Abstract
BackgroundProbably benign breast lesions in the Breast Imaging Reporting and Data Systems (BI-RADS 3) constitute a crucial category and a considerable number of all palpable breast masses. Local data concerning the outcome of such lesions in the Nigerian environment is almost non-existent.ObjectivesThe goal of this article is to report the frequency, outcome and malignancy detection rate among palpable breast masses that were categorised on ultrasound as BI-RADS category 3 (probably benign) according to the American College of Radiology (ACR).MethodsBetween January 2015 and July 2017, 603 patients had diagnostic whole-breast ultrasound scans. There were 277 women who complained of palpable breast masses, of whom 151 women were diagnosed as having BI-RADS 3 lesions. The final lesion outcome was determined by either biopsy or ultrasound follow-up examination for a total of 2 years. All data were recorded and analysed with Statistical Package for the Social Sciences (SPSS) version 20 (Chicago, USA).ResultsThe frequency of BI-RADS category 3 lesions among all the women who underwent breast ultrasound was 25% (151/603); and 54% (151/277) in patients with palpable breast masses. There were 25 patients who were excluded because of incomplete data or who were lost to follow-up. A total of 122 patients had both ultrasound examination and histopathologic diagnosis, while only 4 were followed up for 2 years on ultrasound alone. Of the 122 women biopsied, 117 (95.9%) had benign histologic outcomes, and of the remaining 5, cancer was confirmed in 2 (1.6%), while the remaining 3 patients (2.5%) had lesions considered intermediate at histology (juvenile papillomatosis, borderline phylloides and atypical ductal hyperplasia). Three out of four patients who had ultrasound follow-up alone had stable lesions after 2 years, while one patient had complete resolution.ConclusionThis study found a significantly high biopsy rate of 80% (122/151) for probably benign lesions but a low detection rate for malignancy (1.6%). Follow-up with imaging rather than biopsy for lesions sonographically described as probably benign, will reduce medical costs and unwarranted invasive procedures.
Highlights
The ‘probably benign’ assessment in the Breast Imaging Reporting and Data Systems (BI-RADS) is assigned to lesions with specific imaging findings
Radiologists have a key role to play in deciding on the definitive management as to whether the mass should be biopsied or not
The American College of Radiology (ACR) management recommendation is a short-interval imaging follow-up usually at 6, 12 and 24 months, which is considered a reasonable alternative to biopsy.[1,4,5,6]
Summary
The ‘probably benign’ assessment (category 3) in the Breast Imaging Reporting and Data Systems (BI-RADS) is assigned to lesions with specific imaging findings. These include a solid mass with an oval shape, circumscribed margin, parallel orientation, homogenous echo texture and no suspicious malignant characteristics.[1,2] While these masses have benign imaging features, there is still a low (< 2%) risk for malignancy.[3] Radiologists have a key role to play in deciding on the definitive management as to whether the mass should be biopsied or not. Benign breast lesions in the Breast Imaging Reporting and Data Systems (BI-RADS 3) constitute a crucial category and a considerable number of all palpable breast masses. Local data concerning the outcome of such lesions in the Nigerian environment is almost non-existent
Sign-in/Register to view highlights & summary 
Published Version (
Free)
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call