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Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS.

Abstract：

BACKGROUND:The 5th edition of Breast Imaging Reporting and Data System subdivides suspicious calcifications into two categories: 4B-amorphous, coarse heterogeneous, and fine pleomorphic calcifications; 4C-fine linear or fine linear branching calcifications. We investigated whether these revised categories are appropriate for malignancy risk stratification. METHODS:We studied 246 patients (mean age 48.2 years) with suspicious microcalcifications detected on mammography who underwent stereotactic biopsy (n = 154) or surgical excisional biopsy with preoperative mammogram-guided needle localization (n = 92). Pre-biopsy mammograms were reviewed retrospectively, and imaging features were analyzed according to the revised morphology and distribution descriptors. Pathological results of stereotactic biopsy and surgical excision were considered, with the surgical results being the reference standard. Positive predictive values (PPVs) were calculated and compared using the χ (2) test or Fisher's exact test. RESULTS:Overall PPV of suspicious microcalcifications was 22.4 %. PPVs of morphology descriptors were as follows: amorphous 7.9 %, coarse heterogeneous 17.8 %, fine pleomorphic 63.2 %, fine linear/fine linear branching 100 % (p < 0.001). PPVs of distribution descriptors were as follows: regional 8.8 %, grouped 14.3 %, linear 87.5 %, segmental 63.6 % (p < 0.001). For morphology and distribution descriptors combinations, PPVs for amorphous/regional and amorphous/grouped microcalcifications were 4.2 and 7.6 %, resepectively. The PPV for fine pleomorphic/linear or segmental was 93.8 %. CONCLUSIONS:Subcategorization of morphology descriptors for suspicious microcalcifications is needed because of the different PPVs for amorphous, coarse heterogeneous, and fine pleomorphic microcalcifications. Combining morphology and distribution descriptors for suspicious microcalcifications provides accurate risk stratification.

journal_name

Ann Surg Oncol

journal_title

Annals of surgical oncology

authors

Kim SY,Kim HY,Kim EK,Kim MJ,Moon HJ,Yoon JH

doi

10.1245/s10434-014-4362-6

subject

Has Abstract

pub_date

2015-09-01 00:00:00

pages

2895-901

issue

eissn

1068-9265

issn

1534-4681

journal_volume

pub_type

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Evaluation of malignancy risk stratification of microcalcifications detected on mammography: a study based on the 5th edition of BI-RADS.