Şüpheli Meme Lezyonlarında BI-RADS Sınıflamasının Tanısal Etkinliği: Batı Anadolu’da Tek Merkezli Deneyim

Öz

Amaç: Bu çalışmada, meme ultrasonografisi (US) ve mamografi ile BI-RADS (Breast Imaging Reporting and Data System) 3, 4 ve 5 olarak gruplandırılan ve US eşliğinde tru-cut biyopsi (TCB) yapılan lezyonlardaki histopatolojik ve radyolojik uyumluluğun araştırılması amaçlanmıştır. Gereç ve Yöntemler: Ocak 2019-Aralık 2022 tarihleri arasında US ve mamografi ile BI-RADS 3, 4 ve 5 meme lezyonu saptanan ve US eşliğinde TCB yapılan ardışık 196 kadın hasta retrospektif olarak taranarak çalışmaya dahil edildi. Lezyon lokalizasyonları, en büyük çapları, biyopsi sonuçları ve benign-malign lezyonların yaşla ilişkisi incelendi. BI-RADS 3 lezyonlarında malignite için negatif prediktif değer (NPD), BI-RADS 4 ve 5 lezyonlarında malignite için pozitif prediktif değer (PPD) hesaplandı. Bulgular: Yaş ortalaması 50.38±13.53 (18-80) olan hastalarda 52 yaş üzerinde malignite olasılığı artmaktadır. Benign ve malign lezyonların büyüklükleri ve lokalizasyonları arasında istatistiksel olarak fark izlenmedi (p>0.05). BI-RADS ile histopatolojik tanı arasında istatistiksel olarak güçlü ve anlamlı bir korelasyon vardı (p<0.0001, r=0.725). BI-RADS 3 lezyonlarda malignite için NPD %93.5 ve BI-RADS 4 ve 5 lezyonlarında malignite için PPD sırasıyla %61.4 ve %96.7 bulundu. Sonuç: TCB, BI-RADS 3, 4 ve 5 olarak gruplandırılan lezyonların tanısı için etkili ve güvenilir bir yöntemdir. BI-RADS 3 lezyonlarda malignite için NPD nispeten düşüktür. BI-RADS 4 lezyonlarda, lezyon spektrumunun genişliği ve alt kategorilere ayırmadaki subjektif kriterler nedeni ile malignite için PPD düşüktür. BI-RADS 5 lezyonlarda ise malignite için PPD oldukça yüksektir.

Anahtar Kelimeler

• Meme kitlesi
• BI-RADS
• Meme tru-cut biyopsi

Diagnostic Effectiveness of BI-RADS Classifıcation In Suspected Breast Lesions: A Single Center Experience in the West Anatolia

Abstract

Objective: In this study, we aimed to investigate the histopathological and radiological compatibility of the lesions grouped as BI-RADS (Breast Imaging Reporting and Data System) categories 3, 4, and 5 with breast ultrasonography (US) and mammography and performed trucut biopsy (TCB) under US guidance. Material and methods: Between January 2019 and December 2022, 196 consecutive female patients who were diagnosed with BI-RADS 3, 4, and 5 lesions by US and mammography examinations and underwent US-guided TCB were retrospectively scanned and included in the study. Lesion localizations, largest diameters, biopsy results, and the relationship of benign-malignant lesions with age were examined. Negative predictive value (NPV) for malignancy in BI-RADS 3 lesions and positive predictive value (PPV) for malignancy in BI-RADS 4 and 5 lesions were calculated. Results: In patients with a mean age of 50.38±13.53 (18-80), the probability of malignancy increased over the age of 52. There was no statistical difference between the sizes and locations of benign and malignant lesions (p>0.05). There was a statistically strong and significant correlation between BIRADS and histopathological diagnosis (p<0.0001, r=0.725). The NPV for malignancy in BI-RADS 3 lesions was 93.5%, and the PPV for malignancy in BI-RADS 4 and 5 lesions was 61.4% and 96.7%, respectively. Conclusions: Breast trucut biopsy is an effective and reliable method for diagnosing lesions grouped as BI-RADS 3, 4, and 5. The NPV rate for malignancy in BI-RADS 3 lesions is relatively low. In BI-RADS 4 lesions, the PPV for malignancy is low because the lesion spectrum is quite wide, and the division into subcategories is subjective. The PPV for malignancy in BI-RADS 5 lesions is quite high.

Keywords

• Breast mass
• BI-RADS
• Breast tru-cut biopsy

Kaynakça

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