srinagarind Hospital was performed to identify biopsies done for indeterminate micro- calcifications and breast lesions. Specimens showed normal breast tissue, fibroadenosis, fibrocystic changes, fibroadenoma, ductal carcinoma in situ, lobular carcinoma in situ, invasive ductal carcinoma, invasive lobular carcinoma, tubular carcinoma, mucinous carcinoma, medullary carcinoma and diffuse large B-cell lymphoma. They were identified and reviewed by one pathologist. The BI-RADS mammographic classification data was compared with histopathological data. Continuous variables were summarized as mean (standard deviation) or median (range) as appropriate. Categorical variables were summarized as counts and percentages. Associa- tions between histological findings and patterns of radiographic characteristics were determined using logistic regression analysis. These associations were reported as odds ratios. Statistical significance was defined as a p-value of 0.05 or less. All statistical analyses were performed using Stata v. 7 (Stata Corp, College Drive, Texas, USA).
Results: From the 424 studied women, the 250 (58.9%) were categorized as BI-RADS category. Among these, 9 malignant lesions were seen in BI-RADS category 0, 5 in BI-RADS category 2, 11 in BI-RADS category 3, 52 in BI-RADS category 4, 46 cases in BI-RADS category 5 and 2 cases in BI-RADS category 6. Positive predictive value (PPV) of the BI-RADS category 5 criteria in diagnosing breast cancer in the present study was 85% (46 of 54 patients). This PPV was compatible with the PPV advocated by the American Cancer Research (ACR), which proposed a PPV of at least 95%, and that of other published studies which ranged from 80-97%.