Diagnostic value of breast ultrasound in mammography BI-RADS 0 and clinically indeterminate or suspicious of malignancy breast lesions

Aleksandar Z Dobrosavljevic; Snežana Rakić; Branka Nikolić; Svetlana Janković Ražnatović; Svetlana Dragojević Dikić; Zorica Milošević; Aleksandar Jurišić; Milica Skrobić

doi:10.2298/6059

Aleksandar Z Dobrosavljevic Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia
Snežana Rakić Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia
Branka Nikolić Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia
Svetlana Janković Ražnatović Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia
Svetlana Dragojević Dikić Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia
Zorica Milošević Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Aleksandar Jurišić Faculty of Medicine, University of Belgrade, Belgrade, Serbia
Milica Skrobić Clinic of Obstetrics and Gynecology “Narodni Front”, Belgrade, Serbia

DOI: https://doi.org/10.2298/6059

Keywords: breast neoplasms, diagnosis, differential, mammography, ultrasonography, doppler, color, predictive value of tests, risk assessment,

Abstract

Background/Aim. Not only that ultrasound makes the difference between cystic and solid changes in breast tissue, as it was the case at the beginning of its use, but it also makes the differential diagnosis in terms of benign-malignant. The aim of this study was to assess the role of sonography in the diagnosis of palpable breast masses according to the American College of Radiology Ultrasonographic Breast Imaging Reporting and Data System (BI-RADS) and to correlate the BI-RADS 4 and BI-RADS 5 category with pathohistological findings. Methods. A retrospective study was conducted with the breast sonograms of 30 women presented with palpable breast masses found to be mammography category BI-RADS 0 and ultrasonographic BI-RADS categories 4 and 5. The sonographic categories were correlated with pathohistological findings. Results. Surgical biopsy in 30 masses revealed: malignancy (56.7%), fibroadenoma (26.7%), fibrocystic dysplasia with/without atypia (10%), lipoma (3.3%) and intramammary lymph node (3.3%). Correlation between BI-RADS categories and pathohistological findings was found (p < 0.05). All BI-RADS 5 masses were malignant, while in BI-RADS 4A category fibroadenomas dominated. A total of 53.8% of all benign lesions were found in women 49 years of age or younger as compared with 35.3% of all malignancies in this group (p < 0.05). Conclusion. Ultrasonography BI-RADS improved classification of breast masses. The ultrasound BI-RADS 4 (A, B, C) and BI-RADS 5 lesions should be worked-up with biopsy.

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