scholarly journals The importance of breast elastography added to the BI-RADS® (5th edition) lexicon classification

2015 ◽  
Vol 61 (4) ◽  
pp. 313-316 ◽  
Author(s):  
Eduardo de Faria Castro Fleury

SummaryObjective:the aim of this study was to investigate the addition of elastography to the BI-RADS® lexicon for the classification of breast lesions.Methods:a total of 955 consecutive patients who were subjected to breast percutaneous biopsy from January 2010 to December 2012 were retrospectively assessed. Overall, 26 patients who did not present with masses on conventional ultrasound were excluded. The patients were classified according to the fifth edition of the breast imaging and reporting data system (BI-RADS®) lexicon, which includes elastographic findings. The BI-RADS®classification is based on the same classification principles that have been suggested by the author, which classify lesions as soft, intermediate, or hard.Results:the addition of elastographic findings to the BI-RADS® lexicon improved the sensitivity (S), specificity (SP), and diagnostic accuracy (DA) of ultrasound in the assessment of breast lesions, which increased from 93.85, 72.07, and 76.64 to 95.90, 80.65, and 91.39%, respectively.Conclusion:these findings suggest that the addition of elastography to the BIRADS ® lexicon will improve the SP and DA of ultrasound in the screening of breast lesions.

Ultrasound ◽  
2021 ◽  
pp. 1742271X2199872
Author(s):  
Sepideh Sefidbakht ◽  
Sara Haseli ◽  
Neda Khalili ◽  
Vahid Bazojoo ◽  
Pedram Keshavarz ◽  
...  

Introduction We aimed to describe shear wave elastography parameters of non-mass lesions of the breast and to assess the measures of diagnostic accuracy of shear wave elastography in the differentiation of non-mass lesions compared with conventional ultrasound, using histopathologic results as the reference standard. Methods This retrospective study included breast ultrasound-detected non-mass lesions with a confirmed pathologic diagnosis during a two-year study period. B-mode ultrasound and shear wave elastography were performed for all lesions before biopsy. Ultrasound features, shear wave elastography parameters (mean elasticity and maximum stiffness color), as well as Breast Imaging-Reporting and Data System categories were recorded for each lesion. Measures of diagnostic accuracy of ultrasound and ultrasound + shear wave elastography were also assessed. Results From a total of 567 breast lesions requiring core-needle biopsy, 49 (8.6%) were considered as non-mass lesions. Based on histopathologic reports, 32 patients (65.3%) had non-high-risk benign lesions, five (10.2%) had high-risk benign lesions, five (10.2%) had ductal carcinoma in situ, and seven (14.3%) had invasive carcinoma. There was no significant difference in patients’ age and palpability between benign and malignant lesions ( p = 0.16 and p = 0.12, respectively). Mean elasticity values and Breast Imaging-Reporting and Data System categories were significantly higher among malignant lesions compared with benign non-mass lesions (both p < 0.001). Furthermore, the addition of shear wave elastography to grayscale ultrasound increased the specificity, positive predictive value, and diagnostic accuracy. Conclusion The complementary use of shear wave elastography with conventional ultrasound might help in the differentiation of non-mass breast lesions and has the potential to decrease the frequency of unnecessary biopsies performed for benign non-mass lesions.


2021 ◽  
Vol 9 (11) ◽  
pp. 1077-1083
Author(s):  
Indira Sahu ◽  
Suman Ruhela ◽  
Laghuta Verma

Aims & Objective: To determine the yield, reliability and diagnostic accuracy of Breast Imaging Reporting and Data System in evaluation of breast lesions taking histopathology as gold standard. Material and Methods: This cross-sectional, analytical study was conducted at Pathology dept. Of SMSMC Jaipur from June 2019 to June 2020. The data of the core needle biopsies of breast lesions received at the Pathology department which had been also categorized on mammogram, according to the Breast Imaging Reporting and Data System (BI-RADS), were selected for the study. All clinical parameters, the site of the biopsy, the radiological findings, the pathological diagnoses were studied. The concordance between the radiological and pathological results was studied . According to BI-RADS, categories II and III were classified as benign and BI-RADs IV and V as malignant. The breast core biopsies were classified as benign and malignant, according to the diagnosis. Results: A total of 115 patients were included in the study. BI-RADS system for reporting whencompared with histopathology had sensitivity of 93.55%, specificity 68.18%, positive predictive value92.55%, negative predictive value 71.43% and diagnostic accuracy 88.70%. Conclusion: The findings of this study report a high diagnostic accuracy of BI-RADS in the diagnosis ofbreast carcinoma.


2020 ◽  
Vol 93 (1112) ◽  
pp. 20200195
Author(s):  
Jiamin Pan ◽  
Wenjuan Tong ◽  
Jia Luo ◽  
Jinyu Liang ◽  
Fushun Pan ◽  
...  

