Screening value of BI-RADS combined with ultrasound elastography for guiding Mammotome procedure for resecting breast lumps

YAO Leshen; JIN Zhibin; WU Min

doi:10.3969/j.issn.1009-0460.2018.02.014

Abstract：Objective To investigate the screening value of breast imaging report and data system (BI-RADS) combined with ultrasound elastography for guiding Mammotome procedure for resecting breast lumps. Methods From March 2016 to August 2017,653 breast lumps from 531 patients undergoing Mammotome surgery were classified using BI-RADS and detected by elastography. Based on pathological results,the diagnostic efficiencies of ultrasound elastography in general and different BI-RADS 3-4 lesions were analyzed,and the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accordance rate were calculated. Results Six hundred and fifty-three breast lumps (592 benign lesions and 61 malignant lesions) included 414 cases of BI-RADS3,159 cases of BI-RADS 4A,54 cases of BI-RADS 4B and 26 cases of BI-RADS 4C. The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accordance rate of ultrasound elastography in diagnosing breast lesions were 85.2％,88.0％, 42.3％,98.3％ and 87.7％,respectively. Combined with BI-RADS classification, the sensitivity of ultrasound elastography were 85.7％, 58.3％, 91.3％ and 94.7％, specificity were 91.4％, 89.8％, 41.9％ and 57.1％, and the diagnostic accordance rates were 91.3％,87.4％, 87.4％ and 87.4％ for BI-RADS categorization of 3, 4A,4B and 4C. There was no significant difference in the diagnostic accuracy of ultrasound elastography in diagnosing BI-RADS 3, 4A and 4C lesions (P>0.05),but all were superior to those of BI-RADS 4B lesions (P<0.05). Conclusion For lesions of BI-RADS 3-4A,benign lesions suggested by ultrasound elostography were feasible for Mammotome surgery, while maligant lesions should be punctured for biopsy. Lesions of BI-RADS 4B-4C were not suitable for Mammotome surgery.