title: BI-RADS categorisation of 2,708 consecutive nonpalpable breast lesions in patients referred to a dedicated breast care unit.
abstract: OBJECTIVE
  To determine the malignancy rate of nonpalpable breast lesions, categorised according to the Breast Imaging Reporting and Data System (BI-RADS) classification in the setting of a Breast Care Unit.
  
  
  METHODS
  All nonpalpable breast lesions from consecutive patients referred to a dedicated Breast Care Unit were prospectively reviewed and classified into 5 BI-RADS assessment categories (0, 2, 3, 4, and 5).
  
  
  RESULTS
  A total of 2708 lesions were diagnosed by mammography (71.6%), ultrasound (8.7%), mammography and ultrasound (19.5%), or MRI (0.2%). The distribution of the lesions by BI-RADS category was: 152 in category 0 (5.6%), 56 in category 2 (2.1%), 742 in category 3 (27.4%), 1523 in category 4 (56.2%) and 235 in category 5 (8.7%). Histology revealed 570 malignant lesions (32.9%), 152 high-risk lesions (8.8%), and 1010 benign lesions (58.3%). Malignancy was detected in 17 (2.3%) category 3 lesions, 364 (23.9%) category 4 lesions and 185 (78.7%) category 5 lesions. Median follow-up was 36.9 months.
  
  
  CONCLUSIONS
  This pragmatic study reflects the assessment and management of breast impalpable abnormalities referred for care to a specialized Breast Unit. Multidisciplinary evaluation with BI-RADS classification accurately predicts malignancy, and reflects the quality of management. This assessment should be encouraged in community practice appraisal.
authors.affiliation: Breast Disease Center, Saint Louis Hospital, AP-HP, Université Paris VII, 1 avenue Claude Vellefaux, 75010 Paris, France. anne-sophie.hamy@sls.aphp.fr
authors.forename: A-S
authors.initials: AS
authors.lastname: Hamy
authors.forename: S
authors.initials: S
authors.lastname: Giacchetti
authors.forename: M
authors.initials: M
authors.lastname: Albiter
authors.forename: C
authors.initials: C
authors.lastname: de Bazelaire
authors.forename: C
authors.initials: C
authors.lastname: Cuvier
authors.forename: F
authors.initials: F
authors.lastname: Perret
authors.forename: S
authors.initials: S
authors.lastname: Bonfils
authors.forename: P
authors.initials: P
authors.lastname: Charvériat
authors.forename: H
authors.initials: H
authors.lastname: Hocini
authors.forename: A
authors.initials: A
authors.lastname: de Roquancourt
authors.forename: M
authors.initials: M
authors.lastname: Espie
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001706:Biopsy; D001940:Breast / Q000473:pathology*; D001943:Breast Neoplasms / Q000145:classification* / Q000175:diagnosis / Q000473:pathology; D005260:Female; D005500:Follow-Up Studies; D006757:Hospital Units; D006801:Humans; D033183:Interdisciplinary Communication; D038801:International Classification of Diseases; D008279:Magnetic Resonance Imaging; D008327:Mammography / Q000379:methods; D008485:Medical Audit; D008875:Middle Aged; D010173:Palpation; D011230:Precancerous Conditions / Q000145:classification* / Q000175:diagnosis; D011446:Prospective Studies; D012017:Referral and Consultation; D018570:Risk Assessment; D012680:Sensitivity and Specificity