Varas Ximena, Leborgne José H, Leborgne Francisco, Mezzera Julieta, Jaumandreu Sylvia, Leborgne Felix
Instituto de Radiología y Centro de Lucha Contra el Cáncer, Pereira Rossell Hospital, B. Artigas 1550, 11600 Montevideo, Uruguay.
AJR Am J Roentgenol. 2002 Sep;179(3):691-5. doi: 10.2214/ajr.179.3.1790691.
Using data collected for one series during 1987-1989 and data collected for another series during 1996, we sought to compare the frequency of and positive predictive value for carcinoma of the breast in nonpalpable, probably benign lesions that had been detected on and followed up with mammography.
During 1996, mammography was performed in 18,435 women of whom 544 (3.0%) had lesions assigned to Breast Imaging Reporting and Data System (BI-RADS) category 3 for nonpalpable, probably benign lesions. The lesions in the women were assessed as BI-RADS category 3 after the patients had undergone a diagnostic study that included additional imaging, sonography, and a focused physical examination. Patients with BI-RADS category 3 lesions were recommended for mammographic surveillance. A minimum of 2 years of follow-up data was available for 511 patients, our study population. We compared the findings for our study population with those of the previous study.
Ninety-seven percent of the follow-up mammograms showed stability or regression of the BI-RADS category 3 lesions. Fourteen patients (3%) had nonpalpable interval progression revealed on mammography and underwent biopsy. The breast cancer detection rate in category 3 lesions among the study population was 0.4% (2/511), which was 14% of the patients who had undergone biopsies because of interval progression of the lesions. The pathologic stage of the cancers in these two patients was T1b N0.
Compared with the findings from the 1987-1989 study, the frequency of BI-RADS category 3 lesions has remained stable; patient compliance for follow-up has increased; and the positive predictive value of category 3 lesions for cancer has decreased from 1.7% to 0.4% (p = 0.04).
利用1987 - 1989年期间为一个系列收集的数据以及1996年为另一个系列收集的数据，我们试图比较在乳腺钼靶检查中发现并随访的不可触及的、可能为良性病变中乳腺癌的发生频率和阳性预测值。
1996年，对18435名女性进行了乳腺钼靶检查，其中544名（3.0%）女性的病变被归类为乳腺影像报告和数据系统（BI-RADS）3类，为不可触及的、可能为良性的病变。在患者接受了包括额外影像学检查、超声检查和重点体格检查的诊断性研究后，这些女性的病变被评估为BI-RADS 3类。建议BI-RADS 3类病变的患者进行乳腺钼靶监测。我们的研究人群为511名患者，他们至少有2年的随访数据。我们将研究人群的结果与先前研究的结果进行了比较。
97%的随访乳腺钼靶检查显示BI-RADS 3类病变稳定或消退。14名患者（3%）在乳腺钼靶检查中显示有不可触及的间期进展并接受了活检。研究人群中3类病变的乳腺癌检出率为0.4%（2/511），占因病变间期进展而接受活检患者的14%。这两名患者癌症的病理分期为T1b N0。
与1987 - 1989年的研究结果相比，BI-RADS 3类病变的发生频率保持稳定；患者的随访依从性有所提高；3类病变对癌症的阳性预测值从1.7%降至0.4%（p = 0.04）。
