Mammographic features and correlation with biopsy findings using 11-gauge stereotactic vacuum-assisted breast biopsy (SVABB).
BACKGROUND
Mammograms are assigned a BI-RADS (Breast Imaging Reporting and Data System) category, which indicates the level of suspicion for cancer.


OBJECTIVE
(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.


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%.
Auxilio Mutuo Cancer, Hospital Auxilio Mutuo, San Juan, Puerto Rico.
A
A
Mendez
F
F
Cabanillas
M
M
Echenique
K
K
Malekshamran
I
I
Perez
E
E
Ramos
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle; D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D002114:Calcinosis / Q000000981:diagnostic imaging / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000000981:diagnostic imaging / Q000473:pathology; D018275:Carcinoma, Lobular / Q000000981:diagnostic imaging / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008327:Mammography; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011237:Predictive Value of Tests; D012680:Sensitivity and Specificity; D014618:Vacuum