Benjamin Kaltenbach1, Volker Brandenbusch2, Volker Möbus3, Gerhard Mall4, Stephan Falk5, Marcus van den Bergh6, Frauke Chevalier7, Markus Müller-Schimpfle7. 1. Institute of Radiology (RZI), Klinikum Frankfurt/Main - Höchst, Academic Teaching Hospital of the University of Frankfurt/Main, Germany; Institute for Diagnostic and Interventional Radiology, Johann Wolfgang Goethe-University, Frankfurt/Main, Germany. Electronic address: benjamin.kaltenbach@kgu.de. 2. Diagnostic Breast Center Turmcarée, Mammography Screening, Frankfurt/Main, Germany. 3. Department of Obstetrics and Gynecology, Klinikum Frankfurt/Main-Höchst, Germany. 4. Institute of Pathology, Klinikum Frankfurt/Main-Höchst, Germany. 5. OptiPath, Pathology Associates, Frankfurt/Main, Germany. 6. Asthenis, Medical Data Management, Aschheim, Germany. 7. Institute of Radiology (RZI), Klinikum Frankfurt/Main - Höchst, Academic Teaching Hospital of the University of Frankfurt/Main, Germany.
Abstract
OBJECTIVE: The purpose of this retrospective analysis was to evaluate the likelihood of malignancy in prospectively categorized BI-RADS 4 and BI-RADS 5 calcifications. MATERIAL AND METHODS: This analysis included 849 women who underwent vacuum biopsy for BI-RADS 4 (with the subgroups 4A, 4B and 4C) or BI-RADS 5 calcifications between February 2007 and May 2015. Calcifications were classified according to the morphology and distribution descriptors of the BI-RADS lexicon (BI-RADS 4th edition lexicon). A standardized scheme (matrix) was used to combine the characteristics of the grouped calcifications with the BI-RADS assessment category. RESULTS: Overall, 275/849 (32%) lesions were found to be malignant. 285/327/208/29 calcified lesions were prospectively classified as BI-RADS 4A/4B/4C/5 indicating a risk for malignancy of 16%/27%/55%/90%, respectively. The morphology descriptors predicted the risk for malignancy as follows: typically benign (n=55): 2%; indeterminate (n=676): 27%; typically malignant (n=118): 80%. The distribution descriptors correlated with a malignant histology as follows: diffuse (n=0); round or oval (n=261): 22%; regional (n=398): 33%; segmental (n=106): 42%; linear or branching (n=85): 55%. There was a significant difference between the descriptor categories (p<0.0001). CONCLUSION: A standard scheme combining the morphology and distribution characteristics proved to be a helpful tool in diagnosis of calcifications, bridging the gap between description and classification of these lesions.
OBJECTIVE: The purpose of this retrospective analysis was to evaluate the likelihood of malignancy in prospectively categorized BI-RADS 4 and BI-RADS 5 calcifications. MATERIAL AND METHODS: This analysis included 849 women who underwent vacuum biopsy for BI-RADS 4 (with the subgroups 4A, 4B and 4C) or BI-RADS 5 calcifications between February 2007 and May 2015. Calcifications were classified according to the morphology and distribution descriptors of the BI-RADS lexicon (BI-RADS 4th edition lexicon). A standardized scheme (matrix) was used to combine the characteristics of the grouped calcifications with the BI-RADS assessment category. RESULTS: Overall, 275/849 (32%) lesions were found to be malignant. 285/327/208/29 calcified lesions were prospectively classified as BI-RADS 4A/4B/4C/5 indicating a risk for malignancy of 16%/27%/55%/90%, respectively. The morphology descriptors predicted the risk for malignancy as follows: typically benign (n=55): 2%; indeterminate (n=676): 27%; typically malignant (n=118): 80%. The distribution descriptors correlated with a malignant histology as follows: diffuse (n=0); round or oval (n=261): 22%; regional (n=398): 33%; segmental (n=106): 42%; linear or branching (n=85): 55%. There was a significant difference between the descriptor categories (p<0.0001). CONCLUSION: A standard scheme combining the morphology and distribution characteristics proved to be a helpful tool in diagnosis of calcifications, bridging the gap between description and classification of these lesions.
Authors: Thelonius Hawellek; Jan Hubert; Sandra Hischke; Matthias Krause; Jessica Bertrand; Burkhard C Schmidt; Andreas Kronz; Klaus Püschel; Wolfgang Rüther; Andreas Niemeier Journal: Arthritis Res Ther Date: 2018-05-30 Impact factor: 5.156