Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany;
Department of Gynecology and Obstetrics, Hannover Medical School, Hannover, Germany.
In Vivo. 2022 Sep-Oct;36(5):2255-2259. doi: 10.21873/invivo.12953.
BACKGROUND/AIM: Magnetic resonance imaging (MRI) is an important diagnostic tool in the detection of breast cancer. The Breast Center of the municipal Hospital Holweide, Cologne, annually cares for and treats patients with changes in the breast. A special problem is posed by Breast Imaging-Reporting and Data System (BI-RADS) 4 lesions. If a BI-RADS 4 finding is present, is a vacuum biopsy indicated in every case or, if there is already an indication for surgery due to other findings, can the corresponding finding be removed openly without histological clarification? We require real world data regarding the actual in-center likelihood of a BIRADS 4 lesion to be DCIS (Ductal carcinoma in situ) or invasive disease.
This is a retrospective study of 1,641 patients who received MRI examination in the radiological department of the municipal hospital Holweide in 2012 and 2013. Each BI-RADS 4 finding (or higher) classified by MRI was compared with the final histological result.
347 MRIs showed BI-RADS 4 findings or higher and 280 (80.7%) cases showed benign histology. In 67 (19.3%) cases, histology showed DCIS or invasive carcinoma.
BI-RADS 4 lesions have a low probability of malignancy based on real-world data from this center. If there is already an indication for surgery due to other lesions, the patient can also be offered a simultaneous open biopsy in the context of the already initiated surgical treatment. Each center should know the sensitivity and specificity of the MRI imaging performed and counsel patients based on that.
背景/目的：磁共振成像（MRI）是检测乳腺癌的重要诊断工具。科隆市霍韦尔迪德市立医院的乳腺中心每年为有乳腺变化的患者提供护理和治疗。乳腺影像报告和数据系统（BI-RADS）4 级病变是一个特殊的问题。如果存在 BI-RADS 4 级发现，是否在每种情况下都需要进行真空活检，或者如果由于其他发现已经有手术指征，是否可以在不进行组织学明确的情况下通过开放性手术切除相应的发现？我们需要关于实际中心 BI-RADS 4 病变为导管原位癌（DCIS）或浸润性疾病的实际可能性的真实世界数据。
这是对 2012 年和 2013 年在市政医院 Holweide 放射科接受 MRI 检查的 1641 名患者的回顾性研究。比较了每个 MRI 分类的 BI-RADS 4 级发现（或更高）与最终组织学结果。
347 次 MRI 检查显示 BI-RADS 4 级发现或更高，280 例（80.7%）为良性组织学。67 例（19.3%）显示为 DCIS 或浸润性癌。
根据该中心的真实世界数据，BI-RADS 4 级病变恶性肿瘤的可能性较低。如果由于其他病变已经有手术指征，也可以在已经开始的手术治疗背景下为患者提供同时进行的开放性活检。每个中心都应该了解其进行的 MRI 成像的敏感性和特异性，并据此为患者提供咨询。
