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Annals of Oncology 15:450-454, 2004
© 2004 European Society for Medical Oncology

Original Paper

Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy (SVABB)

Received 16 June 2003; revised 13 October 2003; accepted 6 November 2003;

Background:

Mammograms are assigned a BI-RADS (Breast Imaging Reporting and Data System) category, which indicates the level of suspicion for cancer.

Objectives:

(i) To evaluate the use of BI-RADS categories in a non-academic radiology practice based in a community hospital compared with local radiology private offices; (ii) to determine positive predictive value (PPV), sensitivity and specificity of mammograms; and (iii) to explore the correlation of BI-RAD 3–5 and lesion description with diagnosis of cancer.

Patients and methods:

We performed 947 SVABBs (stereotactic vacuum-assisted breast biopsies) on 911 patients with BI-RADS 3–5. Lesions were classified as: 1 = microcalcifications; 2 = asymmetric density; 3 = circumscribed mass; and 4 = spiculated mass.

Results:

BI-RADS category correlated with diagnosis of breast cancer (atypia excluded): category 3 = 4%; category 4 = 15%; and category 5 = 79%. The PPV of BI-RADS 4 and 5 for breast cancer or atypia was 20%, in contrast to 5% for BI-RADS 3. Sensitivity and specificity were 95% and 19%, respectively. For BI-RADS 3 without microcalcifications only 3% were positive, in contrast to 8% for remainder.

Conclusions:

First, there is a stepwise increase in cancer for each of the BI-RADS categories 3–5. Secondly, in BI-RADS 3 with microcalcifications, a biopsy is indicated according to our findings. Finally, the sensitivity of mammograms is 95% but the specificity is 19%.

A. Mendez, F. Cabanillas*, M. Echenique, K. Malekshamran, I. Perez and E. Ramos

Auxilio Mutuo Cancer, Hospital Auxilio Mutuo, San Juan, Puerto Rico

Key words: biopsy, BI-RADS category, cancer diagnosis, mammography, SVABB


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