Correlation Of Bi-Rads 4 Subcategories Breast Lesions On Tomosynthesis And Histopathological Examination With P63 Immunohistochemistry Expression.

Abstract

Mammography is considered to be the gold standard for screening and detection of breast malignancies. Among different biochemical markers used to detect carcinoma of breasts, p63 has been widely popularized for its effectiveness in the detection of myoepithelial cells which are an important indicator of breast benignity. In this study, we plan to statistically analyze and correlate the Breast Imaging Reporting and Data System (BI-RADS) 4 subcategories grading on mammogram imaging with p63 immunostaining. A total of 80 patients were taken into the study within a period of two years (2016-2018) after ensuring the inclusion and exclusion criteria. They were further sorted into different BI-RADS 4 subcategories, i.e., taking into consideration X-ray mammogram and tomosynthesis findings, 57 samples were categorized as low suspicion (BI-RADS 4A), while 12 were classified as intermediate (BI-RADS 4B), and the remaining 11 samples were categorized as highly suspicious (BI-RADS 4C). Although considered to be leaning toward malignancy, a BI-RADS reading of 4 (namely 4A-low suspicion, 4B-moderate suspicion, and 4C-high suspicion for malignancy) needs further evaluation for accurate diagnosis. There have been cases within our own observation where a lesion that is highly suspicious of malignancy has turned out to be a benign finding. Further, evaluating the expression of a p63 marker can help prevent mutilating surgeries for indeterminate lesions. The present study has been conducted to study the correlation of tomosynthesis grading of lesions that has been categorized from low-to-high suspicion, with a p63 immunostaining pattern in these lesions.