Comparative Study Of Ultrasound BI-RADS 4 Breast Lesions And Their Clinicopathology

Objective:Through reviewing the ultrasound of BI-RADS4 breast lesions in the past three years and the related cases of it’s clinical pathology,the ultrasound image characteristics of benign and malignant breast lesions were compared and analyzed to provide important clinical basis for early diagnosis and treatment.Method:A retrospective analysis was made of 170 patients who were hospitalized in the department of thyroid and breast surgery in our hospital from January 2018 to December 2021 and were diagnosed as BI-RADS4 type breast lesions by ultrasound,and their ultrasonic image characteristics and postoperative pathology and other relevant clinical data were collected.Taking the postoperative pathological diagnosis as the"gold standard",the positive predictive value of ultrasound BI-RADS grading results was calculated;And adoptχ~2.Conduct single factor analysis for the test.In this study,SPSS26.0 was used for statistical analysis,and the difference was statistically significant(P<0.05).Results:The positive predictive value of grade 4A breast cancer was 14%,grade 4B 64%,and grade4C 89%.In the benign group,the proportion of multiple lesions,diameter<2cm,clear ultrasound boundary,regular ultrasound shape,no blood flow signal inside the lesions,and no attenuation of the posterior echo indicating the possibility of benign lesions were 39.82%(45/113),61.95%(70/113),44.25%(50/113),26.55%(30/113),68.14%(77/113),97.35%(110/113),which were significantly higher than that of the malignant group(14.04%(8/57),33.33%(19/57),22.80%(13/57)8.77%(5/57),10.53%(6/57),85.96.11%(49/57),and the difference was statistically significant(P<0.05).In 57 cases of breast cancer,38 cases(66.67%)had focal diameter≥2cm;There were 52 cases with spicule sign on the edge of the mass,the incidence was 91.23%(52/57);Most of the lesions had blurred ultrasound boundary,with an incidence of 77.19%(44/57);14.04%(8/57)of the cases had echo attenuation behind the mass;There were 47 cases(82.46%)with calcification inside the nodules;In terms of growth orientation,48 cases grew vertically,with an incidence of 84.21%;There were 13 cases of axillary lymph node metastasis,the incidence was 22.81%;From the perspective of blood supply,the incidence of rich blood flow and poor blood flow was 89.47%(51/57)and10.53%(6/57)respectively.Conclusion:In ultrasound BI-RADS4 breast grading,the higher the grading,the higher the positive predictive value of breast cancer.In the ultrasound BI-RADS4 grade breast lesions,if there are malignant features(aspect ratio≥1,the lesions have lobulation or burr sign,rich internal blood flow,etc.),it is recommended that early surgical resection should be performed to avoid invasive puncture before surgery causing cancer cell proliferation and metastasis.