Correlation Between BIRADS Classification and Ultrasound -guided Tru-Cut Biopsy Results of Breast Lesions: Retrospective Analysis of 285 Patients Poster No.: C-1433 Congress: ECR 2014 Type: Scientific Exhibit Authors: G. D. Emlik, H. Kalkan, N. Poyraz, F. K#z#lkaya; Konya/TR Keywords: Pathology, Cancer, Biopsy, Ultrasound, Breast DOI: 10.1594/ecr2014/C-1433 Any information contained in this pdf file is automatically generated from digital material submitted to EPOS by third parties in the form of scientific presentations. References to any names, marks, products, or services of third parties or hypertext links to thirdparty sites or information are provided solely as a convenience to you and do not in any way constitute or imply ECR's endorsement, sponsorship or recommendation of the third party, information, product or service. ECR is not responsible for the content of these pages and does not make any representations regarding the content or accuracy of material in this file. As per copyright regulations, any unauthorised use of the material or parts thereof as well as commercial reproduction or multiple distribution by any traditional or electronically based reproduction/publication method ist strictly prohibited. You agree to defend, indemnify, and hold ECR harmless from and against any and all claims, damages, costs, and expenses, including attorneys' fees, arising from or related to your use of these pages. Please note: Links to movies, ppt slideshows and any other multimedia files are not available in the pdf version of presentations. www.myesr.org Page 1 of 6
Aims and objectives Breast cancer is the most common cancer among women. It has an increased incidence. Definition of focal lesions are increased by the agency of imaging methods. To ensure an accurate diagnosis, the combination of clinical findings, imaging methods, and pathologic evaluation is important. The American College of Radiology has developed the Breast Imaging Reporting and Data System (BI-RADS) to standardize the terminology. BIRADS categorization is used for all breast imaging methods. BIRADS 0 : needs supplemental methods, BIRADS1: normal, BIRADS 2:benign findings, BIRADS 3: probably benign; follow it, BIRADS 4: suspicious for malignancy; recomend biopsy, BIRADS 5: highly suspicious for malignancy; recommend biopsy, BIRADS 6: proved malignancy. BIRADS 4 and 5 lesions require biopsy [1]. BIRADS 3 lesions rarely requires biopsy especially on clinical demands. Correlation between BIRADS classification and histopathological results is very important to predict the lesion nature before biopsy and to decide the procedure which will be applied to the patient [2,3]. We aimed to reveal the correlation between histopathologic diagnosis and BIRADS classification identified by ultrasonography, magnetic resonance imaging, and mammographic findings. Methods and materials Between 2008-2012 years, ultrasound reports of 285 patients who were uderwent ultrasound-guided tru-cut biopsy (TCB) with 16-gauge automated tru-cut biopsy [figures 1,2] were explored retrospectively. Mammography and MRI reports were taken into account in some patients. Images for this section: Page 2 of 6
Fig. 1: B- mode US image of BIRADS 5 shapeless lesion with it's angular margins and hypoechogenity, pathology result was #nvasive ductal carcinoma. Page 3 of 6
Fig. 2: the same patient with figure 1.18-gauge needle of Tru-Cut gun can be seen as echogenic lineer line in the lesion through the subcutaneous tissues. Page 4 of 6
Results The study population is consisted of 285 patients(age range: 17-79,mean age:43,5). Fourty-nine patients were excluded because their histopathologic results were absence. Of the remaining 236 patients, 203 patients (86%) were classified as BIRADS 4, 5 and 33 (14%) patients were BIRADS 3. According to biopsy results 151 patients(%64) had malign tumors and 85 patients(%36) had benign masses (table 1).There was statistically significant correlation according to Pearson Chi-Square test, between pathologic diagnosis and BIRADS classification identified by ultrasonography, magnetic resonance imaging, mammography findings (x² =55,854, p<0.05). Twenty-four lesion of the BIRADS 3 lesions were biopsied because of clinicians' demands. Only one patient who was classified as BIRADS 3 had malign biopsy result.the others were diagnosed as benign and this decreases the identification ratio of malign Fig. 3 on page 5 results of all lesions. Images for this section: Fig. 3 Page 5 of 6
Conclusion This results obtained that Ultrasound-guided tru-cutbiopsy has high diagnostic accuracy. BIRADS classifications and histopathologic results revealed significant correlation according to correlation tests.tcb identification of breast cancers has high correct ratios.melhado et al.[1] had similar results and revealed that BIRADS classification predicts the high suspicion for malignancy in lesions classified as category 5, moderate and low suspicion in lesions classified 4 and 3 respectively. Personal information Associated Professor G.Dilek Emlik,Necmettin Erbakan University Meram School of Medicine, Department of Radiology, Konya,Turkey Dr. Havva Kalkan, Necmettin Erbakan University Meram School of Medicine, Department of Radiology, Konya,Turkey Assistant Professor Necdet Poyraz,Necmettin Erbakan University Meram School of Medicine, Department of Radiology, Konya,Turkey Dr. F#rat K#z#lkaya, Necmettin Erbakan University Meram School of Medicine, Department of Radiology, Konya,Turkey References 1.Melhado VC et al 'Radiological and histological correlation of non-palpable breast lesions in patients submitted to preoperative marking according to BI-RADS classification, Radiol Bras 2007;40(1):9-11. 2. Kim EK, Ko KH, Oh KK, et al. Clinical application of the BI-RADS final assessment to breast sonography in conjunction with mammography. AJR Am J Roentgenol 2008;190:1209. 3. Costantini M, Belli P, Ierardi C, et al. Solid breast mass characterization: use of the sonographic BI-RADS classi#cation. Radiol Med 2007;112:877. Page 6 of 6