Caracterización de lesiones asociadas a microcalcificaciones BI-RADS 4A, en 11 años de biopsias estereotáxicas

Abstract

Substantial advances in breast imaging techniques, especially developments in digital mammo- graphy, have led to early detection of breast cancer. It is well-known that microcalcifications are present in approximately 55% of nonpalpable breast malignancies and are responsible for the detection of 85-90% of cases of ductal carcinoma in situ (DCIS) through mammographic screening. We evaluated the types of associated lesions and the percentage of malignancy in BI-RADS 4A subcategory (low suspicion of malignancy), by performing a database review of stereotactic biopsies of microcalcifications categorized as BI-RADS 4A, between September 1999 and January 2011, which accounted for 21.4% of biopsied microcalcifications in a total of 159 women. Histological findings corresponded to benign lesions in 43.5%, high-risk lesions in 46.5%, and malignant tumors in 10%. Concerning the latter (16 biopsies), 81.3% were DCIS and 18.7% corresponded to infiltrating ductal carcinoma (IDC). The PPV of BI-RADS 4 A category was 13%, a value consistent with that described in the literature. Microcalcifications BI-RADS 4A exhibit low suspicion of malignancy, since they mostly correspond to be - nign lesions (90%). Subcategory 4A constitutes an important ancillary diagnostic tool for a more accurate assessment of lesions suspicious for malignancy; therefore, we strongly recommend its use.