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The positive predictive value of the breast imaging reporting and data system (BI-RADS) as a method of quality assessment in breast imaging in a hospital population

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Abstract

Evaluation of the diagnostic performance of mammography and US in our hospital, based upon the positive predictive value (PPV) for breast cancer of the breast imaging reporting and data system (BI-RADS) final assessment categories, has been performed. A follow-up study of 2,762 mammograms was performed, along with 955 diagnostic exams and 1,807 screening exams. Additional US was performed in 655 patients (23.7%). The combined reports were assigned a BI-RADS category. Follow-up was obtained by pathologic examination, mammography at 12 months or from PALGA, a nationwide network and registry of histo- and cytopathology. Overall sensitivity was 85% (specificity 98.7%); sensitivity of the diagnostic examinations was 92.9% (specificity 97.7%) and of the screening examinations 69.2% (specificity 99.2%). The PPV of BI-RADS 1 was 5 of 1,542 (0.3%), and of BI-RADS 2, it was 6 of 935 (0.6%). BI-RADS 3 was 6 of 154 (3.9%), BI-RADS 4 was 39 of 74 (52.7%) and BI-RADS 5 was 57 of 57 (100%). The difference between BI-RADS 1 and 2 vs. BI-RADS 3 was statistically significant (P<0.01). Analysis of BI-RADS 3 cases revealed inconsistencies in its assignment. Evaluation of the BI-RADS final assessment categories enables a valid analysis of the diagnostic performance of mammography and US and reveals tools to improve future outcomes.

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References

  1. American College of Radiology (1998) Illustrated breast imaging reporting and data system (BI-RADS), 3rd edn. American College of Radiology, Reston

  2. Orel SG, Kay N, Reynolds C, Sullivan DC (1999) BI-RADS categorization as a predictor of malignancy. Radiology 211:845–850

    CAS  PubMed  Google Scholar 

  3. Mendelson EB, Berg WA, Merritt CRB (2001) Toward a standardized breast ultrasound lexicon, BI-RADS: ultrasound. Semin Roentgenol 3:217–225

    Google Scholar 

  4. Liberman L, Menell JH (2002) Breast imaging reporting and data system (BI-RADS) Radiol Clin North Am 40:409–430

    Google Scholar 

  5. American College of Radiology (2003) Illustrated breast imaging reporting and data system (BI-RADS), 4th edn. American College of Radiology, Reston

  6. Barlow WE, Lehman CD, Zheng Y et al (2002) Performance of diagnostic mammography for women with signs or symptoms of breast cancer. J Natl Cancer Inst 94:1151–1159

    Article  PubMed  Google Scholar 

  7. Yasmeen S, Romano PS, Pettinger M et al (2003) Frequency and predictive value of a mammographic recommendation for short-interval follow-up. J Natl Cancer Inst 95:429–436

    Article  PubMed  Google Scholar 

  8. Smith-Bindman R, Chu PW, Miglioretti DL et al (2003) Comparison of screening mammography in the United States and the United Kingdom. J Am Med Assoc 290:2129–2137

    Article  CAS  Google Scholar 

  9. Kerlikowske K, Grady D, Barclay J et al (1998) Variability and accuracy in mammographic interpretation using the ACR breast imaging reporting and data system. J Natl Cancer Inst 90:1801–1809

    Article  CAS  PubMed  Google Scholar 

  10. Lehman C, Holt S, Peacock S, White E, Urban N (2002) Use of the ACR BI-RADS guidelines by community radiologists: concordance of assessments and recommendations assigned to screening mammograms. Am J Roentgenol 179:15–20

    Google Scholar 

  11. Berg WA, D’Orsi CJ, Jackson VP et al (2002) Does training in the breast imaging reporting and data system (BI-RADS) improve biopsy recommendations for feature analysis agreement with experienced breast imagers at mammography? Radiology 224:871–880

