Histopathological Correlation of Breast Carcinoma with Breast Imaging-Reporting and Data System (BI-RADS) in Tertiary Care Hospital of Eastern India

Abstract

Introduction: Early diagnosis and prompt therapy are the most effectiv e interventions for management of breast cancer. The cost of therapy o f breast cancer rises with a more advanced stage of the disease at the diagnosis. The two inexpensive, easily available, non-invasive radiol ogical procedures mammography and ultrasonography are useful in early detection and perform a significant part in diagnosis, treatment, and prognosis and enhance chances of survival in breast cancer patients. T o remove heterogenicity in assessment of certain finding in imaging, a globally recognisable evaluation system must be established. Aims/ ob jective: To evaluate the accuracy, sensitivity, specificity, and predi ctive value of the BI-RADS categorisation and correlate it with histop athological diagnosis. Materials and Method: 203 patients were enrolle d at our centre and their demographic details, clinical history, radio logical and histopathological reports were collected. The chosen parti cipants were divided into BI-RADS categories from 3 to 5. The most pro bable benign BI-RADS category was 3, and the most probable malignant B I-RADS categories were 4 or 5. Sensitivity, specificity, and predictiv e values of BI-RADS categorisation were calculated with respect to fin al diagnosis with histopathology. Results: Histopathologically 12% of patients in BI-RADS category 3 were diagnosed with malignant neoplasm whereas 5.77% patients in BI-RADS category 5 were diagnosed with benig n lesion. Positive predictive value and specificity of BI-RADS categor y 5 to detect malignancy was found to be 94.23% and 93.62% respectivel y which reduced to 43.14% and 64.42% when taking BI-RADS 4 and 5 toget her. Also, most of the post-menopausal women presented with malignant neoplasm (67.31%) while 66.67% of the pre-menopausal women presented w ith benign neoplasm. Conclusion: BI-RADS assessment of mammography and ultrasonography proved to have effective sensitivity and predictive v alues in detection of malignancy. For a complete picture in the early identification of breast cancer, assessment of radiographic findings w ith the BI-RADS categorization should be utilised along with clinical evaluation and histopathology.