Positive Predictive Value of Breast Imaging Reporting and Data Systems Category 5 in Breast Cancer Diagnosis
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Abstract
Objective: To determine the positive predictive value (PPV) of breast imaging reporting and data systems (BI-RADS) category 5 in the diagnosis of breast cancer.
Materials and methods: A retrospective study of consecutive women who underwent mammogram and ultrasound at the Diagnostic Breast Cancer Center, Vajira Hospital from January 1, 2015 to December 31, 2019 was performed. Women who were categorized as BI-RADS category 5 (BI-RADS 5) and had pathological diagnosis were enrolled. Clinical information, mammographic and ultrasonographic findings, method of tissue diagnosis, and pathological results were retrospectively reviewed. The PPV of BI-RADS 5 was analyzed.
Results: Of 14,427 women who underwent mammography in the institution during the study period, 208 categorized as BI-RADS 5 and had pathological diagnosis were included. Mean age was 58.9 years (range 34–91 years). Mass was the most common imaging finding in 49% of the 208 women. Breast cancer was found in 202 women (97.1%) and benign pathology in 6 (2.9%). Invasive ductal carcinoma was the most common malignant pathology (85.6%), whereas fibroadenoma was the most common benign pathology (33.3%). The PPV of breast cancer in BI-RADS 5 was 97.1%.
Conclusion: The PPV of breast cancer in BI-RADS 5 was 97.1%. Although the probability of malignancy is very high, preoperative tissue diagnosis before definite treatment is still recommended.
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