    PubMed  Google Scholar 

  12. Dee KE, Sickles EA (2001) Medical audit of diagnostic mammography examinations. Comparison with screening outcomes obtained concurrently. Am J Roentgenol 176:729–733

    CAS  Google Scholar 

  13. Sohlich RE, Sickles EA, Burnside ES, Dee KE (2002) Interpreting data from audits when screening and diagnostic mammography outcomes are combined. Am J Roentgenol 178:681–681

    Google Scholar 

  14. Baines CJ, Miller AB, Wall C et al (1986) Sensitivity and specificity of first screen mammography in the Canadian National Breast Screening Study: a preliminary report from five centers. Radiology 160:295–298

    CAS  PubMed  Google Scholar 

  15. Duijm LEM, Guit GL, Koomen AR, Willebrand D (1997) Sensitivity, specificity and predictive values of breast imaging in the detection of cancer. Br J Cancer 76:377–381

    CAS  PubMed  Google Scholar 

  16. Zonderland HM, Coerkamp EG, Hermans J et al (1999) Diagnosis of breast cancer: contribution of US as an adjunct to mammography. Radiology 213:412–422

    Google Scholar 

  17. Kopans DB (1992) The positive predictive value of mammography. Am J Roentgenol 158:521–526

    CAS  Google Scholar 

  18. Orel SG, Kay N, Reynolds C, Sullivan DC (1999) BI-RADS categorization as a predictor of malignancy. Radiology 211:845–850

    CAS  PubMed  Google Scholar 

  19. Liberman L, Abramson AF, Squires FB et al (1998) The breast imaging reporting and data system: positive predictive value of mammographic features and final assessment categories. Am J Roentgenol 171:35–40

    CAS  Google Scholar 

  20. Lacquement MA, Mitchell D, Hollingworth AB (1999) Positive predictive value of the breast imaging reporting and data system. J Am Coll Surg 189:34–40

    Article  CAS  PubMed  Google Scholar 

  21. Caplan LS, Blackman D, Nadel M, Monticciolo DL (1999) Coding mammograms using the classification “probably benign” finding short interval follow-up suggested. Am J Roentgenol 172:339–342

    CAS  Google Scholar 

  22. Rosen EL, Baker JA, Soo MS (2002) Malignant lesions initially subjected to short-term mammographic follow-up. Radiology 223:221–228

    PubMed  Google Scholar 

  23. McCarthy BD, Yood MU, Boohaker EA, Ward RE, Rebner M, Johnson CC (1996) Inadequate follow-up of abnormal mammograms. Am J Prev Med 12:282–288

    CAS  PubMed  Google Scholar 

  24. Taplin SH, Ichodawa LE, Kerlikowski K et al (2002) Concordance of breast imaging reporting and data system assessments and management recommendations in screening mammography. Radiology 222:529–535

    PubMed  Google Scholar 

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Acknowledgements

The authors gratefully acknowledge Fraukje Wiersma, medical student, for her efforts with respect to data acquisition from the Hospital Information System and Mariel Casparie, M.D. Internal Medicine, for her efforts with respect to data acquisition from PALGA.

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Authors and Affiliations

  1. Department of Radiology, Data Center, Leiden University Medical Center, P.O. Box 9600, Leiden, 2300 RC, The Netherlands

    Harmine M. Zonderland & Arend J. Nieborg

  2. Department of Radiology, Medical University of South Carolina, P.O. Box 250322, Charleston, SC, 29425, USA

    Thomas L. Pope Jr

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  1. Harmine M. Zonderland
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  2. Thomas L. Pope Jr
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  3. Arend J. Nieborg
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Correspondence to Harmine M. Zonderland.

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Zonderland, H.M., Pope, T.L. & Nieborg, A.J. The positive predictive value of the breast imaging reporting and data system (BI-RADS) as a method of quality assessment in breast imaging in a hospital population. Eur Radiol 14, 1743–1750 (2004). https://doi.org/10.1007/s00330-004-2373-6

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  • DOI: https://doi.org/10.1007/s00330-004-2373-6

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