Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2010, Vol. 32 ›› Issue (4): 456-460.doi: 10.3881/j.issn.1000-503X.2010.04.021

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Sonographic Features of Breast Imaging Reporting and Data System Assessment Category 4 and 5 Non-palpable Breast Lesions

ZHU Qing-li1, JIANG Yu-xin1, ZHANG Jing1, LIU He1, DAI Qing1, SUN Qiang2   

  1. 1Department of Diagnostic Ultrasound,2Department of Surgery, PUMC Hospital, CAMS and PUMC, Beijing 100730, China
  • Received:2009-09-04 Online:2010-08-30 Published:2010-09-10
  • Contact: JIANG Yu-xin E-mail:yuxinjiangxh@yahoo.com.cn
  • Supported by:
    the National Natural Sciences Foundation of China (30570529)

Abstract: Objective To evaluate the diagnostic value of the sonographic features of Breast Imaging Reporting and Data System(BI-RADS)assessment category 4 and 5 non-palpable breast lesions. MethodsA total of 213 non-palpable breast lesions that were pre-operatively assessed to be BI-RADS category 4 and 5 lesions by ultrasound were enrolled in this study. The diagnostic value of their sonographic features were assessed by using pathologic results as the golden standards. ResultsOf these 213 lesions, 128(60.1%)were pathologically confirmed to be benign and 85(39.9%)to be malignant. The mean size was not significantly different between the benign and the malignant lesions(P=0.09). The sensitivity of “irregular shape” for diagnosing breast cancer was 89.9%, while the sensitivities of other sonographic features ranged from 7.6% to 42.4%. The diagnostic specificities were high for “angular margin”, “microlobular”, “spiculation” and “abundant flow”(89.0%-95.6%). The common sonographic findings of benign lesions included “irregular shape”(66.7%), “obscure margin”(35.1%), “shadowing”(27.2%), and “taller-than-wider” (26.3%). Conclusions“Irregular shape” is the most sensitive sonographic feature in the diagnosis of malignant BI-RADS category 4 and 5 non-palpable breast lesions. Ultrasound can accurately identify the invasive margin features of breast cancers, which is especially useful for the diagnosis of BI-RADS category 5 lesions.

Key words: non-palpable breast lesions, Breast Imaging Reporting and Data System, ultrasound

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