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Does patient age affect the PPV3 of ACR BI-RADS Ultrasound categories 4 and 5 in the diagnostic setting?

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Abstract

Objectives

To calculate the positive predictive value of biopsies performed (PPV3) of the Ultrasound section of the American College of Radiology Breast Imaging Reporting and Data System (ACR BI-RADS US) atlas categories 4 and 5 in different age groups and to determine whether patient age influences the PPV3 of each category in the diagnosis of breast lesions.

Methods

We identified 2,433 ACR BI-RADS US categories 4 and 5 lesions with a known pathological diagnosis in 2,433 women. The patients were classified into three age groups (<35, 35–50, and >50 years). The age-related PPV3 of each category in the three age groups were calculated based on the pathological diagnoses and compared using the chi-squared test.

Results

The overall PPV3 of each category was within the reference range provided by the ACR in 2013. PPV3 gradually increased with increasing age in patients with category 4 lesions. PPV3 in the oldest group with subcategories 4A and 4B lesions were close to or exceeded the reference values.

Conclusions

PPV3 and age were significantly associated in patients with category 4 lesions according to the newest edition of ACR BI-RADS US in the diagnostic setting. Closer attention should be given to older patients when assigning a final assessment category.

Key points

• In patients with category 4 lesions , the likelihood of malignancy is associated with age.

• In patients with category 5 lesions, the association is not definite.

• Closer attention should be given to older patients in applying the ACR BI-RADS US.

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Abbreviations

ACR:

American College of Radiology

BC:

Breast cancer

BI-RADS:

Breast Imaging Reporting and Data System

IDC:

Invasive ductal carcinoma

ILC:

Invasive lobular carcinoma

MG:

Mammography

PPV:

Positive predictive value

US:

Ultrasonography

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Funding

This study received funding from the National Natural Science Foundation of China under grant numbers 81672619 and 81372817. This study was supported by a grant (2013, 163) from the Key Laboratory of Malignant Tumor Molecular Mechanism and Translational Medicine of Guangzhou Bureau of Science and Information Technology.

Author information

Author notes

  1. Yue Hu and Yaping Yang contributed equally to this work.

Authors and Affiliations

  1. Guangdong Provincial Key Laboratory of Malignant Tumor Epigenetics and Gene Regulation, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Guangzhou, China

    Yue Hu, Yaping Yang, Ran Gu, Liang Jin, Shiyu Shen, Fengtao Liu, Hongli Wang, Jingsi Mei, Xiaofang Jiang, Qiang Liu & Fengxi Su

  2. Breast Tumor Center, Sun Yat-Sen Memorial Hospital, Sun Yat-Sen University, Yingfeng Road No. 33, 510260, Haizhu district, Guangzhou, Guangdong, China

    Yue Hu, Yaping Yang, Ran Gu, Liang Jin, Shiyu Shen, Fengtao Liu, Hongli Wang, Jingsi Mei, Xiaofang Jiang, Qiang Liu & Fengxi Su

Authors
  1. Yue Hu
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  2. Yaping Yang
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  3. Ran Gu
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  4. Liang Jin
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  7. Hongli Wang
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  8. Jingsi Mei
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  9. Xiaofang Jiang
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  10. Qiang Liu
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  11. Fengxi Su
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Corresponding authors

Correspondence to Qiang Liu or Fengxi Su.

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Guarantor

The scientific guarantor of this publication is Fengxi Su.

Conflict of interest

The authors of this manuscript declare no relationships with any companies, whose products or services may be related to the subject matter of the article.

Statistics and biometry

No complex statistical methods were necessary for this paper.

Informed consent

Written informed consent was waived by the Institutional Review Board.

Ethical approval

Institutional Review Board approval was obtained.

Methodology

• retrospective

• diagnostic or prognostic study

• performed at one institution

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Hu, Y., Yang, Y., Gu, R. et al. Does patient age affect the PPV3 of ACR BI-RADS Ultrasound categories 4 and 5 in the diagnostic setting?. Eur Radiol 28, 2492–2498 (2018). https://doi.org/10.1007/s00330-017-5203-3

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  • DOI: https://doi.org/10.1007/s00330-017-5203-3

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