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Evaluation of Malignancy Risk Stratification of Microcalcifications Detected on Mammography: A Study Based on the 5th Edition of BI-RADS

Authors
 Soo-Yeon Kim  ;  Ha Yan Kim  ;  Eun-Kyung Kim  ;  Min Jung Kim  ;  Hee Jung Moon  ;  Jung Hyun Yoon 
Citation
 Annals of Surgical Oncology, Vol.22(9) : 2895-2901, 2015 
Journal Title
 Annals of Surgical Oncology 
ISSN
 1068-9265 
Issue Date
2015
Abstract
BACKGROUND: The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropriate for malignancy risk stratification. METHODS: We studied 246 patients (mean age 48.2 years) with suspicious microcalcifications detected on mammography who underwent stereotactic biopsy (n = 154) or surgical excisional biopsy with preoperative mammogram-guided needle localization (n = 92). Pre-biopsy mammograms were reviewed retrospectively, and imaging features were analyzed according to the revised morphology and distribution descriptors. Pathological results of stereotactic biopsy and surgical excision were considered, with the surgical results being the reference standard. Positive predictive values (PPVs) were calculated and compared using the χ (2) test or Fisher's exact test. RESULTS: Overall PPV of suspicious microcalcifications was 22.4 %. PPVs of morphology descriptors were as follows: amorphous 7.9 %, coarse heterogeneous 17.8 %, fine pleomorphic 63.2 %, fine linear/fine linear branching 100 % (p < 0.001). PPVs of distribution descriptors were as follows: regional 8.8 %, grouped 14.3 %, linear 87.5 %, segmental 63.6 % (p < 0.001). For morphology and distribution descriptors combinations, PPVs for amorphous/regional and amorphous/grouped microcalcifications were 4.2 and 7.6 %, resepectively. The PPV for fine pleomorphic/linear or segmental was 93.8 %. CONCLUSIONS: Subcategorization of morphology descriptors for suspicious microcalcifications is needed because of the different PPVs for amorphous, coarse heterogeneous, and fine pleomorphic microcalcifications. Combining morphology and distribution descriptors for suspicious microcalcifications provides accurate risk stratification.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/140880
DOI
10.1245/s10434-014-4362-6
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실)
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Yonsei Biomedical Research Center (연세의생명연구원)
Yonsei Authors
김민정(Kim, Min Jung) ; 김수연(Kim, Soo Yeon) ; 김은경(Kim, Eun-Kyung) ; 김하얀(Kim, Ha Yan) ; 문희정(Moon, Hee Jung) ; 윤정현(Yoon, Jung Hyun)
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Full Text
http://link.springer.com/article/10.1245%2Fs10434-014-4362-6
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