title: Subcategorization of ultrasonographic BI-RADS category 4: positive predictive value and clinical factors affecting it.
abstract: The objective of this study was to evaluate the positive predictive value (PPV) in ultrasonographically (US)-detected breast lesions of BI-RADS category 4a, 4b and 4c and to find how various clinical factors influenced the PPV of category 4. A total of 2142 women with 2430 breast lesions diagnosed on US as BI-RADS category 4 and underwent biopsy were included. Among them, 452 (18.6%) were pathologically confirmed as malignancy. PPV of each US BI-RADS subcategory was 7.6% (149/1963) for category 4a, 37.8% (68/180) for category 4b and 81.9% (235/287) for category 4c. Several clinical factors were more significantly seen in malignancy of category 4a and 4b, whereas none of the factors showed significance in category 4c. Subcategorization of category 4 is a feasible method in predicting malignancy in which patients' age, lack of multiplicity and symptoms affected the PPV of category 4 lesions.
authors: Department of Radiology, Research Institute of Radiological Science, Yonsei University, College of Medicine, Seoul, Korea.
authors: Jung Hyun
authors: JH
authors: Yoon
authors: Min Jung
authors: MJ
authors: Kim
authors: Hee Jung
authors: HJ
authors: Moon
authors: Jin Young
authors: JY
authors: Kwak
authors: Eun-Kyung
authors: EK
authors: Kim
mesh_terms: D000328:Adult; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D009367:Neoplasm Staging; D015588:Observer Variation; D011237:Predictive Value of Tests; D016217:Ultrasonography, Mammary / Q000145:classification*