2019년 한 기관에서의 유방 초음파 BI-RADS 범주 4와 5 병변의 양성예측도

Abstract

Purpose: To retrospectively evaluate the positive predictive values (PPVs) of the breast lesions diagnosed as final categories 4a, 4b, 4c, or 5 by using Breast Imaging reporting and Date System ultrasonography (BI-RADS-US) in one institution. Materials and Methods: From January 2019 to December 2019, 1,481 breast lesions of 1,458 patients were diagnosed as BI-RADS final category 4a, 4b, 4c, or 5 by performing breast US at our institution. The final BI-RADS categories were based on the judgment at the time of the examination. The medical records were retrospectively reviewed and the frequency of lesions classified in category 4a, 4b, 4c, or 5, treatment of lesions after US diagnosis, and biopsy results of each lesion were investigated. Also, the positive predictive value (PPV) for each category was evaluated. Results: Of a total of 1,481 lesions, 1439 (97.2%) lesions were pathologically diagnosed. Among them, 947 lesions (65.8%) were diagnosed as benign, and 492 lesions (34.2%) were diagnosed as malignant. The PPV for final BI-RADS category 4 was 25.7% and the PPVs for subcategory 4a, 4b and 4c were 12.2%, 60.9%, and 84.4%, respectively. In the case of subcategory 4a, the PPV decreased to 10.2% when the lesions diagnosed through second look US after MRI were excluded. The PPV for the final category 5 was 98.2%. Conclusion: The PPVs of the breast lesions diagnosed as final category 4a, 4b, 4c, or 5 during 2019 showed values similar to the range suggested by BI-RADS-US or the range suggested by previous studies. Therefore, it is judged that the breast US examinations were performed properly in our institution.