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Correlation Between BIRADS Scoring and Histology in Women Undergoing Breast Surgery in our Institution

S. Rajesh Kumar , Bichu Joseph Maliakal1 , S. Rajesh Kumar2

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New Indian Journal of Surgery 10(1):p 24-30, January-February 2019. | DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10119.4

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Abstract

 Developed in the early 1990s, the BIRADS classification has been used extensively as a surrogate to histopathological reporting of breast cancer. Prior to implementation of BIRADS there was a lack of uniformity in reporting of mammography findings and this often resulted in varied reporting and management strategies. This ambiguity had also led to increased difficulties in establishing performance standards across settings. This had been the main impetus in developing the BIRADS system and several research studies have shown the scoring system to be useful in predicting the likelihood of cancer. These results are also seen in this study and hence further show the value of BIRADS in effective management of breast cancer. In this study, a total of 50 patients aged between 15 and 73 years with mean age being 44 years were included. They underwent preoperative imaging with either ultrasound or mammogram after which they underwent surgery. And their Mammogram/ultrasound findings are compared with their final Histopathology report. The BIRADS categories 1, 2 and 3 are clubbed together and considered as “Benign”, while categories 4, 5 and 6 were clubbed together as “Malignant”. This was compared with the final histopathology report which was either benign or malignant and the correlation was established. Out of the 50 cases, 40 of them were correctly classified. Breast lesions evaluated for malignancy using BIRADS scoring had Sensitivity of 75%, Specificity of 83.3%, Positive predictive value of 75% and Negative predictive value of 83.3%. The standardized terminology of the BI-RADS lexicon allows quantification of the likelihood of carcinoma in a breast lesion. In experienced hands, the BIRADS system can be a very useful predictor of malignancy. However, Imaging should not be used in isolation due to chance of missing malignancy. Imaging should always be done in conjunction with clinically examination and FNAC/Biopsy (Triple Test) to get a comprehensive perspective prior to surgery [25].

Keywords: BIRADS; Prediction; Breast cancer; Mammogram; Histopathology; Correlation.

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DOI: DOI: https://dx.doi.org/10.21088/nijs.0976.4747.10119.4

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