Breast Imaging Reporting and Data System (BI-RADS) ; Breast ; Ultrasonography ; Image-guided biopsy
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 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