Abstract: Background: BIRADS has become the standard in
characterizing the radiological findings of the breast lesions. Compared with
other categories, BIRADS 3 and 4 are more difficult to manage. The aim was to
present our clinical experience in the evaluation of breast lesions classified
as BIRADS 3 and 4.
Methods: Female patients who underwent surgical
intervention for BIRADS 3 or 4 lesions were included in the study. The primary endpoint
was the comparison of preoperative BIRADS scores (BIRADS 3 and 4) and
postoperative histopathological results.
Results: Data of 373 patients with a mean age of 52.3
years was analyzed. Preoperatively, 249 patients had BIRADS 3 lesions, while
124 patients had BIRADS 4 lesions. The mean age of patients with BIRADS 3
lesions was lower than that of patients in BIRADS 4 group. Thirty-six (14.5%)
patients in the BIRADS 3 group and 40 (32.3%) patients in the BIRADS 4 group
were above 50 years. Malignancy was detected in 3 (1.2%) and 31 (25%) patients
in the BIRADS 3 and BIRADS 4 groups, respectively. BIRADS classification was
found to be 91.2% sensitive and 72.6% specific, with an accuracy rate of 74.2%.
Positive and negative predictive values were 25% and 98.8% respectively.
Conclusions: A high malignancy rate of 25% in the BIRADS 4
patients indicated that preoperative histopathological assessment is mandatory.
Although 3% malignancy rate in the BIRADS 3 group was low, it was valuable to
show the importance of careful physical examination and detailed family history
questioning. The malignancy risk in BIRADS 4 lesions was significantly higher
in women above 50 years than in younger women, demonstrating that advanced age
is an important risk factor for BC.
