Correlation between ultrasound BI-RADS® categories and histopathologies of breast lesions in Brazilian women of the northeastern hinterland

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Érika Nicodemos Santana de Lucena
Debora Krutman Zveibil
Edimar Cristiano Pereira
Glaucia Luciano da Veiga
Beatriz da Costa Aguiar Alves
Fernando Luiz Affonso Fonseca
Fernando Luiz Affonso Fonseca


breast neoplasms, image-guided biopsy, interventional ultrasonography, large-core needle biopsy, ultrasound BI-RADS


Background and aim: Breast lesions have been diagnosed more frequently due to the improvement of imaging methods and, more recently, to the percutaneous biopsy technique. Thus, we aimed to evaluate the concordance rate between the ultrasound BI-RADS classification and the histopathological diagnosis of breast lesions.

Methods: A cross-sectional study was conducted with 386 breast lesions submitted to ultrasound-guided core biopsy with a high-frequency linear transducer (7.5 MHz) using a Pro-Mag Ultra automatic pistol and a 14-gauge needle. The strength of the concordance between the percutaneous biopsy result and the ultrasound BI-RADS was measured by the PPV. The differences were considered significant if the p value was greater than 0.05

Results: Lesions ultrasonographically classified in categories 2, 3 and 4 are in accordance with the ultrasound BI-RADS 5th edition. However, 11 benign lesions were erroneously ultrasonographically classified as BI-RADS 5, which resulted in a malignancy of 88.3% while BI-RADS suggested that category 5 lesions had a malignancy ≥ 95%. It can be safely stated that there is a high suspicion for malignancy in lesions classified in category 5.

Conclusions: BI-RADS categories 2 and 3 should avoid unnecessary biopsies. As for the BI-RADS category 4, there is a need for systematic biopsies. (


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