| HOME | HELP | FEEDBACK | SUBSCRIPTIONS | ARCHIVE | SEARCH | TABLE OF CONTENTS |
|
|
|
|||||||
|
|||||||||
Breast Imaging |
1 From the Department of Radiology, University of Pennsylvania Medical Center, 3400 Spruce St, Philadelphia, PA 19104 (S.G.O., N.K.); the Division of Anatomic Pathology, Mayo Clinic, Rochester, Minn (C.R.); and the National Cancer Institute, Rockville, Md (D.C.S.). From the 1997 RSNA scientific assembly. Received May 13, 1998; revision requested July 10; revision received August 17; accepted November 5. Address reprint requests to S.G.O.
PURPOSE: To determine the positive predictive value (PPV) of the American College of Radiology Breast Imaging Reporting and Data System (BI-RADS) categories 0, 2, 3, 4, and 5 by using BI-RADS terminology and by auditing data on needle localizations.
MATERIALS AND METHODS: Between April 1991 and December 1996, 1,400 mammographically guided needle localizations were performed in 1,109 patients. Information entered into the mammographic database included where the initial mammography was performed (inside vs outside the institution), BI-RADS category, mammographic finding, and histopathologic findings. A recorded recommendation was available for 1,312 localizations in 1,097 patients, who composed the study population.
RESULTS: The 1,312 localizations yielded 449 (34%) cancers (139 [31%] were ductal carcinoma in situ [DCIS]; 310 [69%] were invasive cancers) and 863 (66%) benign lesions. There were 15 (1%) category 0 lesions; the PPV was 13% (two of 15 lesions). There were 50 (4%) category 2 lesions; the PPV was 0% (0 of 40 lesions). There were 141 (11%) category 3 lesions; the PPV was 2% (three of 141 lesions). The three cancers in this group were all non-comedotype DCIS. There were 936 (71%) category 4 lesions; the PPV was 30% (279 of 936 lesions). There were 170 (13%) category 5 lesions; the PPV was 97% (165 of 170 lesions).
CONCLUSION: Placing mammographic lesions into BI-RADS categories is useful for predicting the presence of malignancy. Perhaps, most important, a lesion placed into BI-RADS category 3 is highly predictive of benignity, and short-term interval follow-up as an alternative to biopsy would decrease the number of biopsies performed in benign lesions.
Index terms: Breast, biopsy, 00.1261 • Breast neoplasms, localization, 00.125, 00.30 • Breast neoplasms, radiography, 00.11, 00.30
This article has been cited by other articles:
|
|
 |
|
  D. L. Weiss and C. P. Langlotz Structured Reporting: Patient Care Enhancement or Productivity Nightmare? Radiology, December 1, 2008; 249(3): 739 - 747. [Full Text] [PDF]
|
|
|
|
 |
|
 E.-K. Kim, K. H. Ko, K. K. Oh, J. Y. Kwak, J. K. You, M. J. Kim, and B.-W. Park Clinical Application of the BI-RADS Final Assessment to Breast Sonography in Conjunction with Mammography Am. J. Roentgenol., May 1, 2008; 190(5): 1209 - 1215. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 C. Belluco, E. F. Petricoin, E. Mammano, F. Facchiano, S. Ross-Rucker, D. Nitti, C. Di Maggio, C. Liu, M. Lise, L. A. Liotta, et al. Serum Proteomic Analysis Identifies a Highly Sensitive and Specific Discriminatory Pattern in Stage 1 Breast Cancer Ann. Surg. Oncol., September 1, 2007; 14(9): 2470 - 2476. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Liberman, C. Tornos, R. Huzjan, L. Bartella, E. A. Morris, and D. D. Dershaw Is Surgical Excision Warranted After Benign, Concordant Diagnosis of Papilloma at Percutaneous Breast Biopsy? Am. J. Roentgenol., May 1, 2006; 186(5): 1328 - 1334. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
