2017년 한 기관에서의 유방 초음파 BI-RADS 범주 4와 5 병변의 양성예측도

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 2017 and December 2017, 1,661 breast lesions of 1,588 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 value (PPV)s for category 4a, 4b, 4c and 5 were evaluated. Results: Among the 1,661 lesions, 1,601 lesions were pathologically diagnosed. Among them, the 1050 lesions were pathologically confirmed as benign lesions and the 551 lesions were pathologically confirmed as malignant lesions. The PPV for category 4 was 23.9% and the PPVs for subcategory 4a, 4b and 4c were 12.4%, 40.8%, and 85.2%. When we excluded 4a lesions detected on second look US, the PPV became 10.7%. And the PPV for category 5 was 99.1%. Conclusion: The PPVs for category 4 and 5 lesions in 2017 were mostly within the reference range of BI-RADS. 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.