Wiratkapun Cholatip, Lertsithichai Panuwat, Wibulpholprasert Bussanee
Department of Radiology, Faculty of Medicine, Ramathibodi Hospital, Rajthewee, Bangkok, Thailand.
J Med Assoc Thai. 2006 Aug;89(8):1253-9.
To determine positive predictive value (PPV) of the breast imaging reporting and data systems (BI-RADS) category 5 mammogram and ultrasound (US) in the diagnosis of breast cancer in the study center and correlation between clinical, mammographic and US findings, and breast cancer.
Four hundred and ninety seven patients with BI-RADS category 5 who underwent mammograms and US at the Breast diagnostic center, Ramathibodi Hospital from January, 1, 2002 to December 31, 2004 were enrolled into the present study. Selected clinical information, mammographic and US findings, and histopathological diagnosis were retrospectively reviewed.
Breast cancer was found in 467 of 497 patients, giving a PPV of 94%. Invasive ductal carcinoma was the most common malignancy (89.5%). Fibrocystic change was the most common benign pathology found in the remaining patients. Discrete mass was the most frequently encountered lesion detected on mammography and US, followed by mass containing calcifications. Patients with advanced age, having a clinically palpable breast mass, with mammographic and US evidence of mass containing calcifications showed significant statistical association with breast cancer.
PPV of BI-RADS category 5 lesions in the present study was comparable to other published studies. Although the probability of malignancy was very high, a small number of patients had benign pathologies. Preoperative histopathologic diagnosis is necessary before definitive treatment.
确定在本研究中心乳腺影像报告和数据系统（BI-RADS）5类乳腺X线摄影及超声检查在乳腺癌诊断中的阳性预测值（PPV），以及临床、乳腺X线摄影和超声检查结果与乳腺癌之间的相关性。
纳入2002年1月1日至2004年12月31日在拉玛蒂博迪医院乳腺诊断中心接受乳腺X线摄影和超声检查的497例BI-RADS 5类患者。回顾性分析所选的临床信息、乳腺X线摄影和超声检查结果以及组织病理学诊断。
497例患者中有467例发现乳腺癌，PPV为94%。浸润性导管癌是最常见的恶性肿瘤（89.5%）。纤维囊性变是其余患者中最常见的良性病变。在乳腺X线摄影和超声检查中最常发现的病变是离散性肿块，其次是含钙化的肿块。年龄较大、临床上可触及乳腺肿块、乳腺X线摄影和超声检查有含钙化肿块证据的患者与乳腺癌有显著统计学关联。
本研究中BI-RADS 5类病变的PPV与其他已发表的研究相当。尽管恶性概率非常高，但仍有少数患者为良性病变。在进行确定性治疗前，术前组织病理学诊断是必要的。