E. Lazarus, M. B. Mainiero, B. Schepps, S. L. Koelliker, and L. S. Livingston BI-RADS Lexicon for US and Mammography: Interobserver Variability and Positive Predictive Value Radiology, May 1, 2006; 239(2): 385 - 391. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 M. M. Eberl, C. H. Fox, S. B. Edge, C. A. Carter, and M. C. Mahoney BI-RADS Classification for Management of Abnormal Mammograms J Am Board Fam Med, March 1, 2006; 19(2): 161 - 164. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
D. L. Weaver, P. M. Vacek, J. M. Skelly, and B. M. Geller Predicting Biopsy Outcome After Mammography: What Is the Likelihood the Patient Has Invasive or In Situ Breast Cancer? Ann. Surg. Oncol., August 1, 2005; 12(8): 660 - 673. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 S. Yasmeen, P. S. Romano, M. Pettinger, R. T. Chlebowski, J. A. Robbins, D. S. Lane, and S. L. Hendrix Frequency and Predictive Value of a Mammographic Recommendation for Short-Interval Follow-Up J Natl Cancer Inst, March 19, 2003; 95(6): 429 - 436. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
Y. R. Parisky, A. Sardi, R. Hamm, K. Hughes, L. Esserman, S. Rust, and K. Callahan Efficacy of Computerized Infrared Imaging Analysis to Evaluate Mammographically Suspicious Lesions Am. J. Roentgenol., January 1, 2003; 180(1): 263 - 269. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 A Rieber, H Schirrmeister, A Gabelmann, K Nuessle, S Reske, R Kreienberg, H J Brambs, and T Kuehn Pre-operative staging of invasive breast cancer with MR mammography and/or PET: boon or bunk? Br. J. Radiol., October 1, 2002; 75(898): 789 - 798. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
L. Liberman, E. A. Morris, M. J.-Y. Lee, J. B. Kaplan, L. R. LaTrenta, J. H. Menell, A. F. Abramson, S. M. Dashnaw, D. J. Ballon, and D. D. Dershaw Breast Lesions Detected on MR Imaging: Features and Positive Predictive Value Am. J. Roentgenol., July 1, 2002; 179(1): 171 - 178. [Abstract] [Full Text] [PDF]
|
|
|
|
 |
|
 B. N. Fahy, R. J. Bold, P. D. Schneider, V. Khatri, and J. E. Goodnight Jr Cost-Benefit Analysis of Biopsy Methods for Suspicious Mammographic Lesions Arch Surg, September 1, 2001; 136(9): 990 - 995. [Abstract] [Full Text] [PDF]
|
|
|
|
|
|
W. K. Moon, J.-G. Im, Y. H. Koh, D.-Y. Noh, and I. A. Park US of Mammographically Detected Clustered Microcalcifications Radiology, December 1, 2000; 217(3): 849 - 854. [Abstract] [Full Text]
|
|
|
|
|
|
W. K. Moon, J.-G. Im, D.-Y. Noh, and M. C. Han Nonpalpable Breast Lesions: Evaluation with Power Doppler US and a Microbubble Contrast Agent-Initial Experience Radiology, October 1, 2000; 217(1): 240 - 246. [Abstract] [Full Text]
|
|
|
|
|
|
C. J. Vyborny, T. Doi, K. F. O'Shaughnessy, H. M. Romsdahl, A. C. Schneider, and A. A. Stein Breast Cancer: Importance of Spiculation in Computer-aided Detection Radiology, June 1, 2000; 215(3): 703 - 707. [Abstract] [Full Text]
|
|
|
|
|
|
W. A. Berg, C. Campassi, P. Langenberg, and M. J. Sexton Breast Imaging Reporting and Data System: Inter- and Intraobserver Variability in Feature Analysis and Final Assessment Am. J. Roentgenol., June 1, 2000; 174(6): 1769 - 1777. [Abstract] [Full Text]
|
|
|
|
|
|
S. H. Taplin, L. E. Ichikawa, K. Kerlikowske, V. L. Ernster, R. D. Rosenberg, B. C. Yankaskas, P. A. Carney, B. M. Geller, N. Urban, M. B. Dignan, et al. Concordance of Breast Imaging Reporting and Data System Assessments and Management Recommendations in Screening Mammography Radiology, February 1, 2002; 222(2): 529 - 535. [Abstract] [Full Text] [PDF]
|
|
