title: Characterization of solid breast masses: use of the sonographic breast imaging reporting and data system lexicon.
abstract: 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.
authors.affiliation: Department of Bio-Imaging, Catholic University, Rome, Italy. mcostantini@rm.unicatt.it
authors.forename: Melania
authors.initials: M
authors.lastname: Costantini
authors.forename: Paolo
authors.initials: P
authors.lastname: Belli
authors.forename: Roberta
authors.initials: R
authors.lastname: Lombardi
authors.forename: Gianluca
authors.initials: G
authors.lastname: Franceschini
authors.forename: Antonino
authors.initials: A
authors.lastname: Mulè
authors.forename: Lorenzo
authors.initials: L
authors.lastname: Bonomo
mesh_terms: 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*