Sonographic features of breast imaging reporting and data system assessment category 4 and 5 non-palpable breast lesions / 中国医学科学院学报

ABSTRACT

<p><b>OBJECTIVE</b>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.</p><p><b>METHODS</b>A 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.</p><p><b>RESULTS</b>Of 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%).</p><p><b>CONCLUSIONS</b>"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.</p>