AbstractBackground: Breast cancer is the commonest cancer among women in urban India. Triple assessment includes clinical, radiological and cytological assessment of breast lesions. Guided core needle biopsy has replaced fine needle aspiration cytology in most of the western countries. Aim of the study: The aim of the study is to analyze the concordance of histopathological and radiological findings in BIRADS categories 2, 3, 4 and 5 lesions following core biopsy. Materials and Methods: This was a prospective study done over a period of two years from June 2017 to June 2019. A total of 100 patients with breast lumps who underwent mammographic evaluation were selected for ultrasound guided trucut biopsies which were performed by a single radiologist. Only BIRADS categories 2, 3, 4 and 5 lesions were selected for trucut biopsies. The histopathological diagnosis was correlated with the BIRADS scoring. Results: Most of the women with breast lump were in the fifth decade. Out of 100 patients who underwent core needle biopsy, the positive predictive value for BIRADS 5 lesions for malignancy was 100%, the positive predictive value for BIRADS 4 lesions was 49% and the negative predictive value for BIRADS 2 and 3 lesions for malignancy was 87.5%. Conclusion: Core biopsy is a reliable method to diagnose breast lesions and has high accuracy compared to mammographic categorization using BIRADS score. The present study confirms high positive and negative predictive value for malignancy in BIRADS 5 and BIRADS 3 lesions. The positive predictive value for BIRADS 4 lesions is less due to inclusion of wide spectrum of lesions and also as the subcategorization is subjective. Objective and clear subclassification rules are needed for BIRADS 4 category.
Keywords: Breast trucut biopsy; BIRADS scoring; Histopathology and BIRADS scoring comparison.