2019, Number 2-3
Diagnostic Concordance among BIRADS report by interventional radiology and histopathological diagnosis in patients with breast biopsy
Full text
Language: Spanish
References: 19
Page: 44-52
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ABSTRACT
Background: There are several modalities for the study of breast cancer, including mammography, ultrasound and magnetic resonance; others are image-guided percutaneous biopsy, cutting needle biopsy, marking and surgical biopsies (incisional and excisional). In the patients included in the study, the definitive diagnosis of breast cancer was made by biopsy, this was the most common surgical procedure and considered the gold standard for the diagnosis of palpable or radiological abnormalities. Objectives: To analyze the concordance of the Breast Imaging Reporting and Data System (BIRADS) report by interventional radiology and the histopathological diagnosis in patients with a breast biopsy. Determine the most frequent imaging and BIRADS presentation. Know the frequency of the histological type. To know the frequency of the types of biopsy used, in patients submitted to a breast biopsy in the Unidad Médica de Alta Especialidad (UMAE) No. 1 León, Guanajuato. Methodology: The cases from January to December 2017 were analyzed. It was performed in the Radiology and Image and Pathology Service of the UMAE No. 1 Bajío clinic. The variables were analyzed: age, histopathological report, and radiological evaluation of the breast. Concordance analysis was used to calculate sensitivity and specificity, positive and negative predictive value, and kappa value. Results: We included 94 patients with a mean age of 51.30 ± 10.86 years, who underwent a mammography study and had a radiological diagnosis that required an image biopsy with suspicion of malignancy. The frequency of the categories was as follows: BIRADS 3: 17 (18.18%) (7 complex cysts, 10 fibroadenomas), BIRADS 4A: 58 (61.7%), BIRADS 4B: 12 (12.7%), BIRADS 4C: 5 (5.3%), BIRADS 5: 2 (2.12%), the biopsies performed were trucut 57 (60.6%), breast fine needle aspiration (BFNA) 12 (12.7%) and ultrasound marking 25 (26.6%). The histopathological diagnosis of mammary carcinoma was confirmed in 20 (21%) biopsies, 90% ductal and 10% infiltrating lobulillar. When analyzing the concordance between the cases with BIRADS 4A, B, C, BIRADS 5 with the histopathological diagnosis, a kappa of 0.75 was obtained, which corresponds to a considerable concordance. Conclusions: The biopsy performed under the range of procedures done by interventional radiology of breast has a high concordance of 0.75. Its advantages are many, little ionizing radiation, widely available equipment, access to all mammary areas, visualization of the biopsy needle in real time, multidirectional sampling, low rate of complications, allows better planning of surgery, low cost, greater patient comfort and speed of execution, a strategy that benefits in time and costs the timely diagnosis of breast cancer.REFERENCES
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Lee CH, Dershaw DD, Kopans D, Evans P, Monsees B, Monticciolo D et al. Breast cancer screening with imaging: recommendations from the Society of Breast Imaging and the ACR on the use of mammography, breast MRI, breast ultrasound, and other technologies for the detection of clinically occult breast cancer. J Am Coll Radiol. 2010; 7: 18-27.