Objective: To compare the efficacy of contrast-enhanced ultrasound enabled reclassification of Breast Imaging Reporting and Data System (CEUS-BI-RADS) with MRI in the diagnosis of breast lesions with calcification. Methods: A total of 52 breast lesions with calcification from 51 patients were detected by ultrasound as hyperechoic foci and categorized as BI-RADS 3–5. The 51 patients further underwent CEUS scan and MRI. The ultrasound-BI-RADS combined with CEUS 5-point score system redefined the classification of BI-RADS which was called CEUS-BI-RADS. The diagnostic efficacy of three methods was assessed by receiver operating characteristic (ROC) curve analysis. Histopathological assessment used as the gold-standard. Results: The sensitivities of Ultrasound-BI-RADS, MRI classification of BI-RADS (MRI-BI-RADS) and CEUS-BI-RADS were 85%, 90% and 95% without significant difference among the three modalities (p > 0.05). The diagnostic specificities of ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS were 78.1%, 78.1% and 96.8%, respectively (p < 0.05); and the accuracy were 80.7%, 82.6% and 96.1% for ultrasound-BI-RADS, MRI-BI-RADS and CEUS-BI-RADS, respectively (p < 0.05). The area under ROC (AUROC) in differentiation of breast lesions with calcification was 0.945 for CEUS-BI-RADS, 0.907 for MRI-BI-RADS and 0.853 for ultrasound-BI-RADS, with no significant difference among the three modalities (p > 0.05). Conclusion: The CEUS-BI-RADS has a better diagnostic efficiency than MRI-BI-RADS in the differentiation of the breast lesions with calcification. Advances in knowledge: •CEUS is a better method in differentiation of breast lesions with calcification. •CEUS-BI-RADS increases the efficiency of diagnosis compared to MRI.


2009 ◽  
Vol 127 (2) ◽  
pp. 66-70 ◽  
Author(s):  
Renato Coimbra Mazzini ◽  
Simone Elias ◽  
Afonso Celso Pinto Nazário ◽  
Cláudio Kemp ◽  
Ângela Flávia Logullo

CONTEXT AND OBJECTIVE: Genetic abnormalities in cell proliferation-regulating genes have been described in premalignant lesions. The aims here were to evaluate c-myc protein expression in non-palpable breast lesions associated with microcalcifications, detected by screening mammography, and to compare these results with histopathological, clinical and epidemiological variables. DESIGN AND SETTING: Analytical cross-sectional study, with retrospective data collection, in a university hospital in São Paulo. METHODS: Seventy-nine female patients who underwent routine mammography between 1998 and 2004 were studied. Lesions classified by the Breast Imaging Reporting and Data System (BI-RADS) as 4 or 5 underwent percutaneous biopsy using a large-core needle. Ninety-eight lesions were studied anatomopathologically. Paraffin blocks properly representing the lesions were selected for immunohistochemical analyses using the streptavidin-biotin-peroxidase technique with monoclonal mouse c-myc antibodies. RESULTS: Among the 98 lesions, 29 (29.6%) contained malignant neoplasia; 40 (40.8%) had a positive immunohistochemical reaction for c-myc. When the groups were divided between lesions without atypias versus atypical lesions plus malignant lesions, 31.03% of the 58 lesions without atypias were positive for c-myc and 55% of the 40 malignant and atypical lesions (P = 0.018). Comparing the atypical lesions with ductal carcinoma in situ versus the benign lesions without atypias, c-myc was present in 51.61% of the 31 atypical lesions and 31.03% of the benign lesions without atypias (P = 0.057). CONCLUSION: C-myc protein was more frequently expressed in atypical and malignant lesions than in benign lesions without atypias. C-myc expression correlated with the presence of atypias (P = 0.018).


2020 ◽  
Vol 2 (5) ◽  
pp. 484-491
Author(s):  
Beatriz E Adrada ◽  
Tanya Moseley ◽  
S Cheenu Kappadath ◽  
Gary J Whitman ◽  
Gaiane M Rauch

Abstract Molecular breast imaging (MBI) is an increasingly recognized nuclear medicine imaging modality to detect breast lesions suspicious for malignancy. Recent advances have allowed the development of tissue sampling of MBI-detected lesions using a single-headed camera (breast-specific gamma imaging system) or a dual-headed camera system (MBI system). In this article, we will review current indications of MBI, differences of the two single- and dual-headed camera systems, the appropriate selection of biopsy equipment, billing considerations, and radiation safety. It will also include practical considerations and guidance on how to integrate MBI and MBI-guided biopsy in the current breast imaging workflow.


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