Bérubé M, Curpen B, Ugolini P, Lalonde L, Ouimet-Oliva D
Department of Radiology, Centre hospitalier de l'Université de Montréal, Que.
Can Assoc Radiol J. 1998 Aug;49(4):223-8.
To determine whether the categories defined in the Breast Imaging Reporting and Data System (BI-RADS) are useful predictors of malignancy and to assess their positive predictive value.
A retrospective study was undertaken from July 1, 1994, to June 30, 1995. Of 568 abnormal mammograms for which largecore biopsy was recommended, 495 were available for review. The mammographic features of the lesions, as defined by the BI-RADS lexicon, were used to assess the level of suspicion. The lesions were classified as "probably benign," "suspicious" or "highly suggestive of malignancy." These diagnostic impressions were then correlated with the histologic diagnosis made after core biopsy.
The diagnostic impressions before core biopsy were as followed: 16 (3%) benign lesions, 397 (80%) suspicious lesions and 82 (17%) lesions highly suggestive of malignancy. All benign lesions remained in the same category after core biopsy, whereas, of the suspicious lesions, 91% were diagnosed as benign, only 4% as malignant, and the other 5% as atypical hyperplasia. Among the lesions highly suggestive of malignancy according to the BI-RADS lexicon, 54% were found to be malignant at core biopsy.
The BI-RADS lexicon is helpful in discriminating between lesions that are probably benign and probably malignant from the mammographic features. However, the rate of malignancy in the "suspicious" category is low.
确定乳腺影像报告和数据系统（BI-RADS）中定义的类别是否为恶性肿瘤的有用预测指标，并评估其阳性预测值。
进行了一项回顾性研究，时间跨度为1994年7月1日至1995年6月30日。在568例建议进行粗针活检的异常乳房X光片中，有495例可供复查。根据BI-RADS词典定义的病变乳房X光特征用于评估可疑程度。病变被分类为“可能为良性”、“可疑”或“高度提示恶性”。然后将这些诊断印象与粗针活检后的组织学诊断进行关联。
粗针活检前的诊断印象如下：16例（3%）为良性病变，397例（80%）为可疑病变，82例（17%）为高度提示恶性的病变。所有良性病变在粗针活检后仍属于同一类别，而在可疑病变中，91%被诊断为良性，仅4%为恶性，另外5%为非典型增生。在根据BI-RADS词典高度提示恶性的病变中，54%在粗针活检时被发现为恶性。
BI-RADS词典有助于从乳房X光特征区分可能为良性和可能为恶性的病变。然而，“可疑”类别的恶性率较低。
