title: Outcomes of unconventional utilization of BI-RADS category 3 assessment at opportunistic screening.
abstract: Background An important difficulty regarding the Breast Imaging Reporting and Data System (BI-RADS) category 3 assessment is the need for extensive diagnostic workup and an additional 6-month follow-up study. Purpose To evaluate the feasibility of the BI-RADS category 3 assessments at opportunistic screening. Material and Methods Mammography charts of 9062 screening patients in a major teaching hospital situated in an urban setting of a developing country were evaluated retrospectively (1997-2010). BI-RADS category 3 patients, called for a 6-month follow-up, which comprised a single-view spot or magnification mammogram. The length of follow-up period, compliance to periodic mammographic surveillance, cancer detection rate, and negative predictive values of category 3 assessments were calculated. Results Of the screened population, 9.2% were assigned BI-RADS category 3, and 31.2% of these cases were lost to follow-up. The mean follow-up period for 606 patients was 36.9 months. The negative predictive values for 6-month, 12-month, and final control studies were 90.9%, 87.5%, and 100%, respectively. Patient compliance for 6 months, 12 months, and any control evaluations beyond 12 months was low (50.0%, 29.8%, and 47.5%, respectively). Cancer detection rate was 0.8%. Conclusion Results of the study supports the feasibility of the BI-RADS category 3 assessments at opportunistic screening without any additional diagnostic workup. The practice of category 3 assessment following screening mammograms may be a more cost-effective method for developing countries with high recall rates and low resources in eliminating the maximum risk with minimum cost within the limits of available resources.
authors.affiliation: 1 Department of Radiology, Ercis State Hospital, Turkey.
authors.forename: Hilal
authors.initials: H
authors.lastname: Altas
authors.affiliation: 1 Department of Radiology, Ercis State Hospital, Turkey.
authors.forename: Derya
authors.initials: D
authors.lastname: Tureli
authors.affiliation: 2 Department of Radiology, Van Bolge Research and Education Hospital, Turkey.
authors.forename: Ismet
authors.initials: I
authors.lastname: Cengic
authors.affiliation: 3 Department of Radiology, Marmara University School of Medicine, Turkey.
authors.forename: Fikret
authors.initials: F
authors.lastname: Kucukkaya
authors.affiliation: 3 Department of Radiology, Marmara University School of Medicine, Turkey.
authors.forename: Erkin
authors.initials: E
authors.lastname: Aribal
authors.affiliation: 4 Department of Pathology, Marmara University School of Medicine, Turkey.
authors.forename: Handan
authors.initials: H
authors.lastname: Kaya
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000145:classification / Q000000981:diagnostic imaging* / Q000453:epidemiology*; D002983:Clinical Competence / Q000706:statistics & numerical data*; D003906:Developing Countries / Q000706:statistics & numerical data*; D055088:Early Detection of Cancer / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008327:Mammography / Q000706:statistics & numerical data*; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D015995:Prevalence; D011379:Prognosis; D015203:Reproducibility of Results; D018570:Risk Assessment / Q000379:methods; D012680:Sensitivity and Specificity; D014421:Turkey / Q000453:epidemiology
keywords: BI-RADS category 3; Breast cancer; cancer detection rate; screening mammography; short-interval follow-up