Guennoun Ahmed, Krimou Yousra, Bouchikhi Chahrazed, Mamouni Nisrine, Errarhay Sanaa, Banani Abdelaziz
Service d'Obstétrique et de Gynécologie I, Hôpital Universitaire Hassan II, Fès, Maroc.
Pan Afr Med J. 2018 Mar 2;29:140. doi: 10.11604/pamj.2018.29.140.13699. eCollection 2018.
The Bi-RADS (Breast Imaging Reporting and Data System) classification developed by the ACR (American College of Radiology) is the classification system for radiological images recommended for breast cancer screening. The ACR 4 microcalcification is an indeterminate or suspected abnormality with 2-95% probability of malignancy, according to studies. This disparity pushed us to conduct this retrospective study of 181 patients in the Department of Obstetrics and Gynecology I at the Hassan II University Hospital, Fez, over a period of 5 years. This study aimed to report the histological results of breast lesions radiologically classified as ACR4 in order to assess their radio-histological correlation and to improve therapeutic approach. All patients underwent breast imaging examinations and then anatomopathologic examination was performed using different techniques. There was a clear predominance of benign lesions with a rate of 62% versus 29% of malignant lesions and only 9% were intermediate lesions. Adenofibroma was the most common histological finding (30% of cases), invasive ductal carcinoma was the most frequent malignant lesion (17% of cases). We performed a literature review which showed that our results were in line with findings of other studies, with a positive predictive value of 29%. Nevertheless, ACR classification divided into subcategories 4a, b and c should be used due to the significant number of unnecessary surgical interventions.
由美国放射学会（ACR）制定的乳腺影像报告和数据系统（Bi-RADS）分类是推荐用于乳腺癌筛查的放射影像分类系统。根据研究，ACR 4类微钙化是一种不确定或疑似异常，恶性概率为2-95%。这种差异促使我们对非斯哈桑二世大学医院第一妇产科的181例患者进行了为期5年的回顾性研究。本研究旨在报告放射学分类为ACR4的乳腺病变的组织学结果，以评估其放射学与组织学的相关性，并改进治疗方法。所有患者均接受了乳腺影像学检查，然后采用不同技术进行了病理检查。良性病变明显占优势，比例为62%，恶性病变为29%，中间性病变仅占9%。腺纤维瘤是最常见的组织学发现（占病例的30%），浸润性导管癌是最常见的恶性病变（占病例的17%）。我们进行了文献综述，结果表明我们的结果与其他研究结果一致，阳性预测值为29%。然而，由于不必要的手术干预数量众多，应使用分为4a、b和c子类的ACR分类。
