title: Clinical impact of BI-RADS classification in Taiwanese breast cancer patients: BI-RADS 5 versus BI-RADS 0-4.
abstract: OBJECTIVE
  The aim of this study was to analyze and determine the prognostic value of the Breast Imaging Reporting and Data System (BI-RADS) classification in Taiwanese patients with breast cancer.
  
  
  METHODS
  Nine hundred ninety-eight patients with breast cancer were diagnosed between January 1, 1999, and August 31, 2005, and 491 (49%) of them were classified as BI-RADS 5. Overall survival and disease-free survival were estimated with the Kaplan-Meier method and compared across the two groups (BI-RADS 5 versus BI-RADS 0-4) using the log-rank test. Univariate and multivariate analyses were used to identify the prognostic factors.
  
  
  RESULTS
  The median follow-up time was 81.8 months. Kaplan-Meier analysis showed a significant difference between the two subgroups in five-year overall survival (P = 0.001) and five-year disease-free survival (P < 0.0001). On univariate analysis, the mammographic findings (BI-RADS 5 versus BI-RADS 0-4) were statistically significantly associated with five-year overall survival and disease-free survival, as were tumor size, lymph-node status, tumor grade, estrogen-receptor status, progesterone-receptor status, and HER-2 status. On multivariate analysis, only the mammographic findings, lymph-node status, HER-2 status, and tumor grade were significant factors related to five-year overall survival and disease-free survival.
  
  
  CONCLUSIONS
  The BI-RADS classification is a reliable prognostic and predictive factor. Patients with BI-RADS 5 breast cancer showed a worse pattern of relapse than that of BI-RADS 0-4 breast cancer patients.
authors.affiliation: Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan and Dou-Liou Branch, 138 Sheng Li Road, Tainan 704, Taiwan.
authors.forename: Yao-Lung
authors.initials: YL
authors.lastname: Kuo
authors.forename: Lili
authors.initials: L
authors.lastname: Cheng
authors.forename: Tsai-Wang
authors.initials: TW
authors.lastname: Chang
mesh_terms: D001943:Breast Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology*; D016009:Chi-Square Distribution; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008327:Mammography; D008875:Middle Aged; D060787:Neoplasm Grading; D009367:Neoplasm Staging; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone; D015996:Survival Rate; D013624:Taiwan
chemical_list: D018719:Erb-b2 Receptor Tyrosine Kinases; D011960:Receptors, Estrogen; D011980:Receptors, Progesterone