title: Influence of age on PPV of sonographic BI-RADS categories 3, 4, and 5.
abstract: OBJECTIVE
  The purpose of this retrospective study was to calculate the positive predictive value (PPV) of sonographic Breast Imaging Reporting and Data System (BI-RADS) categories 3, 4, and 5 in different age groups to investigate whether age influences the PPV of the BI-RADS category in breast ultrasound.
  
  
  METHODS
  From our sonography-guided core biopsy database of breasts between 2006 and 2008, we identified 2817 BI-RADS category 3, 4, and 5 lesions with known pathological diagnosis in 2587 women, all of whom underwent the earlier breast assessment via ultrasound with a sonographic BI-RADS lexicon and later sonography-guided core biopsy. All lesions were classified into three age groups (< 45, 45 - 59, and > 59 years). The age-related PPVs of each BI-RADS category among three age groups were calculated on the basis of pathological diagnoses and were compared using a χ(2)-test.
  
  
  RESULTS
  The overall PPV of each BI-RADS category was 2.2 % in category 3, 6.5 % in category 4a, 35.2 % in category 4b, 79.6 % in category 4c, and 99.6 % in category 5. The age-related PPVs of category 3 varied significantly among the three age groups (0.9 % versus 3.9 % versus 2.0 % p = 0.048), and notably, the age-related PPV in group 2 was higher than the others. Additionally, there was a significant positive association between the age-related PPVs and increasing age in categories 4a and 4b (4a, p < 0.0001 and 4b, p = 0.0139), but not in categories 4c and 5 (4c, p = 0.1853 and 5, p = 0.2871).
  
  
  CONCLUSIONS
  The incidence of female breast cancer differs not only in different sonographic BI-RADS categories, but also in different age groups. Therefore, more attention should be paid to the special age group that we found for sonographic BI-RADS categories 3, 4a, and 4b.
authors.affiliation: Division of General Surgery, Department of Surgery, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Fu
authors.forename: H-H
authors.initials: HH
authors.lastname: Hsu
authors.forename: J-C
authors.initials: JC
authors.lastname: Yu
authors.forename: G-C
authors.initials: GC
authors.lastname: Hsu
authors.forename: K-F
authors.initials: KF
authors.lastname: Hsu
authors.forename: D-C
authors.initials: DC
authors.lastname: Chan
authors.forename: C-H
authors.initials: CH
authors.lastname: Ku
authors.forename: T-C
authors.initials: TC
authors.lastname: Lu
authors.forename: C-H
authors.initials: CH
authors.lastname: Chu
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D001707:Biopsy, Needle / Q000706:statistics & numerical data*; D047688:Breast Cyst / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D044584:Carcinoma, Ductal / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D002285:Carcinoma, Intraductal, Noninfiltrating / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D018275:Carcinoma, Lobular / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology* / Q000473:pathology; D003431:Cross-Cultural Comparison; D003430:Cross-Sectional Studies; D005260:Female; D018226:Fibroadenoma / Q000145:classification / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000473:pathology; D006801:Humans; D008875:Middle Aged; D011237:Predictive Value of Tests; D012107:Research Design / Q000706:statistics & numerical data; D012189:Retrospective Studies; D013624:Taiwan; D018084:Ultrasonography, Interventional / Q000706:statistics & numerical data*; D016217:Ultrasonography, Mammary / Q000706:statistics & numerical data*