Clinical implications of subcategorizing BI-RADS 4 breast lesions associated with microcalcification: a radiology-pathology correlation study

The Breast Journal
Mary Ann SandersSunati Sahoo

Abstract

Currently radiologists have the option of subcategorizing BI-RADS 4 breast lesions into 4A (low suspicion for malignancy), 4B (intermediate suspicion of malignancy), and 4C (moderate concern, but not classic for malignancy). To determine the clinical significance of BI-RADS 4 subcategories and the common pathologic changes associated with these mammographic lesions, a retrospective review of 239 consecutive stereotactic-needle core biopsies (SNCB) for microcalcifications was performed. All 239 SNCBs were BI-RADS 4 lesions, and of these, 191 were subcategorized to 4A, 4B or 4C. Ninety-four of 191 (49%) were 4A, 73 (38%) were 4B, and 24 (13%) were 4C. Fibrocystic change was the most common finding (66/239; 28%) followed by ductal carcinoma in situ (DCIS) accounting for 23% of cases. This was followed by columnar cell alteration with or without atypia (47/239; 19%), and fibroadenoma (45/239; 19%). While 70% (17/24) of BI-RADS 4C category lesions were DCIS, only 21% (15/73) of BI-RADS 4B and 10% (10/94) of BI-RADS 4A were DCIS. Without sub-categorization, carcinoma was diagnosed in 23% (55/239) of all cases with BI-RADS 4. Therefore, subcategorizing BI-RADS 4 lesions is important since it not only benefits the patient and clinician...Continue Reading

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Citations

Oct 27, 2012·Asian Pacific Journal of Cancer Prevention : APJCP·Arkom ChaiwerawattanaKanchana Thongkham
Jun 24, 2015·AJR. American Journal of Roentgenology·João Ricardo Maltez de AlmeidaMário de Seixas Rocha
Dec 21, 2012·American Journal of Preventive Medicine·Katrina ArmstrongMirar N Bristol Demeter
Apr 15, 2015·Journal of Medical Imaging and Radiation Oncology·Nan-Jing PengHong-Tai Chang
Aug 10, 2017·AJR. American Journal of Roentgenology·Roberta M StrigelWendy B DeMartini
Dec 1, 2012·Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine·Catherine S GiessRobyn L Birdwell

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