Department of Radiology, Addington Hospital, Durban, South Africa.
S Afr Med J. 2013 Mar 4;103(4):251-4. doi: 10.7196/samj.6361.
Stereotactic core-needle biopsies (SCNBs) are a reliable alternative to surgical biopsy for microcalcifications. The positive predictive value (PPV) of SCNB has been shown to be reproducible in several studies using the Breast Imaging Reporting and Data System (BIRADS) classification, which is the current gold standard in mammographic reporting. At this stage, no study has been done in KwaZulu-Natal to assess local outcomes against BIRADS. The current standard of care utilises vacuum-assisted breast biopsy, but is not available in a resource-constrained environment such as ours. The need, therefore, is for constant evaluation of existing practice to ensure that it is optimised for the challenges and limitations facing local radiologists.
To assess the PPV of SCNB in Addington Hospital, and to compare it with that of BIRADS. Material and methods. Mammographically detected lesions were assigned to 3 categories: benign, indeterminate and suspicious. A retrospective review of 67 SCNBs was performed for lesions falling within the suspicious category, and the PPV and rates of ductal carcinoma in situ (DCIS) were determined.
Our study demonstrated a PPV of 20.9%. This correlated well with international studies for BIRADS 4 and 5 lesions. DCIS accounted for 21.4% of detected malignancies, which is in keeping with current literature.
Despite resource limitations, local outcomes were comparable to those of BIRADS. Given our fairly general categorisation of lesions, however, it should be emphasised that BIRADS allows better organisation, consistency and clarity in breast imaging reporting, as well as accurate data comparison between centres facing limitations similar to our own.
立体定向核心针活检（SCNB）是微钙化症外科活检的可靠替代方法。使用乳腺影像报告和数据系统（BIRADS）分类，已经有几项研究证明了 SCNB 的阳性预测值（PPV）具有可重复性，BIRADS 是目前乳腺影像学报告的金标准。在这一阶段，夸祖鲁-纳塔尔省尚未针对 BIRADS 评估局部结果的研究。目前的护理标准是使用真空辅助乳房活检，但在我们这样资源有限的环境中并不适用。因此，需要不断评估现有实践，以确保针对当地放射科医生面临的挑战和限制进行优化。
评估 Addington 医院 SCNB 的 PPV，并与 BIRADS 进行比较。材料和方法。对乳腺 X 线摄影检测到的病变分为 3 类：良性、不确定和可疑。对可疑类别内的病变进行了 67 例 SCNB 的回顾性分析，并确定了 PPV 和导管原位癌（DCIS）的发生率。
我们的研究显示 PPV 为 20.9%。这与国际上针对 BIRADS 4 和 5 类病变的研究结果相吻合。DCIS 占检出恶性肿瘤的 21.4%，与目前的文献一致。
尽管资源有限，但当地的结果与 BIRADS 相似。然而，鉴于我们对病变的分类相当笼统，应该强调的是，BIRADS 允许在乳腺影像学报告中进行更好的组织、一致性和清晰度，以及在面临与我们类似的限制的中心之间进行准确的数据比较。
