title: Effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up.
abstract: OBJECTIVE
  To determine the effectiveness of assigning BI-RADS category-3 to breast lesion with respect to follow-up.
  
  
  METHODS
  A cohort study.
  
  
  METHODS
  Radiology Department, the Aga Khan University Hospital, Karachi, from January 2002 to December 2004.
  
  
  METHODS
  Women undergoing X-ray mammography and assigned BI-RADS category-3 and recommended short-term (6-monthly) follow-up were included. Out of these, 44 patients were lost to follow-up and were excluded from the study. The lesions that remained stable after short-term follow-up were recommended routine (annual) follow-up. Needle localization and open surgical biopsy was performed, if the lesion progressed or calcifications increased in number/size and/or on physician or patient preference. The effectiveness of this approach was analyzed by determining the sensitivity, specificity, positive and negative predictive value for BI-RADS category-3.
  
  
  RESULTS
  Of the 65 lesions, 55 remained stable. Of the remaining 10 lesions, two showed increase in number of microcalcification prompting biopsy. Both turned out to be ductal carcinoma in situ. Eight biopsies were performed on clinician or patient preference which turned out to be benign. The sensitivity, specificity, positive and negative predictive values were 100%, 87%, 20% and 100% respectively.
  
  
  CONCLUSIONS
  Assessment with short-interval mammographic follow-up is useful to confirm the nature of most non-palpable breast lesions considered probably benign and permits detection of a small number of breast cancers at an early stage. The local setup, patient compliance is a major limitation for performing a follow-up study, as the available numbers can have a profound effect on the determined accuracy value.
authors.affiliation: Department of Radiology, The Aga Khan University Hospital, Karachi. imrana.masroor@aku.edu
authors.forename: Imrana
authors.initials: I
authors.lastname: Masroor
mesh_terms: D000328:Adult; D000368:Aged; D001706:Biopsy; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000473:pathology / Q000517:prevention & control*; D015331:Cohort Studies; D018450:Disease Progression; D005260:Female; D006801:Humans; D008327:Mammography / Q000145:classification*; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D011237:Predictive Value of Tests