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Scoring system based on BI-RADS lexicon to predict probability of malignancy in suspicious microcalcifications

 Ji Hyun Youk  ;  Eun Ju Son  ;  Jeong-Ah Kim  ;  Hee Jung Moon  ;  Min Jung Kim  ;  Chung Hyun Choi  ;  Eun-Kyung Kim 
 ANNALS OF SURGICAL ONCOLOGY, Vol.19(5) : 1491-1498, 2012 
Journal Title
Issue Date
Adult ; Aged ; Area Under Curve ; Biopsy, Needle ; Breast Diseases/diagnostic imaging ; Breast Diseases/pathology ; Breast Diseases/surgery ; Breast Neoplasms/diagnostic imaging ; Breast Neoplasms/pathology* ; Breast Neoplasms/surgery ; Calcinosis/diagnostic imaging ; Calcinosis/pathology* ; Calcinosis/surgery ; Carcinoma in Situ/diagnostic imaging ; Carcinoma in Situ/pathology* ; Carcinoma in Situ/surgery ; Carcinoma, Ductal, Breast/diagnostic imaging ; Carcinoma, Ductal, Breast/pathology* ; Carcinoma, Ductal, Breast/surgery ; Diagnosis, Differential ; Female ; Humans ; Hyperplasia/pathology ; Logistic Models ; Mammography/standards ; Middle Aged ; Predictive Value of Tests ; Probability ; ROC Curve ; Reproducibility of Results ; Sensitivity and Specificity
Positive Predictive Value ; Digital Mammography ; Needle Localization ; Lower Positive Predictive Value ; Fine Linear
PURPOSE: To develop a scoring system allowing quantification of the probability of malignancy of suspicious microcalcifications based on Breast Imaging Reporting and Data System (BI-RADS). METHODS: A total of 163 microcalcification lesions surgically excised in 147 women (aged 28-65 years) were included. Two radiologists independently reviewed each lesion with BI-RADS (4th edition). The interobserver agreement and positive predictive value (PPV) for each descriptor were determined and multivariate analysis was used to develop a scoring system. The scores were compared between benign and malignant lesions and among BI-RADS categories by using the two-sample t-test or the analysis of variance. To assess the discriminative power of the scoring system, the area under the receiver-operating characteristic curve (AUC) and cutoff values for categorization were determined. For the test of the scoring system, the validation data set from a different facility was applied. RESULTS: Interobserver agreement was fair to moderate for distribution, morphology, and category (κ = 0.45, 0.40, and 0.37). PPVs were significantly different among BI-RADS descriptors and categories (P < 0.0001). Of the scoring system developed, the AUC was 0.75. The scores between benign and malignant lesions were significantly different. By means of cutoff values, PPV in category 4a, 4b, 4c, and 5 was 7.0%, 15.0%, 44.8%, and 83.3%, respectively. For the validation data set, the AUC was 0.79 and the PPV in category 4a, 4b, 4c, and 5 was 9.4%, 24.1%, 62.5%, and 80.0%, respectively. CONCLUSIONS: In suspicious microcalcifications, our scoring system based on BI-RADS (4th edition) could help to derive a specific final category with good stratification of the probability of malignancy.
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1. College of Medicine (의과대학) > Dept. of Radiology (영상의학교실) > 1. Journal Papers
Yonsei Authors
Kim, Min Jung(김민정) ORCID logo https://orcid.org/0000-0003-4949-1237
Kim, Eun-Kyung(김은경) ORCID logo https://orcid.org/0000-0002-3368-5013
Kim, Jeong Ah(김정아) ORCID logo https://orcid.org/0000-0003-4949-4913
Moon, Hee Jung(문희정) ORCID logo https://orcid.org/0000-0002-5643-5885
Son, Eun Ju(손은주) ORCID logo https://orcid.org/0000-0002-7895-0335
Youk, Ji Hyun(육지현) ORCID logo https://orcid.org/0000-0002-7787-780X
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