Clinical Application of the BI-RADS Final Assessment to Breast Sonography in Conjunction with Mammography

• Published in: American journal of roentgenology (1976) Vol. 190; no. 5; pp. 1209 - 1215
• Main Authors: Kim, Eun-Kyung, Ko, Kyung Hee, Oh, Ki Keun, Kwak, Jin Young, You, Jai Kyung, Kim, Min Jung, Park, Byoung-Woo
• Format: Journal Article
• Language: English
• Published: Leesburg, VA Am Roentgen Ray Soc 01.05.2008; American Roentgen Ray Society
• Subjects: Adult; Aged; Aged, 80 and over; Biological and medical sciences; Breast Neoplasms - classification; Breast Neoplasms - diagnostic imaging; Carcinoma - classification; Carcinoma - diagnostic imaging; Female; Follow-Up Studies; Genital system. Mammary gland; Humans; Investigative techniques, diagnostic techniques (general aspects); Mammography; Medical sciences; Middle Aged; Predictive Value of Tests; Prospective Studies; Radiodiagnosis. Nmr imagery. Nmr spectrometry; Reproducibility of Results; Ultrasonography, Mammary; Sonography; Nuclear medicine; Radiodiagnosis; Radiology; Breast; Mammography; Mammary gland
• ISSN: 0361-803X; 1546-3141
• DOI: 10.2214/AJR.07.3259

The objective of our study was to report the results of classification of sonographic findings according to BI-RADS and to calculate the positive predictive value (PPV) for each BI-RADS assessment category. We prospectively classified 4,668 breast sonograms according to BI-RADS final assessment category. Suspicious sonographic findings were divided into major and minor suspicious findings. Category 1 was normal and category 2 was a benign finding such as cyst or nodule with uniform and intense hyperechogenicity. A nodule neither category 2 nor category 4 or 5 was defined as category 3. A nodule with one or more suspicious findings, not category 5, was defined as category 4. A nodule with two or more major suspicious findings was defined as category 5. Of the 4,668 cases, 321 cases failed to undergo follow-up of at least 1 year. The PPV was 0.1% in category 1 (3/2,191), 0% in category 2 (0/773), 0.8% in category 3 (6/737), 31.1% in category 4 (161/519), and 96.9% in category 5 (123/127). In palpable lesions (n = 751), the PPV was 2.2% in category 1 (2/93), 0.9% in category 3 (2/217), 54% in category 4 (107/198), and 98% in category 5 (98/100). In nonpalpable lesions (n = 3,596), the PPV was 0.05% in category 1 (1/2,098), 0.8% in category 3 (4/520), 16.8% in category 4 (54/321), and 92.6% in category 5 (25/27). As with mammography, placing sonographic lesions into BI-RADS categories is useful for predicting the presence of malignancy.