An Analysis of the Results of Breast Imaging Reporting and Data System 4 Lesions in Tertiary Care Center in South India.

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.