Revi Lakshmi, Pillai Chitrathara Kesava, Sreedhar Anupama, Puzhakkal Sanam
Department of Surgical and Gynaecological Oncology, Lakeshore Hospital and Research Centre, Kochi, Kerala India.
Indian J Surg Oncol. 2025 Feb;16(1):312-319. doi: 10.1007/s13193-024-02089-4. Epub 2024 Sep 12.
The Breast Imaging Reporting and Data System (BIRADS) is a reporting system used to describe the results of mammogram, breast ultrasound, or breast MRI in a standard way. BIRADS ranks the test findings according to one of the seven categories, ranging from normal or benign to highly suspicious of cancer or malignant. This has specific accuracy for breast cancer. Out of the seven categories, BIRADS 4 is linked with a greater possibility for carcinoma breast. The research objective was to establish the rate of malignancy and clinical net result of BIRADS 4 lesions. The retrospective study, conducted in in Lakeshore Hospital and Research Centre (LHRC), Kochi, for a duration of 3 years, from December 2019 to December 2022, includes patients diagnosed as BIRADS 4 by mammographic or ultrasonographic or MRI findings. Previous medical records and electronic database were used to collect data. The study includes patients with BIRADS 4 lesions who went through surgery. Predictors such as patient demographics, comorbidities, and imaging features were considered. The rate of malignancy and positive predictive factor of BIRADS 4 lesions associated with carcinoma breast was calculated. A total of 394 lesions were classified as BIRADS 4 according to mammogram, ultrasound, or MRI for a time period of 3 years, from December 2019 to December 2022 at LHRC. Nevertheless, only 383 BIRADS 4 lesions for whom surgery was done were included in the survey. Out of the 383 lesions, the final histopathological report of the biopsied samples revealed 339 lesions to be malignant. Multivariate logistic regression analysis showed that menopausal status, mass lesions and spiculations in mammogram, and ductal abnormality in ultrasonography were greatly linked with carcinoma breast. Invasive breast carcinoma was the most common malignant lesion while fibro-cystic disease remained the predominant benign pathology. This study showed that majority of the BIRADS 4 lesions in LHRC were malignant. Both mammogram and ultrasonography were able to pick up early-stage breast cancer. Tissue diagnosis had higher sensitivity and is useful to avoid surgeries for non-significant lesions which can be followed up. Routine health check-up should be done according to the recent guidelines to detect early-stage breast cancer.
乳腺影像报告和数据系统（BIRADS）是一种用于以标准化方式描述乳房X光检查、乳腺超声或乳腺MRI结果的报告系统。BIRADS根据七个类别之一对检查结果进行分级，范围从正常或良性到高度怀疑癌症或恶性。这对乳腺癌具有特定的准确性。在这七个类别中，BIRADS 4与乳腺癌的可能性更大相关。研究目的是确定BIRADS 4类病变的恶性率和临床最终结果。这项回顾性研究在高知湖岸医院和研究中心（LHRC）进行，为期3年，从2019年12月至2022年12月，纳入了通过乳房X光检查、超声检查或MRI检查结果诊断为BIRADS 4的患者。使用既往病历和电子数据库收集数据。该研究包括接受手术的BIRADS 4类病变患者。考虑了患者人口统计学、合并症和影像特征等预测因素。计算了与乳腺癌相关的BIRADS 4类病变的恶性率和阳性预测因素。在2019年12月至2022年期间的3年里，LHRC共有394个病变根据乳房X光检查、超声检查或MRI被分类为BIRADS 4。然而，调查仅纳入了383个接受手术的BIRADS 4类病变。在这383个病变中，活检样本的最终组织病理学报告显示339个病变为恶性。多因素逻辑回归分析表明，绝经状态、乳房X光检查中的肿块病变和毛刺征以及超声检查中的导管异常与乳腺癌密切相关。浸润性乳腺癌是最常见的恶性病变，而纤维囊性疾病仍然是主要的良性病理类型。这项研究表明，LHRC的大多数BIRADS 4类病变是恶性的。乳房X光检查和超声检查都能够发现早期乳腺癌。组织诊断具有更高的敏感性，有助于避免对可随访的非显著病变进行手术。应根据最新指南进行常规健康检查以发现早期乳腺癌。
