Diagnostic Imaging Division, Internal Medicine Department, School of Medicine of Ribeirao Preto, University of Sao Paulo, Brazil.
Clinics (Sao Paulo). 2011;66(3):443-8. doi: 10.1590/s1807-59322011000300014.
To evaluate the outcomes and diagnostic performance of ultrasonography after a Breast Imaging Reporting and Data System (Bi-RADS) category 0 mammogram.
This retrospective study reviewed 4,384 consecutive patients who underwent a screening mammography from January 2005 to July 2006; 391 of the 4,384 exams were classified as Bi-RADS category 0. After exclusions, 241 patients received subsequent sonogram. Ultrasonography was considered diagnostic when the Bi-RADS category was changed to 2, 4, or 5, and it was considered indeterminate (Bi-RADS 3) when the results indicated that the patients should return for a mammographic follow-up. The outcomes of these patients were assessed to evaluate the diagnostic performance of ultrasonography.
The mean age of the patients was 53.3 years (ranging from 35 to 81). Of the 241 patients, ultrasonography was considered diagnostic in 146 (60.6%) patients and indeterminate in 95 (39.4%) patients. In the diagnostic group, 111 out of 146 patients (70.2%) had a sonogram result of Bi-RADS category 2 after a 2-year follow-up without evidence of malignancy. Furthermore, 35 out of 146 patients (29.8%) had a suspicious sonogram with a result of Bi-RADS category 4. After a tissue sampling procedure, 10 patients were confirmed to have breast cancer, and 25 had benign histopathological features without any evidence of malignancy after a 2-year follow-up. The sensitivity of ultrasonography was 100%, specificity was 89.1%, and overall accuracy was 89.6%.
Based on the degree of resolution and its diagnostic performance, ultrasonography was determined to be an excellent method for the subsequent evaluation of Bi-RADS 0 mammograms.
评估乳腺影像报告和数据系统（BI-RADS）分类 0 型乳腺 X 线摄影后的超声检查结果和诊断性能。
本回顾性研究纳入了 2005 年 1 月至 2006 年 7 月间连续 4384 例接受筛查性乳腺 X 线摄影的患者；其中 391 例检查结果为 BI-RADS 分类 0 型。排除后，241 例患者接受了后续超声检查。当 BI-RADS 分类变为 2、4 或 5 时，超声检查被认为具有诊断性；当结果表明患者应进行乳腺 X 线摄影随访时，超声检查被认为是不确定的（BI-RADS 3 类）。评估这些患者的结果以评估超声检查的诊断性能。
患者的平均年龄为 53.3 岁（范围为 35 至 81 岁）。在 241 例患者中，超声检查被认为具有诊断性的有 146 例（60.6%），不确定的有 95 例（39.4%）。在诊断组中，146 例患者中有 111 例（70.2%）在 2 年随访中，超声检查结果为 BI-RADS 2 类，且无恶性证据。此外，146 例患者中有 35 例（29.8%）超声检查结果为 BI-RADS 4 类，可疑恶性。在进行组织取样后，10 例患者被确诊为乳腺癌，25 例患者的组织学特征为良性，且无恶性证据，在 2 年随访中无恶性进展。超声检查的敏感性为 100%，特异性为 89.1%，总准确性为 89.6%。
基于其分辨率和诊断性能，超声检查被确定为 BI-RADS 0 型乳腺 X 线摄影的后续评估的一种极好方法。
