Effect on biopsy technique of the breast imaging reporting and data system (BI-RADS) for nonpalpable mammographic abnormalities.
OBJECTIVE
To determine if the breast imaging reporting and data system (BI-RADS) defines a group of patients with mammographic abnormalities in whom stereotactic core needle biopsy (SCNB) is appropriate.


METHODS
A blinded retrospective validation sample.


METHODS
A university-affiliated hospital.


METHODS
One hundred and nine consecutive patients who underwent fine-wire localization breast biopsy (FWLB) between Jan. 1, 1994, and June 1, 1999, with a known final pathological diagnosis.


METHODS
Blinded mammographic review and classification using the BI-RADS; review of corresponding pathological findings from FWLBs.


METHODS
Correlation of pathological findings with each BI-RADS category and analysis of the predictive value of clinical and radiologic features.


RESULTS
BI-RADS findings were as follows: 0 malignant lesions in 10 category 3 cases, 18 malignant lesions (3 in situ, 15 invasive) in 68 category 4 cases and 24 malignant lesions (8 in situ and 16 invasive) in 31 category 5 cases. There was 1 malignant lesion in 22 category 4 cases in women younger than 50 years.


CONCLUSIONS
SCNB should be applied to BI-RADS categories 3 and 4 (< 50 yr of age). FWLB should be reserved for category 4 (> 50 yr of age) and category 5 cases. This algorithm will reduce the morbidity and cost of breast biopsies in patients with nonpalpable mammographic abnormalities.
Ball
Chad G
CG
University of Toronto School of Medicine, Ont.
Butchart
Michael
M
MacFarlane
John K
JK
D000465:Algorithms; D001707:Biopsy, Needle / Q000379:methods* / Q000706:statistics & numerical data; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000175:diagnosis / Q000473:pathology*; D005260:Female; D006801:Humans; D008327:Mammography / Q000145:classification; D008875:Middle Aged; D015588:Observer Variation; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D009626:Terminology as Topic