Department of Radiology, Research Institute of Radiological Science, Yonsei University College of Medicine, Seodaemun-ku, Shinchon-dong 134, Seoul 120-752, South Korea.
Eur Radiol. 2011 Apr;21(4):667-75. doi: 10.1007/s00330-010-1955-8. Epub 2010 Sep 19.
To assess the performance of breast ultrasound based on BI-RADS final assessment categories in women with mammographically negative dense breast.
Of 3,820 cases with mammographically negative dense breast and subsequent hand-held bilateral whole-breast ultrasound, a total of 1,507 cases in 1,046 women who had biopsy or at least 2-year follow-up ultrasound constituted the basis of this retrospective study. Cancer rate of each sonographic BI-RADS category was determined and medical audit was performed separately in screening-general, screening-treated, and diagnostic group.
A total of 43 cases (2.9%) were confirmed as malignancy. Cancer rate among BI-RADS categories was significantly different (p < 0.0001). Among three groups, the cancer rate was significantly different (p < 0.0001) and the highest in diagnostic group (15.8%, 22 of 139). Abnormal interpretation rate, PPV of biopsy performed, cancer detection rate, and rate of early stage cancer, and the size of invasive cancer were significantly different among three groups and the highest in diagnostic group. Regarding cancer characteristics, the proportion of advanced cancer was the highest in diagnostic group.
Breast ultrasound based on BI-RADS as an adjunctive to negative mammography can be useful for predicting malignancy in women with dense breast.
评估基于 BI-RADS 最终评估类别的乳腺超声在乳腺钼靶阴性致密乳腺女性中的表现。
在 3820 例乳腺钼靶阴性致密乳腺且随后行手持双侧全乳腺超声的患者中，共有 1046 例患者的 1507 例（共 1046 例患者）接受了活检或至少 2 年的随访超声检查，这些患者构成了本回顾性研究的基础。确定了每个超声 BI-RADS 类别的癌症发生率，并分别在筛查-常规组、筛查-治疗组和诊断组进行医学审核。
共 43 例（2.9%）被确认为恶性肿瘤。BI-RADS 类别中的癌症发生率存在显著差异（p<0.0001）。在三组中，癌症发生率存在显著差异（p<0.0001），诊断组最高（15.8%，139 例中的 22 例）。异常解读率、活检的阳性预测值、癌症检出率、早期癌症率和浸润性癌的大小在三组中存在显著差异，诊断组最高。关于癌症特征，诊断组中晚期癌症的比例最高。
作为乳腺钼靶阴性的辅助检查，基于 BI-RADS 的乳腺超声可用于预测致密乳腺女性的恶性肿瘤。
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