title: Breast imaging reports for malignant lesions: are we maintaining recommended BI-RADS(®) lexicon standards?
abstract: BACKGROUND
  The purpose of this study was to evaluate mammography reports for diagnosed breast cancer cases in major government and private centers in Karachi, Pakistan, with respect to concordance with the Breast Imaging Reports And Data System (BI-RADS(®)) lexicon.
  
  
  METHODS
  A prospective, descriptive, multicenter study was conducted in the radiology sections of the Aga Khan University Hospital, Pakistan Naval Station Shifa Hospital, Advanced Radiology Clinic, Karachi Institute of Radiotherapy and Nuclear Medicine, and Civil Hospital Karachi between May and October 2010 after approval from the ethical review committee of Aga Khan University. Mammograms reported as BI-RADS category 4 and 5 were included in the study. Mammograms reported as BI-RADS category 0, 1, 2 and 3 were excluded. Fifty reports were collected from each center. Data were collected about the clinical indication, breast density, location and description of the lesion, calcification, and comments on axillary lymph nodes. This description was compared with the BI-RADS lexicon.
  
  
  RESULTS
  The mean age of the patients was 50 ± 12 years. The clinical indication, breast parenchymal density, lesion location, and presence of calcification were better described by the private centers, while description of lymph node status was better stated by the government centers. This difference was statistically significant, except for lesion description. The description of masses by the two reporting groups was comparable.
  
  
  CONCLUSIONS
  Mammographic reporting of malignant breast lesions in the private sector is more in line with the BI-RADS lexicon, as compared with government sector hospitals in Karachi, Pakistan. Lymph node documentation was better in government sector reports.
authors.affiliation: Radiology Department, Aga Khan University Hospital, Karachi, Pakistan.
authors.forename: Imrana
authors.initials: I
authors.lastname: Masroor
authors.forename: Muhammad
authors.initials: M
authors.lastname: Azeemuddin
authors.forename: Saima
authors.initials: S
authors.lastname: Sakhawat
authors.forename: Madiha
authors.initials: M
authors.lastname: Beg
authors.forename: Saba
authors.initials: S
authors.lastname: Sohail
authors.forename: Rashid
authors.initials: R
authors.lastname: Ahmed
authors.lastname: Irfan-Ul-Haq
authors.forename: Javed
authors.initials: J
authors.lastname: Mehboob