Characterization of solid breast masses: use of the sonographic breast imaging reporting and data system lexicon.
OBJECTIVE
The purpose of this study was to determine the reliability of sonographic American College of Radiology Breast Imaging Reporting And Data System (BI-RADS) classification in differentiating benign from malignant breast masses.


METHODS
One hundred seventy-eight breast masses studied by sonography with a known diagnosis were reviewed. All lesions were classified according to the sonographic BI-RADS lexicon. Pathologic results were compared with sonographic features. Sensitivity, specificity, accuracy, and positive predictive value (PPV) and negative predictive value (NPV) for the sonographic BI-RADS lexicon were calculated.


RESULTS
Twenty-six cases were assigned to class 3, 73 to class 4, and 79 to class 5. Pathologic results revealed 105 malignant and 73 benign lesions. The sonographic BI-RADS lexicon showed 71.3% accuracy, 98.1% sensitivity, 32.9% specificity, 67.8% PPV, and 92.3% NPV. The NPV for class 3 was 92.3%. The PPVs for classes 4 and 5 were 46.6% and 87.3%. Typical signs of malignancy were irregular shape, antiparallel orientation, noncircumscribed margin, echogenic halo, and decreased sound transmission. Typical signs of benignity were oval shape and circumscribed margin.


CONCLUSIONS
The sonographic BI-RADS lexicon is an important system for describing and classifying breast lesions.
Costantini
Melania
M
Department of Bio-Imaging, Catholic University, Rome, Italy. mcostantini@rm.unicatt.it
Belli
Paolo
P
Lombardi
Roberta
R
Franceschini
Gianluca
G
Mulè
Antonino
A
Bonomo
Lorenzo
L
D000328:Adult; D000368:Aged; D001943:Breast Neoplasms / Q000145:classification* / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000473:pathology; D005260:Female; D006801:Humans; D008396:Maryland / Q000453:epidemiology; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D012720:Severity of Illness Index; D009626:Terminology as Topic; D016217:Ultrasonography, Mammary / Q000379:methods* / Q000592:standards / Q000706:statistics & numerical data*