The value of ultrasound classification in BI-RADS category 4 of breast complex cystic masses
10.3760/cma.j.issn.0253-3766.2018.09.006
- VernacularTitle: 超声分型在乳腺复合囊肿乳腺影像报告及数据系统4类中的应用价值
- Author:
Jinpeng YAO
1
;
Lijuan NIU
1
;
Yong WANG
1
;
Chengyun GENG
1
;
Qing CHANG
1
;
Yu CHEN
1
;
Li ZHU
1
Author Information
1. Department of Ultrasound, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China
- Publication Type:Clinical Trail
- Keywords:
Breast neoplasms;
Ultrasound;
Complex cystic breast masses;
Breast imaging reporting and data system, BI-RADS
- From:
Chinese Journal of Oncology
2018;40(9):672-675
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To analyze the feature of breast complex cystic masses and to classify it at ultrasonography (US), which applied to the Breast Imaging Reporting and Data System (BI-RADS) categories 4a to 4c with pathological results as the golden standards.
Methods:The ultrasonographic data and clinical features of 78 patients with complex cystic masses confirmed by pathology in Cancer Hospital from July 2014 to June 2017 were retrospectively reviewed. The complex cystic breast masses were divided into four classes on the basis of their US features: type 1 [thick wall and (or) thick septa (> 0.5 mm)], type 2 (one or more intra-cystic masses), type 3 (mixed cystic and solid components with cystic components more than 50%) and type 4 (mixed cystic and solid components with solid components more than 50%). Positive values (PPVs) were calculated for each type. Multiple linear regression analysis was used to analyze the ultrasonographic features of the masses (lesion size, margins, blood flow resistance index, calcification, and axillary lymph nodes, etc.) with malignant correlation.
Results:There were 81 lesions in 78 patients. Among the 81 masses based on US appearance, 14 (17.3%) were classified as type Ⅰ, 18 (22.2%) as type Ⅱ, 18 (22.2%) as type Ⅲ, and 31 (38.3%) as type Ⅳ. The positive predictive values of the malignant lesions of type Ⅰ, type Ⅱ, Ⅲ and Ⅳ were 7.1%, 16.7%, 61.1% and 48.3%, respectively (P=0.040). In all the 81 masses, 14 were BI-RADS categories 4a, 18 were BI-RADS categories 4b and 49 were BI-RADS categories 4c. Masses with maximum diameter equal to or larger than 2.0 cm, unclear margins, RI≥0.7 and presence of abnormal axillary nodes assessment had a high probability of malignancy (P=0.030, 0.038, <0.001 and 0.025, respectively).
Conclusion:Ultrasound typing is helpful for differentiating benign and malignant breast complex cysts and classifying BI-AIDS 4a to 4c, thus providing clearer treatment for clinical practice.
