BI-RADS Ultrasonography in Differentiation of Benign from Malignant Lesions of the Breast: A Preliminary Result

Breast imaging reporting and data system (BI-RADS) was established by the American College of Radiology in 1992 and contained ultrasonography (BI-RADS-US) when BI-RADS was revised in 2003. The aim of this article was to assess the capacity of BI-RADS-US in differentiation between benign and malignant lesions of the breast.Between January 2006 and March 2007, 69 female patients with breast disease having 72 masses or nodules were examined using ultrasound.The age of them range 14-83 years (mean= 41.6). The differentiation of benign from malignant lesions was relied on traditional non-BI-RADS method firstly and then undertaken based on BI-RADS-US criterion in which the BI-RADS-US lexicon and category were included.The categories 2 and 3 were benign and probably benign findings, the category 4 was indeterminate in nature, and the category 5 was highly suggestive malignancy.The sensitivity, specificity, and accuracy of both evaluations were calculated and compared.Among 72 foci, 40 were diagnosed as the benign and 23 were considered as the malignant according to the non-BI-RADS, with accordance to pathologic diagnoses in 38 (95.0%) and 18 (78.3%), and 9 were indeterminate.Based on the BI-RADS-US, 37 lesions were classified as the categories 2 or 3(benign) and 31 as the category 5 (malignant), which having 36 (97.2%) and 22(71.0%) compatible to pathology, and there were 4 of the category 4 (indeterminate in nature). There were no statistically significant differences between the evaluations of non-BI-RADS and BI-RADS-US in aspects of accuracy (83.3% and 81.9%,P=1.000), sensitivity (91.7% and 95.8%,P=1.000), and specificity (79.2% and 75.0%, P=0.754).In our preliminary study, the first edition of BI-RADS-US has a higher sensitivity in deferential diagnosis of breast benign from malignant lesions, but no apparent differences when compared with non-BI-RADS.