Quantitative Scoring Research Of BI-RADS Categories 3~5 In Breast Lesions

Objective To discuss the value of ultrasound breast imaging report and data system(BI-RADS)quantitative scoring method in the risk assessment of benign and malignant breast lesions.Methods The sonographic features of 824 breast lesions included in the study were analyzed,including composition,echo pattern,aspect ratio,margin,posterior features,calcifications,surrounding tissue,internal blood flow and axillary lymph node.The score of sonographic features and the age of patient were assigned.To calculate the total score of each lesion.The pathological results were used as the gold standard,the ROC curve was drawn.The BI-RADS classification of each lesion was obtained according to its total score and the score range that has been set and then to calculate the proportion of malignant of BI-RADS categories.Results The sensitivity of solid,hypoechoic,angular or microlobulated or spiculated margin in the diagnosis of breast cancer were higher,98.48%,100%and 97.73%,respectively.Aspect ratio?0.8,posterior shadowing,intraductal mass and duct dilatation,calcifications,the changes of surrounding tissue,Vmax?20cm/s,RI?0.70,arteriovenous fistula and axillary lymph nodeabnormalities were more specific for the diagnosis of breast cancer,the specificity was 81.50%,97.25%,99.57%,85.11%,95.95%,98.70%,87.57%,99.71%,98.41%,respectively.There were 824 breast lesions including 692 cases benign lesions and 132 cases malignant lesions were pathologically confirmed.The total score of benign lesions was 3 to18,the median score was 6and the total score of malignant lesions was 6 to 21 and the median score was14.5,the median score of malignant lesions were significantly higher than benign lesions(p<0.001).The area under ROC curve of the total scores of all lesions was 0.936.Score 10(corresponds to BI-RADS category 4b)was selected as the cut-off value for differentiating benign and malignant breast lesions.The sensitivity,specificity,accuracy,positive predictive value and negative predictive value were 84.85%,82.51%,82.89%,48.01% and 96.62%,respectively.The proportion of malignant of BI-RADS category 3,4a,4b,4c and 5 were 0%,6.47%,19.83%,62.90% and 90.91%,respectively.Conclusion 1.The BI-RADS quantitative scoring method is feasible and it has high accuracy in the risk assessment of breast cancer.2.The results of BI-RADS quantitative scoring can be used as a reference for clinicians to make treatment plan.3.The BI-RADS quantitative scoring method has important promotion and application values.