Relationship between BI-RADS 4 Ultrasound Index and Pathological Findings and Clinical Outcomes in Breast Lesions

Introduction: breast cancer is listed as the most common type of cancer in women and many patients suffer from this disease worldwide. However, the timely diagnosis of the condition can lower the rate of mortality and morbidity. Breast imaging-reporting and data system (BI-RADS) is a noninvasive scoring system. The aim of our study was to assess the BI-RADS for patients and evaluate the correspondence of BI-RADS score with pathological findings. Methods: Ultrasound data for 250 patients who were BI-RADS 4 or above were gathered. Moreover, information like demographic data, family history, the involved breast (right or left), and the location of involvement was extracted. Furthermore, pathological grading based on the core needle biopsy or open surgery was assessed. Results: The mean age of the patients was 44.43 ± 13.10 years, and 20.8% had a family history of breast cancer. The number of cases categorized as BI-RADS 4A was 109 (43.6%), 39 cases (15.6%) were 4B, and 102 cases (40.8%) were 4C. Furthermore, in 128 cases (51.2%) the right breast and in 122 cases (48.8%) the left breast was involved. Age and percentage of lymphadenopathy in 4C group were significantly higher than 4A and 4B groups (P = 0.0001). Also, the location of the lesion (P = 0.004), pathologic diagnosis (P = 0.0001) and pathologic grade (P = 0.0001) were significantly different among the three categories. A total of 11.9% of 4A cases, 30.8% of 4B cases, and 90.2% of 4C cases were reported as carcinoma. Conclusion: The results of our study showed that the positive predictive value for the three categories of A, B, and C were equal to 11.9%, 30.8%, and 90.2%, respectively. However, more studies are still needed to examine this index more closely.