Common Jessica, Abdullah Peri, Alabousi Abdullah
Faculty of Health Science, Department of Radiology, 3710McMaster University, Hamilton, ON, Canada.
Faculty of Health, Department of Kinesiology and Health Science, 7991York University, Toronto, ON, Canada.
Can Assoc Radiol J. 2023 Feb;74(1):69-77. doi: 10.1177/08465371221121706. Epub 2022 Aug 30.
To evaluate outcomes of breast lesions assessed at our institution as probably benign (Breast Imaging Reporting and Data System [BI-RADS] category 3) with an expected malignancy rate of less than or equal to 2 %. Average-risk women with a BI-RADS 3 assessment following mammographic and/or ultrasound evaluation at our institution between January 1 and December 31, 2017 were included. Cancer yield was calculated within 90 days and at 6-month intervals up to 36 months. Among 517 women (median age, 52 years; range, 13-89 years) with a BI-RADS 3 assessment, 349 (67.5 %) underwent biopsy or completed follow-up imaging up to 36 months. One hundred and 68 (32.5 %) were lost to follow-up. Thirty of 349 (8.6 %) had their imaging upgraded and underwent biopsy, yielding six cancers (cancer yield, 6 of 349 women [1.7 %]). Among 569 lesions assessed as BI-RADS 3, 92 (16.2 %) were characterized by morphologic features other than those validated as probably benign in prospective clinical studies. Fifty three of 517 women (10.3 %) had follow-up beyond 24 months, and 24 (4.6 %) had follow-up beyond 36 months. Overall utilization of the BI-RADS 3 assessment category at our institution is appropriate with a 1.7 % cancer yield. However, the rate of loss to follow-up, percentage of non-validated findings assessed as probably benign, and redundancy in follow-up protocols are too high, and warrant intervention. A patient handout explaining the BI-RADS 3 assessment category and automatic scheduling of follow-up studies have been implemented at our center to address loss to follow-up.
为评估在本机构中被判定为可能良性（乳腺影像报告和数据系统[BI-RADS]3类）且预期恶性率小于或等于2%的乳腺病变的转归情况。纳入2017年1月1日至12月31日期间在本机构经乳腺X线摄影和/或超声检查后BI-RADS评估为3类的平均风险女性。在90天内以及之后每6个月计算一次癌症检出率，最长至36个月。在517名BI-RADS 3类评估的女性（年龄中位数52岁；范围13 - 89岁）中，349名（67.5%）接受了活检或完成了长达36个月的后续影像检查。168名（32.5%）失访。349名中的30名（8.6%）影像结果升级并接受了活检，检出6例癌症（癌症检出率为349名女性中的6例[1.7%]）。在569个被评估为BI-RADS 3类的病变中，92个（16.2%）具有在前瞻性临床研究中未被确认为可能良性的形态学特征。517名女性中的53名（10.3%）随访超过24个月，24名（4.6%）随访超过36个月。本机构BI-RADS 3类评估分类的总体应用是合适的，癌症检出率为1.7%。然而，失访率、被判定为可能良性的未经验证的发现百分比以及随访方案的冗余度都过高，需要进行干预。我们中心已实施一份患者手册来解释BI-RADS 3类评估分类并自动安排后续检查，以解决失访问题。
