Study of ultrasound BI-RADS for small solid breast masses

Abstract

Objective To evaluate the clinical value of ultrasound breast imaging reporting and data system （BI-RADS） in small solid breast masses with diameter 41 cm.Methods The ultrasound features of 230 solid breast masses with diameter ≤ 1 cm were described by ultrasound BI-RADS, the relationship between ultrasound features,BI-RADS final assesment and pathology were analyzed.Results Of these 230 masses,72（31.3%） were pathologically confirmed to be malignant and 158 （68.7%） to be benign. The ultrasound BI-RADS features of mass shape, margin, orientation, posterior acoustic features, and microcalcificaition were significantly different between malignant and benign masses （ P 〈 0.05）. Irregular shape, noncircumscribed, nonparallel orientation, postrior shadowing, microcalcifications were regarded as malignant ultrasound features, their positive predictive values （PPV）, sensitivity, specificity and accuracy for malignancy were 53.3% - 100% ,2.8% - 75.0% ,82.3% - 100% ,69.6% - 80.9% ,respectively. One hundred and fifty-two（66.1%）,62（27.0%）, 16（7.0%） masses were classified into grade 3,4,and 5 ,respectively.The PPV for grade 3,4 and 5 were 10.5 %, 64.5 %, 100 % respectively. Among BI-RADS grade 3 cases, 87.5 % malignant masses were intraductal carcinoma in situ and special type of invasive cancer,among pathological benign BI-RADS grade 4 masses,90.9% were hyperplasia and intraductal papilloma.Conclusions In small breast masses with diameter ≤ 1 cm, due to the sensitivity of malignant signs are not high, the overlap between signs of benign and malignant lesions, pathological type and other factors, the positive predictive value of BI-RADS grade 3 is higher than criteria of American College of Radiology, so BI-RADS classification requires further detailed study. Key words: Ultrasonography ; Breast diseases ; BI-RADS